chapter 8 - kidney and urinary tract disorders

Question 1

what are the 2 primary purposes of the kidney

Answer 1

filter the nitrogenous products of metabolism (urea and creatinine) from the blood and to maintain water and electrolyte homeostasis

Question 2

what hormones does the kidney produce

Answer 2

erythroprotein (stimulates bone marrow to proceed red blood cells) and an active form of vitamin D that the kidney makes from the inactive form produced in the diet or formed in the skin on exposure to sunlight

Question 3

what are the 2 distinct zones of the kidney

Answer 3

outer layer - cortex.

inner layer- the medulla.

Question 4

where does kidney filtration take place

Answer 4

in the nephron

Question 5

what are the 2 parts of the nephron

Answer 5

the glomerulus and the tubule

Question 6

at what rate does urine form

Answer 6

about one cc per minute

Question 7

when is ADH produced

Answer 7

when the concentration of sodium rises

Question 8

what does aldosterone do

Answer 8

causes the kidneys to retain sodium

Question 9

together, what do ADH and aldosterone accomplish

Answer 9

blood volume and sodium level to be controlled

Question 10

what is angiotensin

Answer 10

a hormone that causes more salt to be retained and constricts small blood vessels, causing an increase in pressure

Question 11

what is renin

Answer 11

produced by kidneys, triggers formation of angiotensin when the blood volume or BP falls

Question 12

what is the most common evidence of renal disease

Answer 12

proteinuria

Question 13

what are common benign causes of proteinuria

Answer 13

1. exercise, fever, stress, excessive cold, vaginal contamination.
2. orthostatic proteinuria

Question 14

what are causes of microalbuminuria

Answer 14

diabetes, HTN, lipid abnormalities, some immune disorders

Question 15

is microalbuminuria a risk factor for coronary artery disease

Answer 15

yes

Question 16

what are the most common causes of hematuria

Answer 16

stones, nephritis, tumors, prostate disease, benign familial hematuria, menstrual contamination

Question 17

what is pyuria most commonly due to

Answer 17

cystitis, urethritis, prostatitis

Question 18

is finding of hyaline casts considered benign

Answer 18

yes

Question 19

red blood cell casts can indicate what

Answer 19

glomerulonephritis

Question 20

WBC casts can indicate what

Answer 20

inflammatory conditions, glomerulonephritis, pyelonephritis, interstitial cystitis.

Question 21

epithelial casts can indicate what

Answer 21

nephritis syndrome, tubular injury, glomerulonephritis

Question 22

granular casts can indicate what

Answer 22

glomerulonephritis

Question 23

fatty casts can indicate what

Answer 23

nephrotic syndrome

Question 24

waxy casts can indicate what

Answer 24

advanced renal failure

Question 25

what is azotemia

Answer 25

elevation of BUN and creatinine levels

Question 26

what are causes of azotemia

Answer 26

infrarenal diseases, pre-renal diseases, post renal causes d/t obstruction to urinary flow after it leaves the kidney (BPH)

Question 27

what is uremia and what are signs and symptoms associated

Answer 27

a raised level in the blood of urea and other nitrogenous waste compounds that are normally eliminated by the kidneys. condition resulting from the advanced stages of kidney failure (marked by signs and symptoms such as anemia, weight loss, weakness, N/V, excessive bleeding, edema, convulsions, lethargy progressing to coma)

Question 28

what is oliguria

Answer 28

decreased urine output (<500 ml in 24 hrs)

Question 29

what are common causes of oliguria

Answer 29

dehydration, total urinary tract obstruction, severe infection leading to shock, medications

Question 30

what is anuria

Answer 30

<100 ml urine in 24 hrs

Question 31

what is renal spasm caused by

Answer 31

spasm of ureter as a stone is being forced from the kidney to the bladder

Question 32

what is nephrotic syndrome

Answer 32

heavy proteinuria with edema, DLD, hyper coagulability and hypoalbuminuria.

Question 33

what is BUN

Answer 33

waste product of protein metabolism

Question 34

what is serum creatinine

Answer 34

waste product of muscle metabolism

Question 35

what is creatinine clearance

Answer 35

volume of plasma cleared of creatinine per minute

Question 36

what is cystatin C

Answer 36

sensitive early marker for CKD

Question 37

what is IVP

Answer 37

intravenous pyelogram. iodine injection and XR as it passes thru kidneys.

Question 38

what is retrograde pyelogram

Answer 38

like IVP, uses dye injected thru catheter then XRs. done when allergy to IV contrast for IVP or IVP can't be done

Question 39

what is renal scan

Answer 39

uses radioactive isotope then scan with gamma camera, good for showing blood flow and organ function

Question 40

is MRI good for detecting calcifications or stones

Answer 40

no

Question 41

what can renal angiography show

Answer 41

tumors, blood clots, stenosis or aneurysms of the renal artery

Question 42

do males or females get bladder cancer more often

Answer 42

males

Question 43

do males or females have worse survival rate

Answer 43

females have slightly worse 5 yr survival rate

Question 44

what is the most important risk factor for development of bladder cancer

Answer 44

cigarette smoking

Question 45

risk of bladder cancer increases how much with smoking

Answer 45

2-3 times that of a nonsmoker

Question 46

what are other risk factors for bladder cancer (other than smoking)

Answer 46

age (over 40 with 90% of cases over age 55), race (caucasian), gender (male), family hx, personal hx (80% recur rate), chemo for other types of cancer, occupation (exposure to carcinogens)

Question 47

90% of bladder cancers are which type

Answer 47

transitional cell carcinoma (TCC).

Question 48

what are the rarer types of bladder cancer that are considered more aggressive than TCC

Answer 48

squamous cell, adenocarcinoma, small cell and others (lymphoma, sarcoma)

Question 49

urinary retention can be caused by all of the following EXCEPT: 1. prostate enlargement 2. mucous colitis 3. diabetes mellitus 4. neurological disease

Answer 49

mucous colitis

Question 50

all of the following statements regarding PCKD are correct EXCEPT: 1. multiple cysts are present in both kidneys 2. it rarely progresses to end-stage renal disease 3. HTN if often present 4. cysts can occur in the liver

Answer 50

2- it rarely progresses to end stage renal disease (is not true)

Question 51

what other measurement closely estimates the GFR rate

Answer 51

creatinine clearance