chapter 33 and 35: disorders of renal function Flashcards
(110 cards)
1
Q
__ remove excess water by the kidneys (not used if renal disease is present)
A
diuretics
2
Q
diuretics __ urine
A
dilute
3
Q
diuretics are used for __, __, ___, and __
A
htn; congestive heart failure; pulmonary edema; anascara (generalized edema)
4
Q
diuretics are used for htn because it gets rid of __ and water. sodium takes water with it from the blood, __ (increasing/decreasing) the amount of fluid flowing through the blood vessels, which __ (lowers/increases) blood pressure
A
sodium; decreasing; lowers
5
Q
diuretics are used for congestive heart failure because it removes unneeded __ and salt, which makes it __ (easier/harder) for the heart to pump. it eases __ and water ___.
A
water; easier; swelling; builup
6
Q
diuretics are used for pulmonary edema and anascara to get rid of __ fluid
A
excess
7
Q
the 4 diuretics are: __, __, __, and __
A
hydrochlorothiazide; furosemide; spironolactone; osmotic diuretic
8
Q
hydrochlorothiazide is a __ (mild/potent) diuretic that leads to __ wasting
A
mild; potassium
9
Q
furosemide is a __ (mild/potent) diuretic that leads to __ wasting
A
potent; potassium
10
Q
furosemide can have the side effects of __ and __ hypotension
A
excessive loss of electrolytes; orthostatic hypotension
11
Q
the side effect of excessive loss of electrolytes for furosemide can cause __ and __
A
muscle weakness; arrhythmias
12
Q
spironolactone is a __ (osmotic/potassium sparing) diuretic
A
potassium sparing
13
Q
these drugs lower K+ in spironolactone
A
aldosterone antagonists
14
Q
a(n) __ (osmotic/furosemide) diuretic is given through an IV
A
osmotic
15
Q
the relationship between creatinine and renal function are a(n) __ (direct/inverse) relationship
A
inverse
16
Q
as renal function __ (increases/declines), creatinine levels __ (increase/decrease)
A
declines; increase or increases; decrease
17
Q
__ is the loss of voluntary control of the bladder due to many causes
A
incontinence
18
Q
the five types of incontinence are __, __, __, __, and __
A
stress; urge; mixed; overflow; functional (ACRONYM: SUMOF)
19
Q
__ (overflow/stress/mixed/urge/functional) incontinence is where an increase in intra-abdominal pressure forces urine through the external sphincter due to things like coughing or laughing
A
stress
20
Q
__ (stress/urge/mixed/overflow/functional) incontinence is the involuntary loss of urine associated with a strong desire to void
A
urge
21
Q
__ (mixed/overflow/functional) incontinence is the combination of stress and urge incontinence
A
mixed
22
Q
__ (stress/mixed/urge/overflow/functional) incontinence is urine loss when bladder pressure exceeds the maximum urethral pressure, causing __ distention in the absence of muscle contraction (outflow obstruction)
A
overflow; bladder
23
Q
__ (stress/urge/mixed/combination/functional) incontinence is a physical/mental impairment that keeps you from making it to the toilet in time
A
functional
24
Q
“bed wetting” is also known as __ (continuous urinary leakage/postmicturition dribble/nocturnal enuresis)
A
nocturnal enuresis
25
__ is where the urine remaining in the urethra after voiding the bladder slowly leaks out after urination
postmicturition dribble
26
__ is constant leakage of urine due to an inherited abnormality or sphincter (valve) injury
continuous urinary leakage
27
__ is the inability to empty the bladder
retention
28
__ blocks the micturition reflex and leads to the retention of urine where a catheter is needed
spinal damage at the sacral level or after anesthesia
29
when assessing bladder function, you must observe __, __, and __ for __ obstruction
frequency; hesitancy straining to urinate; weak/interrupted urine stream; out flow
30
__ gives us information about the amount of urine left in the bladder after voiding
post void urine residual volume
31
__ (renal agenesis/renal hypoplasia/renal dysplasia/horseshoe kidney) is the complete failure of the kidney to develop (born w/o one or both kidneys)
renal agenesis
32
__ (renal agenesis/renal hypoplasia/renal dysplasia/horseshoe kidney) are when the kidneys are smaller in size and have less calyces and nephrons
renal hypoplasia
33
__ (renal agenesis/renal hypoplasia/renal dysplasia/horshoe kidney) is the undifferentiated structures in the kidney
renal dysplasia
34
__ (renal agenesis/renal hypoplasia/renal dysplasia/horseshoe kidney) is when the patient's kidneys fuse together to form a horseshoe-shape during development in the womb
horseshoe kidney
35
__ are epithelial lined cavities filled with fluid or semisolid material
renal cysts
36
renal cysts can be __, __, and __
single; multiple; symptomatic vs asymptomatic
37
polycystic kidney disease is __ (genetic/acquired)
