Renal

Question 1

what is another name for kidney stones

Answer 1

calculi

Question 2

pathophysioloy of urinary tract obstruction

3 steps. what urine does, what it affects and results, what this leads 2

Answer 2

1. Urine backs up proximal to the obstruction causing dilation of the tract.
2. Back-up of urine eventually affects the nephrons resulting in decreased GFR, reabsorption, secretion and urine concentration and also increases the risk of urinary tract infections.
3. This decreased nephron function can ultimately lead to acute kidney injury or chronic renal disease.

Question 3

signs of cytisis

Answer 3

lower abdominal pain, increased urgency and frequency to urinate, dysuria (painful urinating)

Question 4

main causes of acute tubular necrosis

Answer 4

ischemia and toxins

Question 5

whats Acute glomerulonephritis

Answer 5

1. caused by a bacterial infection
2. the resulting antibody-antigen complexes become trapped within the glomeruli
3. causing an inflammatory response that damages the glomerular basement membrane.

Question 6

pre-renal causes of AKI

before the kidney

Answer 6

hypotension
cardiac failure
burns
septic shock
dehydration
hemorrhage

Question 7

intrinisc causes of AKI

kidney itself

Answer 7

Glomerulonephritis
Acute tubular necrosis
polycystic kidney disease

Question 8

whats acute tubular necrosis

Answer 8

1. the tubular epithelial cells of the nephron are damaged due to ischemia and/or nephrotoxins.
2. cells fall off and plug up nephron resulting in back up of filtrate and reduced GFR and oliguria
3. can be back leak of filtrate so more substances go back into blood
   ischemia occurs due to decreased renal blood flow from causes of AKI

Question 9

substances toxic to nephrons

Answer 9

heavy metals (e.g. lead, mercury)
poisonous mushrooms
ethylene glycol
insecticides
gentamicin - antibiotic

Question 10

post renal causes of AKI

Answer 10

kidney stones
neurognic bladder
prolasped uterus
benign prostate hyperplasia
all make urine go back to kidneys which it cant filter

Question 11

describe uremia

Answer 11

A syndrome of chronic kidney disease characterized by azotemia (high levels of waste products in blood) and the associated systemic signs & symptoms.

Question 12

what are kidney labs

Answer 12

Urea, GFR, Creatinine

Question 13

what does it mean if Urea is only high lab,

and whats urea

Answer 13

dehydration
waste product made by liver from protein

Question 14

whats creatinine and whats it mean if high lab

Answer 14

protein in muscles, should only have little amount, if high then there is kidney dysfunction or crush injury/burn (broken muscle cells)

Question 15

whats GFR and whats it mean if its low lab

Answer 15

glomerular filtration rate(how fast kidneys filter out waste). main kidney lab. low means kidney dysfunction

Question 16

whats AKI

Answer 16

acute kidney injury, sudden decrease in kidneys ability to filter chemicals from blood, and regulate fluids, electrolytes and acid base balance

Question 17

whats AKI associated with

symptoms/complications

Answer 17

a reduction of GFR by 25% or more, oliguria (in most cases) and retention of metabolic wastes, particularly azotemia; these changes typically occur within a few hours to days of the initial insult.
other - fluid retention & oedema, metabolic acidosis, anuria, nausea/vomiting or anorexia and various neurological manifestations such as irritability, drowsiness or confusion.

+ SOB, dyspnoea, uremia

Question 18

management of AKI

Answer 18

identification and treatment of underlying causes and also includes:

maintenance of adequate fluid, electrolyte and acid-base balances
adequate nutrient intake
prevention/management of infection

Question 19

treatment of aki

pre, intrinisic, post

Answer 19

Prerenal - give fluids
Intrarenal - fluids and steroids
Postrenal - catheter, surgery.

Question 20

whats kidney stones

Answer 20

calcium undissolves from urine and the renal calculus gets stuck in the ureter, leads to Hydroureter - ureter swells up above the kidney stone
Hydronephrosis - kidney swells from back up of water
Only likely to cause AKI if both ureters are affected.

Question 21

RF and s/s of kidney stones

Answer 21

AKI and dehydration

s/s - renal colic (abdominal pain)
Nausea/vomiting
buring urination
Horrible flank pain that radiates to the groin

Question 22

whats cystitis

and treatment

Answer 22

uti due to ascending microbes and causes inflammation of bladder.

microorganisms gain access to bladder through uretha

antibiotics

Question 23

cysititis s/s

Answer 23

urinary frequency
urinary urgency
dysuria
lower abdominal/back pain

Question 24

whats pyelonephritis

Answer 24

uti due to ascending microbes or microbes in blood. causes inflammation in renal pelvis and interstitium

Question 25

s/s and RF of pyelonephritis

Answer 25

rf - Urinary obstruction and vesicouretal reflux same as found with cystitis, but also: fever, chills flank/back/groin pain general malaise polyuria

Question 26

treatment of pyelonephritis

Answer 26

targeted antimicrobal treatment

Question 27

whats Glomerulonephritis | affects

Answer 27

Inflammation of the glomerulus. leading cause of AKI disruption of the filtration membrane that usually results in inadequate GFR, but also increased glomerular permeability, which leads to: proteinuria hematuria oliguria hypertension oedema azotemia

Question 28

management of chronic kidney disease

Answer 28

dietary control with adequate calorie intake and: protein restriction Vit D supplementation fluid evaluation sodium, potassium & phosphate restriction erythropoietin supplementation ACE inhibitors or receptor blockers hyperglycemic control & insulin (for patients with diabetes)

Question 29

whats chronic kidney disease

Answer 29

is progressive and irreversible destruction of nephrons. There is a progressive reduction in GFR and subsequent reductions in nephron function and other kidney functions

Question 30

s/s chronic kidney disease

Answer 30

Uremia is a syndrome of CKD characterized by azotemia and the accompanying systemic symptoms, including: fatigue, anorexia, nausea/vomiting, weight loss, hypertension, pruritis and neurological, musculoskeletal & cardiovascular changes