HLTH urinary system review Flashcards
1
Q
transport/tubular maximum
A
is the limit on reabsorption in the kidneys and for glucose it is 310mg/min
2
Q
where does the renal artery pass through?
A
the renal pelvis
3
Q
obstruction in the kidneys
A
can be dangerous because no anastomoses exist begin vessels in the kidneys, therefore obstruction may cause necrosis and infarction may occur
4
Q
3 mechanisms that control vasoconstriction in the renal vessels
A
local autoregulation, SNS, and RAAS
5
Q
causes of incontinence
A
diabetes, pregnancy, childbirth, enlarged prostate, weak pelvic floor muscles, UTIs, diseases like parkinson’s and MS, injuries to the spinal cord, and severe constipation
6
Q
enuresis
A
means involuntary urination by children after ages 4-5 when bladder control is expected
7
Q
stress incontinence
A
occurs when abdominal pressure on the bladder causes incontinence due to coughing, laughing, lifting, or in women who have had a child
8
Q
overflow incontinence
A
occurs often in the elderly or those with a spinal cord injury and is due to an incompetent bladder sphincter
9
Q
retention
A
is an inability to empty the bladder and may be accompanied by overflow incontinence; can be due to a spinal cord injury that blocks the micturition reflex or following anesthesia
10
Q
normal urine characteristics
A
clear, straw-coloured, and mild odor; pH ranges from 4.5 to 8
11
Q
cloudy urine meaning
A
can indicate large amounts of protein, blood cells, or bacteria
12
Q
dark colour urine meaning
A
hematuria (blood in the urine), very concentrated, or excessive bilirubin content
13
Q
unpleasant odor of urine meaning
A
can indicate an infection
14
Q
what does blood in the urine mean?
A
small amounts indicate infection, inflammation, or tumors; large amounts indicate blood cells can indicate a hemorrhage in the tubules or inadequate filtration
15
Q
what does protein in the urine mean?
A
filtration is inadequate, causing albumin and other proteins to have leaked through the glomerulus
16
Q
urinary casts in the urine meaning
A
these are microscopic molds of the tubules and can indicate inflammation of the tubules
17
Q
elevated serum urea meaning
A
failure to excrete nitrogenous wastes and the GFR was decreased
18
Q
what can anemia mean in regards to kidney function?
A
decreased erythropoietin secretion or bone marrow depression due to accumulated wastes
19
Q
antistreptolysin O serum levels
A
are used to diagnose poststreptococcal glomerulonephritis
20
Q
renin serum levels meaning
A
can indicate hypertension
21
Q
what are diuretics prescribed for?
A
hypertension, edema, pulmonary edema, liver disease, CHF, and renal disease
22
Q
most common type of diuretic
A
those that inhibit NaCl reabsorption, ex. hydrochlorothiazide or furosemide
23
Q
side effects of diuretics
A
loss of electrolytes, often potassium, which may cause muscle weakness or arrhythmias; also common is frequency in the morning, orthostatic hypotension, and dry mouth
24
Q
example of a potassium sparing diuretic
A
spironolactone
25
dialysis
is providing an artificial kidney that functions to sustain life, often after acute renal failure; 2 types
26
diet and dialysis
is very restricted, particularly protein, electrolytes, and fluid
27
2 types of dialysis
hemodialysis and peritoneal dialysis
28
hemodialysis
is provided in a hospital or from home and is taking blood from an artery and filtering it through a machine where the exchange of wastes, fluid, and electrolytes takes place, and returning it back through a vein
29
membrane name in hemodialysis
dialysate and this is impermeable to proteins and large molecules as the glomerulus is
30
what medication is given to patients on hemodialysis?
heparin to prevent clotting
31
how often does a patient require hemodialysis
3 times a week for about 3-4 hours
32
risks associated with hemodialysis
infection (HIV or hep C and B), blood clots, and damage to the shunt (causes new sites to be taken)
33
peritoneal dialysis
can be done in a dialysis unit or at home and the peritoneal membrane is used as the filter of wastes through inserting a catheter here, then the dialysate is drained into a container
34
continuous ambulatory peritoneal dialysis
refers to dialysis done at home during the night
35
hemodialysis vs peritoneal dialysis
peritoneal takes longer but the electrolyte changes are less noticeable for the patient
36
risks during peritoneal dialysis
infection to the peritoneal cavity, causing peritonitis
37
cortical radiate vessel textbook name
interlobular
38
2 infections of the lower urinary tract
cystitis or urethritis
39
infection of the upper urinary tract
pyelonephritis
40
what are most urinary tract infections?