genetic
38
polycystic kidney disease is __ (autosomal dominant/autosomal recessive) in adults and __ (autosomal dominant/autosomal recessive) in children
autosomal dominant; autosomal recessive
39
polycystic kidney disease is __ (autosomal dominant/autosomal recessive) in adults and __ (autosomal dominant/autosomal recessive) in children
autosomal dominant; autosomal recessive
40
an __ cystic disorder can have simple cysts
acquired
41
acquired cystic disorders __, produces __, __, __, and __
usually do not produce any s/s; flank pain; hematuria; infection; htn
42
__ and __ dialysis can cause the formation of renal cysts. its bleeding can cause __
end stage renal disease; prolonged; hematuria
43
antiglomerular membrane antibodies causes __ to the __ membrane leading to __ syndrome
damage; basement; nephrotic
44
circulating antigen-antibody complex deposition causes __ to the __ membrane and leads to __ syndrome
damage; glomerulus; nephritic
45
this kind of glomerular damage has an increase in the amount of extracellular matric
sclerotic
46
glomerular damage __ (increases/decreases) permeability to glomerular membrane which allows __, __, or __ to pass into the urine
increases; blood cells; lipids; proteins
47
acute nephritic syndrome, rapidly progressive glomerulonephritis, nephrotic syndrome, IgA nephropathy, herediatry nephritis, and chronic glomerulonephitis are __ of glomerular function
disorders
48
acute nephritic syndrome = ___
acute postinfectious glomerulonephritis
49
acute nephritic syndrome includes a __ inflammatory response, and acute __ glomerulonephritis, which develops around 7-10 days following strep infection (group A beta-hemolytic streptococcus)
proliferative; poststreptococcal
50
acute nephritic syndrome is a __ (type 1/type 2/type 3/type 4) hypersensitivity reaction because after a strep infection, some of the antibodies are "hanging out" and are deposited into the glomerular vessels (activates complement)
type 3
51
the s/s of acute nephritic syndrome include: 1) __ (swelling of the kidneys) 2) dark cola-colored and cloudy __ 3) __ (increased/decreased) urine production as GFR (increases/declines) leading to oliguria and 4) __ (increased/decreased) BP due to __ (increased/decreased) GFR and increased renin
flank pain; urine; decreased; declines; increased; decreased
52
__, __, and __ can be signs of acute nephritic syndrome
proteinuria; hematuria; erythrocyte casts
53
__ and __ result due to decreased urine production as GFR declines
azotemia (nitrogenous wastes in blood); edema
54
acute nephritic syndrome can be tested with __ tests
blood
55
these 4 signs can indicate acute nephritic syndrome in the blood tests: __, __, __, and __
elevated serum urea & creatinine; decreased compliment; increased strep antibodies (aso); metabolic acidosis: decreased serum bicarbonate
56
1) antibiotics 2) sodium restriction 3) fluid and protein restriction (severe cases) 4) prophylactic antibiotics and 5) corticosteroids and meds are treatments for __
acute nephritic syndrome
57
antibiotics help to __ strep infection
eliminate
58
prophylactic antibiotics __ recurring infection and inflammation
prevent
59
corticosteroids and meds __ immune system
suppress
60
__ can result into chronic renal failure
chronic glomerulonephritis (fibrosis)
61
lupus, diabetes, and infection can cause __
nephrotic syndrome
62
in __ (acute nephritic syndrome/nephrotic syndrome), you can see hypoalbuminemia, imunoglobulins and complement, decreased binding proteins, and loss of clotting and anticlotting factors
nephrotic syndrome
63
hypoalbuminemia leads to __
generalized edema, hyperlipidemia, salt and water retention, increased active drug
64
immunoglobulins and complement lost in urine results in __
decreased immune function
65
decreased binding proteins result in __
low ions and hormones
66
loss of clotting and anticlotting factors can result in __
thrombosis
67
__ are when bacteria enter through the urethra
urinary tract infections
68
__ (keep urinating out, hydrate), __ (prevents pathogens from attaching to bladder wall), __, __, and __ and prostate secretions are host defenses of uti's
washout phenomenon; protective mucin layer; local immune responses and IgA; normal bacterial flora and prostate secretions
69
lower uti's are called __
cystitis and urethritis
70
upper uti's are called __
pyelonephritis
71
__ and __ are more susceptible to a uti
females; males with prostate hypertrophy
72
__: incomplete emptying of the bladder, __ of urine, __ to urine flow, __ are not flushed out of the bladder and consequently begin to __
incontinence; bladder retention; obstruction; bacteria; divide
73
