Chapter 33: Disorders of Renal Function

Question 1

Calcium Stones (Oxalate or Phosphate)

Answer 1

Calcium stones are the most common type, making up 70-80% of all kidney stones. They often form in individuals with high levels of calcium in the blood, which can result from conditions like hyperparathyroidism.
 Risk Factors: Consuming sweetened beverages can increase the risk, as these drinks may elevate calcium levels in the urine and eating a lot of antiacids

Question 2

Magnesium Ammonium Phosphate Stones (Struvite)

Answer 2

Struvite stones are associated with alkaline (basic) urine and often develop in people with urinary tract infections (UTIs) caused by bacteria that produce ammonia and carbon dioxide by breaking down urea

Question 3

Uric Acid Stones

Answer 3

Uric acid stones form in people with high levels of uric acid, such as those with GOUT or individuals who consume a diet high in purines (found in foods like red meat, shellfish, and organ meats).

Question 4

Cystine Stones

Answer 4

Cystine stones are rare and typically found in children with a genetic disorder that affects cystine transport in the kidneys. This disorder is inherited in an autosomal recessive pattern, causing decreased reabsorption of cystine, which leads to stone formation.

Question 5

Nephritic syndrome Pathophysiology

Answer 5

clinical manifestations of glomerular inflammation
-inflammatory process damages CAPILLARY WALL
* sudden onset of hematuria, oliguria, decreased GFR

Question 6

acute post-infectious glomerulonephritis

Answer 6

immune response to group A beta hemolytic streptococci
-azotemia, oliguria, “coke-colored” urine
-hematuria

Question 7

Nephrotic Syndrome Manifestations

Answer 7

Proteinuria
Lipiduria: damage to the glomerular basement membrane- increase permeability

Question 8

nephrotic syndrome manifestations

Answer 8

Hyperlipidemia
Edema:
Increased Susceptibility to Infections & decreased colloidal osmotic pressure
Loss of Ions, Hormones, and Binding Proteins

Question 9

nephrotic syndrome manifestations from damage to glomerular basement membrane

Answer 9

increased: permeability, protein in urine, lipids in blood and urine

decrease: protein in blood

results: edema, hyperlipidemia, increased infections, decreased ions and hormones

Question 10

systemic causes of glomerulonephritis: lupus

Answer 10

-systemic lupus erythematosus
*type II immune complex-mediated disorder
*vasculitis and glomerulonephritis
*common complication: lupus nephritis
** deposition of immune complexes within glomerular wall

Question 11

systemic causes of glomerulonephritis: diabetic nephropathy (diabetic glomerulosclerosis)

Answer 11

-major cause of CKD
-most common cause of kidney failure resulting in dialysis
-thickening of glomerular capillary basement membrane

possible mech:
-defective GBM synthesis
-increased blood glucose causing increase GFR, glomerular pressure, enlarged glomerular capillary pores
**angiotensin II

microalbuminuria
-30-300 mg of albumin in urine Q 24 hours
-dysuria, increased urinary frequency, urgency

Question 12

acute pylenonephritis

Answer 12

bacterial infection of kidney parenchyma and renal pelvis

Question 13

acute pylenonephritis causative agen

Answer 13

gram negative bacteria
-E. coli, proteus, klebsiella

Question 14

acute pylenonephritis two routes

Answer 14

-* ascending infection from lower urinary tract
-blood stream: SEPSIS caused by STAPHYLOCOCCUS AUREUS or infective endocarditis

Question 15

acute pylenonephritis patho

Answer 15

outflow obstruction + incompetence of vesicoureteral orifice
-vesicoureteral reflux

Question 16

acute pylenonephritis: manifestations

Answer 16

abrupt onset of shaking, chills, fever, constant ache in lower back
-unilateral or bilateral pain
-maliase, N/V, abdominal pain
-lower urinary tract symptoms: dysuria, increased urinary frequency, urgency