ascending, meaning then make their way up the continuous mucosa of the urinary tract
41
most common UTI infective agent
E coli
42
risk of UTIs in men
older men who have prostatic hypertrophy causing stasis of urine
43
risk of UTIs in the elderly
incomplete emptying, reduced fluids, immobility, and impaired blood supply to the bladder
44
risk factors for UTIs
retention of urine, obstruction of urine, incomplete emptying, scar tissue, pregnancy, catheters, and renal calculi
45
how does the bladder appear during cystitis and urethritis?
red, swollen, ulcerated, and bladder capacity is reduced
46
causes of cystitis
is most often bacterial but can also be due to radiation, drugs, or irritating products like feminine hygiene or a catheter
47
causes of urethritis
often is an STI but can also be from a catheter or chemicals
48
two types of urethritis
gonococcal urethritis and nongonococcal urethritis
49
gonococcal urethritis
is from neisseria gonorrhea and is transmitted sexuallay
50
nongonococcal urethritis
is from anything other than neisseria gonorrhea and often is chlamydia trachomatis
51
signs of cystitis and urethritis
pain in the lower abdomen, dysuria, urgency, frequency, nocturia, fever, nausea, reactive arthritis, conjunctivitis, and cloudy urine with microscopic hematuria
52
pyelonephritis
is an infection of the kidneys and the ureter, including the renal pelvis and medulla; purulent exudate and necrosis may be seen, and the kidney is inflamed, possibly obstructing the flow of blood
53
risk of recurrent pyelonephritis
scar tissue may form and obstruct the flow of blood
54
signs of pyelonephritis
more marked systemic signs, dysuria, dull aching pain in the lower back, and urinary casts are present in urinalysis
55
role of cranberry juice and UTIs
is a prophylactic measure and inhibits the E coli bacterium from adhering to the bladder mucosa
56
poststreptococcal glomerulonephritis
follows strep throat by an infection from a group A beta-hemolytic Streptococcus; this develops due to antibody-antigen complexes lodging in the glomeruli and initiating a new inflammatory response in both kidneys
57
antibodies present in poststreptococcal glomerulonephritis
IgG and C3 (complement)
58
complications of poststreptococcal glomerulonephritis
obstruction of filtrate forming, causing high levels of serum waste, acute renal failure, and hypertension due to renin secretion
59
signs of poststreptococcal glomerulonephritis
dark and cloudy urine, facial and abdomen edema that spreads, back pain, high BP, urine output decreases, and systemic inflammation signs
60
nephrotic syndrome
is often secondary to renal diseases and systemic disorders and is due to an abnormality in the glomerulus, causing increased permeability, resulting in hypoalbuminemia and hypovolemic shock (sometimes high BP); this leads to aldosterone secretion and hyperlipidemia
61
minimal change disease
is a primary nephrotic syndrome occurring in children aged 2-6
62
signs of nephrotic syndrome
frothy urine and massive edema that impairs respiratory function, eating, and general activity
63
common obstructions of the urinary system
tumors (benign prostatic hypertrophy is common in men), inflammation, scar tissue, stenosis, congenital defects, and renal calculi
64
renal calculi
can develop anywhere in the urinary tract and form when there is high amounts of insoluble salts and insufficient fluid intake causes concentrated urine
65
staghorn calculus
is a very large stone that forms in the renal pelvis and calculi and appears in the shape of a deer
66
nidus
is a large mass that continues to build up and forms the kidney stone; can be a calcium stone, uric acid stone, and these may also include cell debris and insoluble salts
67
renal calculi and infection
create high risk for infection due to obstructing urine and causing stasis of urine
68
hydronephrosis and renal calculi
renal calculi when in the ureters or kidney can cause this by causing dilation of calyces and atrophy or renal tissue
69
calcium stones
are phosphate, oxalate, or carbonate and form due to hypercalcemia, which may be due to a parathyroid tumor, vegetarian diets (high in oxalate), inadequate fluid intake, or alkaline urine
70
uric acid stones
are common due to gout, cancer chemo, or acidic urine
71
signs of renal calculi
small ones are asymptomatic but large ones will cause back/flank pain, renal colic (severe spasms from the back to the groin), nausea, pale skin, moist skin, and rapid pulse
72
hydronephrosis
occurs as a secondary problem often following a tumor, renal calculi, scar tissue, or prostatic enlargement; occurs when there is an obstruction causing backup pressure and dilation of the ureters and kidney, and may cause flank/back pain
73
renal cell carcinoma
