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Disorders Of Renal & LUT Function Flashcards

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1
Q

Renal agenesis

A

without a kidney

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2
Q

Renal hypoplasia

A

small kidney or fewer nephrons

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3
Q

renal dysplasia

A

structures in the kidney are not well differentiated

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4
Q

When are kidneys formed?

A
  • 1st month of pregnancy

- less amniotic fluid means the fetus’ kidney aren’t working well

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5
Q

Autosomal dominant polycystic kidney disease

A

development of cysts on the nephrons and collecting tubules

-causes pain, HTN, infection from sitting urine, hematuria

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6
Q

autosomal recessive polycystic kidney disease

A

almost always progresses to renal failure

-causes pain, HTN, infection from sitting urine, hematuria

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7
Q

Medullary cystic kidney disease

A

occurs in adults only

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8
Q

Nephronophthisis

A

occurs in kids; progresses to renal failure

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9
Q

Acquired form of renal cystic disease

A

results from dialysis

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10
Q

Acute nephritic syndrome

A
  • caused by strep

- 7 to 12 days later you have oliguria

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11
Q

Most common type of kidney cancer

A

Wilms tumor/ nephroblastoma (same thing)

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12
Q

Who gets Wilms tumors?

A

Children 3-5 years old

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13
Q

Distinctive feature of Wilms tumors

A

hypertension

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14
Q

Renal cell carcinoma: who gets it; symptoms

A
  • Adults: usually over 55
  • silent in early stages so it is usually caught in advanced stages
  • late stages: hematuria and flank pain, can metastasize to the lung
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15
Q

What happens when kidneys fail?

A
  • Less waste is removed and more remains in the blood
  • unable to regulate fluid, electrolyte, and pH balance
  • nitrogenous compounds build up in the blood
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16
Q

Acute renal failure

A

abrupt onset and usually reversible but can develop into chronic

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17
Q

Chronic renal failure

A

develops slowly over time and ends up in renal failure

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18
Q

How do we test nitrogenous build up in the blood

A

BUN and creatinine

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19
Q

Prerenal injury

A
  • marked decreased in renal blood flow
  • caused by shock, dehydration, vasoconstricion, clot, atherosclerosis
  • causes decreased CO, and makes them susceptible to ischemia
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20
Q

Intrinsic renal injury

A
  • damage to structures within the kidney (something is wrong with the glomerulus, bowmans capsule or basement membrane
  • caused by ischemia, toxins, intratubular obstruction
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21
Q

Postrenal injury

A
  • obstruction of urine outflow from the kidney

- caused by stones, tumors, enlarged prostate

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22
Q

Acute tubular necrosis

A
  • outcome of prerenal issues in oxygen and blood supply to the kidney
  • if we can’t fix ischemia, we get necrosis or infarct
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23
Q

Which type of kidney injury (AKI) would be most likely to accompany BPH?

