Patho
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| GFR | glomerulo filtration rate
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| more blood floe through the kidneys = ______ | more urine output
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| if the kidneys dont perfuse they will ______ | stop
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| _____ of newborns are born with kidney and ureter abnormalities | 3-4%
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| kidneys develop in the ____ week of gestation | 5th week
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| urine formation begins the ____ week of gestation | 9th-12th week
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| ____ makes up the majority of amniotic fluid | urine
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| fetus renal px will develop _______, which is _______ | oligohydramnios, which is not enough amniotic fluid
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| failure of an organ to develop normally | dysgenesis
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| complete failure of an organ to develop | agenesis
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| renal agensis---wide set eyes, broad flat nose, epicanthic folds, low set ears, receding chin, and limb defects---usually do not live past a few minutes/hours | Potter's Syndrome
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| kidneys do not develop to normal size---rare---usually of one kidney---usually develops into renal failure | Renal hypoplasia
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| upper or lower poles of the kidney are fused together---common---does not always cause px | horseshoe kidney
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| hereditary dx characterized by cyst formation and massive kidney enlargement | polycystic kidney disease
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| mutation of PKD1 gene on chromosome 16, PKD2 on chromosome 4, or PKD3 | polycystic kidney disease
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| what are the 2 types of polycystic kidney disease? who do they effect? | Autosomal dominant: usually adults, progresses slowly-----autosomal recessive: usually affects children, no TX often die young
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| what happen when cysts develop in the kidneys in a polycystic kidney pt? | the kidneys enlarge and the renal vessles and nephrons become obstructed
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| inflammatory disorder of the renal pelvis and the functional portion of the kidney | pyelonephritis
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| ____ causes ascending bladder infections, blood-borne infections, frequent calculi | pyelonephritis
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| most common culprit of pyelonephritis | e. coli
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| TX for pyelonephritis that causes urination to be orange color and changes the pH | pyridium
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| most common primary neoplasms of young children around age os 3 | Wilm's Tumor
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| mixed tumor composed of epithelial and mesenchymal embryonic elements | Wilm's Tumor
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| associated with high BP and a solitary mass that can occur in any part of the kidney and is usually well-defined and encapsulated | Wilm's Tumor
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| most common primary tumor | Renal cell carcinoma
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| may produce hormone or hormone like substances and metastasizes commonly to the lung, mediastinum, bone, lymph nodes, liver, and CNS | Renal Cell Carcinoma
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| what are the 3 classic signs of Renal Cell Carcinoma? | triad-gross hematuria, flank pain, and papable abdominal mass
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| renal cell carcinoma is common in ____, ____, and ____ | men, smoking, and obesity
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| ______ are groups of capillaries with a basement membrane that filter the blood form urine filtrate | glomeruli
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| what are the glomeruli selectively permeable to? (3) | water, electrolytes, and dissolved particles (glucose and amino acids)
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| inflammation of the capillary loops of the glomeruli | glomerulonephritis
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| leading cause of chronic renal failre in US | glomerulonephritis
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| what are the 2 immune responses of glomerulonephritis? | injury resulting from antibodies reacting with fixed glomerular antigens.......injury resulting from circulating antigen=antibody complexes (DNA in SLE, strep) that become trapped in the glomeruli membrane
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| what 3 cellular changes occur in glomerulonephritis? | 1. proliferation- > in cellular componets....2. sclerotic- > in noncellular componets such as collagen.....3. membrane changes- > thickness
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| produces a proliferative inflammatory response (type of glomerulonephritis) | nephritic syndrome
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| _____ is characterized by hematuria with red cell casts, diminished GFR, azotemia, oliguria, and HTN | glomerulonephritis
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| usually in children...usually follows group A beta-hemolytic strep infection, but may also be a result of staph, measles, mumps, and chickpox | acute nephritic syndromes (glomerulonephritis)
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| inflammatory response is immune related-immue cells become trapped in the glomerular membrane and proliferation of the glomerular membrane > permeability to red cells and protein | acute nephritic syndromes (glomerulonephritis)
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| coke colored urine is a s/s because of the bl breakdown and the protein in the urine | acute nephritic syndromes (glomerulonephritis)
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| the glomerular cell proliferate along with macrophages forming cresent-shaped lesions that obstruct the Bowman's capsule | Chronic nephritic syndromes (glomerulonephritis
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| involves increased permeability of the glomerulus | Nephrotic syndrome (glomerulonephritis)
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| characterized by massive proteinuria, lipiduria, hypoalbuminemia, edema, and hyperlipidemia | Nephrotic syndrome (glomerulonephritis)
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| caused by diffused membrane thickening r/t immune cell deposits and is slow and progessive | Membranous Nephrotic syndrome (glomerulonephritis)
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| sclerosis of some but not all of the glmeruli | Focal segmental
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| end stage of glomerular disorders and are vague and slowly progressing | Chronis glomerulonephritis
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| kidneys fail to remove metabolic waste products, regulate pH, fluid, and electrolyte, has an abrupt onset, and is oftern reversible | Acute Renal Failure