these 5 factors all contribute to infection because urine and its contaminants DO NOT flow through and out of the system
pregnancy
scar tissue
congenital defects
renal calculi
vesicoureteral reflex
74
__ can be determined by:
an inflamed urethra and bladder wall
reduced bladder capacity
lower abdominal pain
dysuria (frequency and urgency are common as inflamed bladder is irritated by urine)
systemic signs of infection (fever, malaise, nausea, leukocytosis)
cystitis
75
cystitis is diagnosed by a __
urinalysis (bacteria, pyuria, hematuria; cloudy and smelly urine)
76
structural or functional urinary tract abnormalities is called __
(complicated) pyelonephritis
77
pyelonephritis is considered an __
upper uti
78
true or false. anything that results in the retention of urine can lead to cystitis and then pyelonephritis
true
79
outflow obstruction, pregnancy, neurogenic bladder, and vesicourethral reflux required are factors of __
complicated pyelonephritis
80
pyelonephritis involves __ (one/both/one or both) kidney(s)
one or both
81
pyelonephritis involves the __, __, and the __ in ascending infection
renal pelvis; ureters; medullary tissue
82
pyelonephritis is usually caused by __
e. coli
83
__ exudate fill the kidney __ and the __ are inflamed with necrosis
purulent; pelvis; medullary tubules
84
if pyelonephritis is severe, it can __ the renal artery and vein and obstruct __
compress; urine flow
85
urinary casts of leukocytes or renal epithelial cells
dull, aching flank pain (stretching of renal capsule)
chills w/moderate-high fever
are all __ of pyelonephritis
signs and symptoms
86
the 2 treatments for pyelonephritis include:
antibiotics and increase water intake
87
an __ disorder can be considered unilateral or bilateral, partial or complete, sudden or insidious, or urethra to renal pelvis
obstructive
88
congenital abnormalities, stones, pregnancy, scar tissue, bph, and spinal cord injury are __ of obstructive disorders
causes
89
obstructive disorders are classified based on __, __, and __
site; degree; duration (SDD)
90
in order for something to be a lower urinary tract obstruction, it must be __ and __
below the uretero-vesical junction; bilateral
91
in order for something to be an upper urinary tract obstruction, it must be __ and __
above the uretero-vesical junction; unilateral
92
an obstruction that lasts only a few days is considered __ and leads to the formation of __
acute; renal calculi (kidney stones)
93
an obstruction that develops slowly for a long time is considered __ and can result in __
chronic; congenital ureterovesical abnormalities
94
bilateral acute obstruction is considered __ (acute/chronic/acute renal failure) and can lead to __ (acute renal failure/chronic renal failure)
acute renal failure; chronic renal failure
95
__ and __ can result due to dilation of the renal tubules/tract
hydronephrosis; stasis of urine
96
__ occurs when the renal pelvis and calyces (usually unilateral) are dilated by the filling of urine
hydronephrosis
97
hydronephrosis can result in: __, __, and __
increased pressure inside renal capsule (damage due to back pressure); compartment syndrome compresses blood vessels inside kidney; renal ischemia
98
risk for infection is found as a result of __ due to the dilation of the renal tubules/tract
stasis of urine
99
the four types of renal calculi are: __, __, __, and __
calcium stones (oxalate and phosphate); magnesium ammonium phosphate stones; uric acid stones; cystine stones (CMUC)
100
hypercalcemia, hypercalciuria, and immobilization are contributing factors of __
calcium stones
101
treatment of underlying conditions, increased fluid intake, and thiazide diuretics are treatments for __ (calcium/magnesium/uric acid/cystine)
calcium stones
102
treatment of uti's, acidification of urine, and increased fluid intake are treatments for __
magnesium stones
103
urea-splitting uti's are contributing factors of __ (calcium/magnesium/uric acid/cystine)
magnesium ammonium phosphate stones
104
gout and high-purine diet are contributing factors of __ (calcium/magnesium/uric acid/cystine)
uric acid stones
105
increased fluid intake, allopurinol for hyperuricosuria, and alkalinization of urineare treatments for
uric acid stones
106
cystinuria is a contributing factor of __ (calcium/magnesium/uric acid/cystine)
cystine stones
107
increased fluid intake and alkalinization of urine are treatments for __
cystine stones
108
the most common neoplasm in young children is __
wilms tumor (nephroblastoma): embryonic kidney tumor
109
__ is so dangerous because it doesn't show any s/s until after tumor has metastasized
renal cell carcinoma
110
__ is found during adulthood, is a silent diorder, and has more advances (hematuria, flank pain, palpable flank mass)
renal cell carcinoma