A

Postrenal

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24
Q

chronic kidney disease

A
  • decreased GFR greater than 3 months
  • fewer nephrons are functioning
  • remaining nephrons must filter more which leads to hypertrophy
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25
manifestations of chronic kidney diesase (Uremia, fluid, CV, and GI)
- Uremia/azotemia: CNS, GI, and immune disturbances - Fluid: Salt wasting, acidosis, hyperkalemia - CV: HTN, heart disease - GI: Anorexia, N/V, ulcerations
26
mineral metabolism disorders from chronic kidney disease lead to...
metastatic calcifications and bone disease
27
hyperphosphatemia in chronic kidney disease
hyperphosphatemia → hypocalcemia → increased PTH → calcium resorption from bone → bone loss → metastatic calcifications
28
decreased vitamin D in chronic kidney disease
decreased vitamin D → increased PTH and impaired osteoblasts
29
Manifestations of chronic kidney disease (systemic, CNS and PNS, sexual function, skin)
-systemic: decreased inflammation and immunity CNS/PNS: peripheral neuropathy, RLS, uremic encephalopathy sexual: impotence, hyppfertility, dysmenorrhea skin: dryness, bruising, Terry nails
30
How can the kidney dysfunction affect the CV system
- causes anemia: decreased blood viscosity → increased HR and peripheral vasodilation - angina - decreased platelets → bleeding
31
lower urinary tract disorders: obstruction
- occurs below the bladder | - retention or stasis of urine will cause stone to form
32
s/s of lower urinary tract obstruction
frequency, hesitancy, straining, weak stream (esp in men, post-void residual greater than 200 ml
33
bladder wall hypertrophy
huge prostate has narrowed urethra
34
neurogenic bladder disorders
problems coming from neurological mis-signaling - bladder overactivity - areflexic bladder dysfunction
35
Bladder overactivity
failure to relax and store urine - hyperactivity - common in spinal cord injury and MS
36
Areflexic bladder dysfunction
failure to contract and empty (ANS controls bladder, so when it is stimulated, you get lots of bad reactions) - HTN, bradycardia, sweating - lethal if not fixed - common is sacral cord injuries, trauma, spina bifida
37
Autonomic hyperreflexia/ dysreflexia
- failure to store urine - spinal cord injury - from outside or bodily - causes sudden hypertensive crisis
38
uninhibited bladder
- problem with brain signaling - failure to store urine - stroke, MS, lesions
39
Detrsor-sphincter dyssynergia
- failure to store urine | - detrusor muscles and bladder sphincter can't work together because of trauma or lesions
40
stress incontinence
weakness of detrusor muscles - common in women who've given birth, elderly, obese - do kegel exercises
41
urge incontinence
have to go right away
42
mized incontinence
stress+urge | -common in elderly and menopausal women, women who've given birth, and obesity
43
overflow incontinence
- obstruction or large prostate, tumor | - causes dribbling, leaking, or weak stream
44
nocturnal enuresis
- urinate at night | - normal in children up to 6 years old, lots of drugs or night sedation
45
postmicturition dribble
you think its empty but you get dribble a few mins later
46
continuous urinary leakage
- problems with storing urine or neurological damage that does't allow sphincter to close - tumor
47
UTI
(usually) a bacterial infection that entered from the urethra
48
host defenses for UTIs
- washout phenomenon: body will make a lot of urine to remove bacteria - protective mucin layer: keeps bacteria from colonizing in the bladder - Local immune responses and IgA - Phagocytic blood cells - normal flora and prostate secretions
49
UTI during pregnacy
want to avoid at all costs because it could irritate the uterus and cause premature labor
50
Normal flora and prostate secretions that protect from UTIs
- vagina has lactobascillus which inhibits baterial growth in the same place - prostate has a fluid that comes out with seminal fluid that is antimicrobial
51
urothelial neoplasias: invasive urothelial cell carcinomas
- high grade: infiltrate the structure around the bladder | - malignant and spread
52
#1 sign of invasive urothelial cell carcinomas
painless hematuria (infection causes flank pain, so painless hematuria is much worse)
53
urothelial neoplasias: Malignant tumors
-usually occur in the inside of the bladder lining
54
IgA nephropathy
Buerger's disease
55
Azotemia
Presence of nitrogenous waste in the blood
56
Nephrotic Syndrome: Proteins in Urine
- Albumin--> edema & increased free drug - Immunoglobulins & complement--> immune suppression - Binding proteins--> low ions & hormones - Clotting & anticlotting factors-->thrombosis
57
Nephritic Syndrome
Inflammatory process damages the capillary wall
58
Good pasture syndrome
- nephritic syndrome | - antibodies to your basement membrane
59
Acute tubular necrosis
lack of blood supply to the kidney (think of as renal MI)
60
Tubulointerstitial nephritis
inability to concentrate urine
61
Acute pyelonephritis
- abrupt onset - painful urination - usually caused by E. coli
62
Chronic pyelonephritis
- scarring & atrophy - reflux: urine backs up - ends with renal failure
63
Uncomplicated pyelonephritis
no other comorbidities
64
Complicated pyelonephritis
Pyelonephritis r/t obstruction, catheterization, renal surgery, spinal cord injury, pregnancy, reflux
65
Hydronephrosis
Obstruction resulting from urine filled calculi | Ex: stones, scarring, or tumors can cause this
66
Calcium stones treatment
- Treat underlying conditions - Increased fluid intake - Thiazide diuretics
67
Magnesium ammonium phosphate stones treatment
- Treat UTI - Acidification of urine - Increase fluid intake
68
Cystine Stones
- Kids usually get these | - not infectious for kids
69
Uric acid stones
Gout

Patho (10 decks)

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