CHAPTER 39 Flashcards

Alterations of Renal and Urinary Tract

1
Q

Urinary tract obstruction
Upper urinary tract obstruction
-Compensatory hypertrophy and hyperfunction:
Partially counteracts the negative consequences of _____

  • _____ growth
  • _____ growth
A

unilateral obstruction
Obligatory
compensatory

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2
Q

unilateral obstruction

When the _____ kidney is obstructed, the _____ and _____ in the _____ kidney compensate by _____ in size.

A
right
glomeruli
tubules 
left
increase
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3
Q

kidney stones

  • Composition of mineral salts
  • -Most common type of renal stone _____ and calcium phosphate: 70% to 80%
  • Genetic disorders of amino acid metabolism
  • -Excess urine can cause cystinuric, or xanthine, stone formation in the presence of a _____.
  • _____
  • -Are _____ and fill the _____ and _____ calyces.
A
calcium oxalate 
low urine pH
staghorn calculi
large
minor 
major
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4
Q

struvite stones
-They are more common in _____ than in _____.

  • They grow large and branch into a _____ configuration in _____ and _____.
  • Struvite stones are closely associated with _____ caused by _____-producing bacteria, such as _____.
A
women
men 
staghorn 
renal pelvis 
calyces 
urinary tract infections 
urease
pseudomonas
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5
Q

kidney stones
kidney stone formation
-The function of _____, _____, and _____: They inhibit _____ growth, Prevent stone formation.

A

potassium citrate
pyrophosphate
crystal growth
crystal

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6
Q

clinical manifestation: renacolic (pain)

  • is described as _____ pain
  • Pain originates in the _____ area.
  • Renal colic indicates the presence of _____.
  • Pain radiated to the _____.
  • Renal colic indicates obstruction of the _____ or _____.
A
moderate to severe
flank
renal stones 
groin
renal pelvis 
proximal ureter
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7
Q

lower urinary tract obstruction

  • neurogenic bladder
  • -upper motor neurons
  • –_____: Overactive or hyperreflexive bladder function

—_____: Uninhibited or reflex bladder

A

Dyssynergia

Detrusor hyperreflexia

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8
Q

Detrusor hyperreflexia

-Detrusor hyperreflexia develops from _____ disorders that originate above the _____ result in _____.

A

neurologic
pontine micturition center
detrusor hyperreflexia

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9
Q

Neurogenic bladder

-Is a medical term is used to identify a functional _____ caused by an interruption of the _____ supply to the _____!!!!

A

urinary tract obstruction
nerve
bladder

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10
Q

Lesions of the sacral segments below S1

-_____ and _____ related to the bladder would result from the effects of _____ of the _____ below _____

A
Bladder distension
urinary retention
lesions
sacral segments 
S1
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11
Q

treatment
-The circular muscles of the bladder neck, to treat bladder neck obstruction are _____ (_____) medications

-Because the bladder neck consists of _____ with _____ innervation, _____ may be managed by a-adrenergic blocking (antimuscarinic) medications

A
a-adrenergic blocking
antimuscarinic
circular smooth muscle
adrenergic
detrusor sphincter dyssynergia
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12
Q

risk factors for developing bladder and kidney cancers

  • _____
  • _____
  • _____
A

cigarette smoking
hypertension
exposure to aniline dyes

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13
Q

tumors
renal tumors
-_____: rare

A

renal transitional cell carcinoma

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14
Q

Renal cell carcinoma, classified as clear cell tumors

-Renal cell carcinoma, classified as _____ according to _____ type and extent of _____, arises from the _____

A

clear cell tumors
cell
metastasis
proximal tubular epithelium

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15
Q

bladder tumors

-Bladder cancer is associated with the gene mutation _____

A

TP53 mutations

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16
Q

UTI

  • Most common pathogens
  • the most common cause of uncomplicated urinary tract infections _____
  • _____
A

Escherichia coli

Staphylococcus saprophyticus

17
Q

UTI
-Considering host defense mechanisms, the element in the urine is bacteriostatic is _____!!!

  • _____ washes out _____, and urine with higher urea concentrations (high osmolarity) is more _____.
  • Mechanisms that protect the urinary tract from infection include: _____.
  • The _____ (acidic urine) is a mechanism that reduces the likelihood of infection.
A
urea
Dilute urine
bacteria
bacteriostatic
Acidic urine
low pH
18
Q

Clinical manifestations of a urinary tract infection may be demonstrated in an 85-year-old individual

-Older adults with cystitis may demonstrate _____ or _____ or otherwise be _____.

