Chapter 33

Question 1

name three types of disorders of renal function

Answer 1

1. obstructive disorders
2. glomerular damage
3. tubulointerstital disorders

Question 2

any age, any level of urinary tract. partial or incomplete. sudden or insidious. unilateral or bilateral.

Answer 2

obstructive disorders

Question 3

name some causes of obstructive disorders

Answer 3

infection/inflammation, kidney stones, bengin prostatic hypertrophy, pregnancy, tumors, fibrosis, congenital structural defects.

Question 4

mechanisms of renal damage:

Answer 4

degree and duration

Question 5

effects of obstruction

Answer 5

stasis of urine and progressive dilation of renal collecting ducts and tubular structures

Question 6

bilateral or unilateral obstruction causes

Answer 6

reduced perfusion, reduced GFR, reduced blood flow and renal failure

Question 7

two types of outflow obstruction:

Answer 7

urethral stricture and hydronephrosis

Question 8

causes bladder distention and progresses to ureters and the kidneys

Answer 8

urethral stricture

Question 9

kidney enlarges as urine collects and to dilates the renal pelvis and calyces proximal to a blockage

Answer 9

hydronephrosis

Question 10

kidney stones most commonly develop in the

Answer 10

renal pelvis but can be anywhere

Question 11

predisposing factors of kidney stones:

Answer 11

dehydration, prolonged immoblization, infection, obstruction/stasis, anything that causes urine to be alkaline, metabolic factors

Question 12

which theory: urine is supersaturated with stone components

Answer 12

saturation theory

Question 13

which theory: organic material acts as a nucleus for stone formation

Answer 13

matrix theory

Question 14

deficiency of substance that inhibit stone formation

Answer 14

inhibitor theory

Question 15

four types of kidney stone

Answer 15

calicum stones, magnesium ammonium phospate, uric acid stones, cystine stones

Question 16

calicum stones have increased concentration in

Answer 16

blood and urine

Question 17

contributors to calicum stones

Answer 17

excessive bone resorption and high oxalate concentrations in blood and urine

Question 18

what type of kidney stone: form in alkaline urine. Must have bacteria. alos called staghorn stones. large

Answer 18

MAP (magnesium ammonia phosphate)

Question 19

what kind of kidney stone: elevated uric acid. not visble on xrays. form in acid urine. most common in those with guot.

Answer 19

uric acid stone

Question 20

complication of obstruction:

if untreated what can happen in 48 hours?

Answer 20

permanet damage

Question 21

inflammation of the urinary epithelieum caused by bacteria

Answer 21

UTI

Question 22

cystitis is an __________ of the bladder

Answer 22

inflammation

Question 23

nonbacterial infectious cysititis

Answer 23

interstital cystits

Question 24

intersitital cystitis is most common in

Answer 24

women 20-30 years old

Question 25

what are the manifestations of interstitial cystitis?

Answer 25

bladder fullness, frequency, small urine volume, pelvic pain

Question 26

acute infection of the renal pelvis interstitium

Answer 26

acute pyelonephritits

Question 27

persistent or recurring episodes of acute pyelonephritis that leading to scarring.

Answer 27

chronic pyelonephritis

Question 28

absence of known predisposing factors that affect the microbiolgy, incidence and recurrence rates of UTI.

Answer 28

uncomplicated UTI

Question 29

people who are more at risk for a UTI

Answer 29

those with neurogenic bladder disorders, obstruction and reflux, pregnant women, indwelling catheter, men with prostate problems and diabetics

Question 30

what are some reasons for recurrent UTI?

Answer 30

reflux flow of urine and resistant bacteria

Question 31

glomerular damage will:

Answer 31

- decrease efficency of filtration - allow blood cells, lipids or proteins to pass into urine - may interfere with clearance of waste

Question 32

glomerulonephritis =

Answer 32

inflammation

Question 33

manifestations of glomerulonephritis is

Answer 33

RBC casts and proteins/lipids escape

Question 34

nephritic syndrome =

Answer 34

proliferative inflammatory response

Question 35

nephritic syndrome: | RAA pathway activated=

Answer 35

hypertension

Question 36

nephritic syndrome: | the inflammatory process damages the

Answer 36

capillary wall

Question 37

nephritic syndrome: | RBC escape into the

Answer 37

urine --> hematuria with red cell casts

Question 38

nephritic syndrome: | hemodynamic changes decrease the

Answer 38

GFR (<120) - azotemia - oliguria - will also see proteinuria

Question 39

constellation of clinical findings resulted from increased in glomerular permeability ad loss of plasma proteins (albumin) in the urine- which will also mean low albumin in the blood

Answer 39

nephrotic syndrome

Question 40

which is worse nephrotic or nephritic

Answer 40

nephrotic

Question 41

damage to vessels; thickening and scarring

Answer 41

diabetic nephrtopathy

Question 42

widespread thickening of glomerular capillary basement membrane. ulimate obliteration of glomerulus

Answer 42

diabetic glomerulosclerosis

Question 43

microalbuminuria is an early sign of

Answer 43

vascular damage

Question 44

diabetic neuropathy and diabetic glomerulosclerosis is believed to be related to

Answer 44

elevated blood glucose, HTN, cigarette smoking.

Question 45

inability to concentrate urine. interference with acidification of urine (inability to excrete acid). diminished tubular reabsorption of Na+ and other substances.

Answer 45

tubulointerstital disorders

Question 46

tubulointerstital disorders are caused by

Answer 46

infections, drug induced damage, toxic injuries