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| what are the 3 categories of acute renal failure? | prerenal, intrarenal, postrenal
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| hypovolemia and CV failure; most common acute renal failure | prerenal (occurs before the kidney)
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| vascular diease, glomerulonephritis, nepritis (type of acute renal failure) | intrarenal (occurs in the kidney)
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| extrarenal obstruction, intrarenal obstruction, and bladder rupture | postrenal (occurs after the kidney)
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| what are the 3 phases of acute renal failure? | initiation, maintenance, and recovery
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| begins with the onset of the event causing tubular necrosis; this phase ends with tubular injury | initiation phase of acute renal failure
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| begins with in hours of the initiation ohase and typically lasts 1-2 weeks; it is characterized by persistent reduction in GFR and tubular necrosis | maintenance of acute renal failure
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| begins with the GFR and tubular function have recovered and there is no further elevation of the BUN and creatine; renal function improves rapidly the first 5-25 days and contiunes up to 1 year | recovery of acute renal failure
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| progressive inability over months to years of the kidneys to respond to change in body fluids and electrolytes with an ability to produce sufficient urine | chronic renal failure
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| GFR < 20% and serum creatine > 5mg/dl | chronic renal failure
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| what are the 3 stages of chronic renal failure? | early (renal impairment)....second (renal insufficiency)...third (ESRD)
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| what stage of chronic renal failure do px begin to occur? | second- renal insufficiency
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| when do you see a sharp > in BUN and creatine during chronic renal failure | third ESRD stage
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| what is the most common cause of renal failure in children? | glomerulonephritis and congenutal malformations
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| why is a transplant a good idea for the eldery with renal failure? | b/c they do not respond well to dialysis
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| renal calculi | kidney stones
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| are masses of crystals composed of minerals that are normally excreted in teh urine | calculi
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| what is the most common type of kidney stone? | Ca
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| stones in the UT | urolithiasis
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| stones in the kidney | nephrolithiasis
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| develop in the presence of alkaline urine or bacteria that posses the enzyme, urease; staghorned shaped; difficult to tx; too large to pass | struvite
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| urine-filled dilatation of the renal pelvis and calices with atrophy of renal pelvis and is caused by a urine obstruction | hydronephrosis
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| too much water in the kidneys | hydronephrosis
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| _____ when urine obstruction is below the ureters | bilateral
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| ____ if obstruction is at level of ureters or above | unilateral
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| infection of the bladder, kidney, urethra, or prostate and is classified by location | UTI
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| second most common type of bacterial infection | UTI
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| what are the two ways pathogens enter to cause an UTI? | ascending from the mucous membrane of the perineal area to the lower tract (most common)......and hematogenoulsy from the blood (rare)
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| what causes 90% of UTIs? | e. coli
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| what makes a UTI complicated? | having more than 2 UTIs in 1 year or being male
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| what is the elderly's most common s/s for an UTI? | confusion
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| what are the 3 main levels of neurological control for urine elimination? | spinal cord reflex center....micturation center in the pons.....cortical and subcortical centers
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| where are the centers for reflex control of the bladder emptying or micturition located? | b/t S1 - S4 and T11 - L2
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| what are the 2 classes of causes of urinary obstruction and stasis? | congenital and aquired
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| what are the 2 classes of degrees of urinary obstruction and stasis? | partial or complete
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| what are the 2 classes of duration of urinary obstruction and stasis? | acute or chronic
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| what are the 2 classes of level of urinary obstruction and stasis? | upper or lower UT
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| loss of nerual control of the bladder | neurogenic bladder
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| failure to store urine d/t spasms; caused by spinal cord injury, herniated disks, vascular lesions, tumors, myelitis, stroke, multiple sclerosis, brain tumors | spastic bladder
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| bladder dysfunction caused by spinal cord injury | spinal shock
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| bladder atonic; requires cath; returns w/16 months; then the bladder becomes hyperactive | spinal shock
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| mild; can develop after a stroke, in early multiple sclerosis, of as a result of lesions located in the hibitory centers of hte cortex or the pyramidal tract; senstation remains, stream is normal, no residual urine; decreased bladder capacity | uninhibited spastic bladder
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| miscommunication in the muscles and spincter controlling unrication | detrustor-spincter dyssynergia
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| failure to empty urine; caused by peripheral neuropathies or failure of the extrernal spincter to relax | flaccid bladder
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| involuntary loss of urine that is sufficient to be a px | urinary incontinence
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| urinary incontinence that occurs during increases intrathorasic pressure | stress urinary incontinence
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| urinary incontinence that is due to an overactive bladder; frequnecy, uregency, dysuria, and nocturia | urge urinary incontinence
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| urinary incontinence due to bladder distention | overflow urinary incontinence
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