is a malignant tumor (adenocarcinoma) arising from the tubule epithelium, often in the cortex; it tends to metastasize before it is diagnosed
74
common metastasis spots for renal cell carcinoma
lungs, liver, bone, or CNS
75
signs of renal cell carcinoma
painless hematuria, back/flank pain, a mass, weight loss, anemia, and possibly paraneoplastic syndrome or cushing syndrome
76
bladder cancer
is a malignant tumor often arising from the transitional epithelium, and often penetrates through the wall to metastasize
77
common metastasis spots for bladder cancer
pelvic lymph nodes, liver, and bone
78
signs of bladder cancer
hematuria, dysuria, and frequency
79
risk factors for developing bladder cancer
working with chemicals like dyes, aluminum, or rubber, as well as cigarette smoking
80
nephrosclerosis
involves vascular changes similar to atherosclerosis in the kidneys (thickening and hardening of walls) that reduces blood flow to the kidneys; this leads to ischemia, atrophy, and increased secretion of renin
81
causes of nephrosclerosis
diabetes, essential hypertension, or another disorder
82
vesicoureteral reflux
is a congenital disorder causing a defective valve in the bladder
83
agenesis
is a congenital disorder where one kidney never develops
84
hypoplasia
is a congenital disorder and is failure of the kidney to develop to normal size, usually unilateral
85
ectopic kidney
is a congenital disorder occurring when a kidney and its ureter out of position, common in the abdominal or pelvic cavity
86
fusion of the kidneys
is a congenital disorder when the 2 kidneys fuse to form a single, horseshoe shaped kidney where function remains normal
87
adult polycystic kidney gene
is an autosomal dominant gene located on chromosome 16
88
polycystic disease
is transferred as an autosomal recessive gene and manifests at birth, often causing a stillborn or death as an infant
89
adult polycystic kidney
is a genetic condition that often doesn't manifest until about age 40 with chronic renal failure; occurs when multiple cysts develop on both kidneys and grow throughout the years, causing the kidneys first to enlarge, then compressing kidney tissue; may occur on liver as well
90
wilms tumor another name
nephroblastoma
91
wilms tumor
common in children and is due to defects in tumor suppressing genes on chromosome 11; usually is a unilateral mass that manifests as a mass on the abdomen and high BP
92
where does wilms tumor often spread to?
the lungs
93
characteristics of renal failure
inflammation and necrosis can cause back pressure and obstruction, leading to decreased GFR and no or little urine output
94
causes of acute renal failure
glomerulonephritis, severe and prolonged shock (burns and sepsis), nephrotoxins, and obstructions
95
how may burns cause acute renal failure?
damaged RBCs break down into the circulation and can cause obstruction in the tubules; hemoglobin is also toxic to tubules, causing further inflammation (myoglobin has a similar effect)
96
nephrotoxins
are those that cause tubule necrosis and obstruction and some are penicillin, sulfa drugs, phenacetin, NSAIDS, acetaminophen and aspirin
97
blood levels during acute renal failure
high levels of urea, creatinine, potassium, and metabolic acidosis
98
sign of recovery from acute renal failure
increased urine output
99
chronic renal failure
is the gradual, irreversible (due to scar tissue) destruction of the kidneys that occurs over a long period of time due to decreased nephrons; 3 stages are decreased reserve, renal insufficiency, and end stage renal failure
100
causes of chronic renal failure
bilateral pyelonephritis, polycystic disease, nephrotoxins, or systemic disorders like hypertension or diabetes
101
decreased reserve stage
GFR is decreased, serum nitrogenous wastes are high, and kidneys continue to adapt to the increase their capacity; no clinical signs
102
renal insufficiency stage
about 75% of nephrons are lost at this point and GFR is decreased to about 20%; nitrogenous wastes in the blood rise, BP rises, urine is less concentrated (large volumes of urine), and pH changes by the kidneys are impaired
103
end-stage renal failure
GFR is negligible (>90% of nephrons are lost), very high levels of waste in the blood, and marked oliguria (low urine output) or anuria develop
104
treatment for chronic renal failure
dialysis or a kidney transplant
105
early signs of chronic renal failure
polyuria, general signs like anemia, fatigue, nausea, etc., bone marrow depression, and high BP
106
late signs of chronic renal failure
oliguria or anuria, dry, itching, pigmented skin, decreased lipido, amenorrhea, encephalopathy, CHF, arrhythmias, failure to activate vitamin D, urine breath, and common infections
107
3 As of chronic renal failure
acidosis, azotemia, and anemia
108
azotemia
refers to high levels of uric acid or other nitrogenous wastes in the blood