A

confusion
vague abdominal discomfort
asymptomatic

19
Q

pyelonephritis
acute pyelonephritis
-Evaluation- _____ is required to make the diagnosis of pyelonephritis from that of _____
–_____, indicating _____

A

differentiating sign
cystitis
White blood cell casts
pyelonephritis

20
Q

pyelonephritis
-Pyelonephritis is usually caused by the _____.

  • _____
  • _____
  • _____
A

bacteria
Escherichia coli
Proteus
Pseudomonas

21
Q

creatinine
-The abnormal laboratory value is found in _____ is elevated _____ concentration

-Creatinine is primarily excreted by _____ after being constantly _____ from _____

A
glomerular disorders
creatinine
glomerular filtration
released
muscle tissue
22
Q

Glomerulonephritis
-In glomerulonephritis _____ and _____ damages the epithelial cells that results in _____.

-Activated _____, _____, _____, _____, and _____ attack _____, alter _____, and cause _____.

A
activated complement
altered membrane permeability
proteinuria
complement
inflammatory cytokines
 oxidants
proteases
growth factors
epithelial cells
membrane permeability
proteinuria
23
Q

Acute Glomerulonephritis

  • types
  • _____: Most common cause
  • –_____-mediated glomerular injury with increased glomerular _____ and _____
A

Membraneous nephropathy
Complement
permeability
glomerulosclerosis

24
Q

Acute Glomerulonephritis Membraneous Nephropathy

-_____ of the glomerular _____ with immune deposition of _____ (_____) and _____.

A

Thickening
capillary wall
immunoglobulin G (IgG)
C3

25
Q

Goodpasture Syndrome
-_____ (Goodpasture syndrome) is associated with _____ antibody formation against pulmonary capillary and glomerular _____.

A

Antiglomerular basement membrane disease
immunoglobulin G (IgG)
basement membranes

26
Q
Clinical manifestations
Nephrotic Syndrome
-\_\_\_\_\_
-\_\_\_\_\_
-\_\_\_\_\_
-\_\_\_\_\_
A

Hypothyroidism
Edema
Hyperlipidemia
Lipiduria

27
Q

Acute Kidney Injury (cont’d)
-prerenal: _____: most common cause

-intrarenal: _____ (_____) caused by _____: most common cause

A

renal hypoperfusion
acute tubular necrosis (ATN)
ischemia

28
Q

Prerenal injury from poor perfusion can result from these conditions

  • _____
  • _____
  • _____
  • _____
A

Renal vasoconstriction
Renal artery thrombosis
Hemorrhage
Hypotension

29
Q

Intrarenal renal failure
renal disorders are considered causes of infrarenal renal failure

  • _____
  • _____
  • _____
  • _____
A

Acute glomerulonephritis
Allograft rejection
Tumors
Acute tubular necrosis (ATN)

30
Q

acute tubular necrosis

-_____ are considered “major culprits” in causing _____ (ATN) -the ______ (_____, _____) are the major culprits.

A

Antibiotics
nephrotoxic acute tubular necrosis
aminoglycosides
gentamicin, tobramycin

31
Q

Acute Kidney Injury
treatment:
-_____
–administer _____ and _____ or _____ to drive potassium into the cells

A

hyperkalemia
glucose
insulin
sodium bicarbonate

32
Q

How is glucose and insulin used to treat hyperkalemia associated with acute renal failure?

_____ and _____ used to treat hyperkalemia associated with _____ by ; When _____ transports _____ into the cell, it also carries _____ with it.

_____ can be effective in shifting potassium from the _____ to _____ space, along with the transport of _____.

A
glucose
insulin 
acute renal failure
insulin
glucose
potassium 
Insulin infusions
extracellular
intracellular 
glucose
33
Q

Chronic Kidney Disease (cont’d)
treatment:
-_____ as needed

A

erythropoietin

34
Q

Chronic Kidney Disease

  • _____ of chronic renal failure can be successfully treated with _____.
  • Reduced erythropoietin secretion and reduced _____ production are evident in _____ resulting from chronic renal failure.
A

Anemia
erythropoietin
red cell
anemia