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x 6102 Pathophys > renal > Flashcards

renal Flashcards

(57 cards)

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1
Q

hormonal regulation of blood flow: vasoconstrictors x3

A

sympathetic nerves (epi, nor epi)

angiotensin II

endothelin

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2
Q

hormonal regulation of blood flow: vasodilators x4

A

prostaglandins
nitric oxide
bradykinin
natriuretic peptides (ANP, B-type)

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3
Q

hormonal reg of renal blood flow: epi/norepi moa/stimulus/GFR/RBF

A

vasoconstriction

decreased ECF volume, GFR, RBC

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4
Q

hormonal reg of renal blood flow: angiotensin II moa/stimulus/GFR/RBF

A

vasoconstriction

decreased ECF volume, GFR, RBC

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5
Q

hormonal reg of renal blood flow: endothelin moa/stimulus/GFR/RBF

A

vasoconstriction

decreased ECF volume, increased stretch, and bradykinin, angiotensin II, epi

decreased GFR, RBF

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6
Q

hormonal reg of renal blood flow: prostaglandins moa/stimulus/GFR/RBF

A

vasodilators

decreased ECF volume
increased shear stress, angiotensin II

no change or increased GFR, increased RBF

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7
Q

hormonal reg of renal blood flow: nitric oxide moa/stimulus/GFR/RBF

A

vasodilator

increased shear stress, ACh, histamine, bradykinin, ATP, adenosine

increased GFR, RBF

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8
Q

hormonal reg of renal blood flow: bradykinin moa/stimulus/GFR/RBF

A

vasodilator

bradykinins & ACE

increased GFR, increased RBF

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9
Q

hormonal reg of renal blood flow: natriuretic peptides moa/stimulus/GFR/RBF

A

vasodilator
- inhibits aldosterone resulting in increased NaCl/H2O excretion

increased ECF volume

increased GFR, no change in RBF

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10
Q

the opposite of aldosterone

A

natriuretic peptides

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11
Q

urge incontinence

A

abrupt/strong urgency

  • often assoc with involuntary detrusor contractions
    • detrusor hyperreflexia vs instability (neuro vs non)
  • may be assoc with decreased bladder wall compliance

most common: older adults

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12
Q

stress incontinence

A

physical activity w increased abdominal pressure, cough, sneeze laugh

most common: women

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13
Q

overflow incontinence

A

bladder overdistension
- assoc w neuro lesions below S1, polyneuropathy, urethral obstruction (enlarged prostate)

most common: older women

overactive bladder syndrome

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14
Q

overactive bladder syndrome & incontinence x2

A

stress & overflow

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15
Q

functional incontinence

A

d/t dementia or immobility

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16
Q

intrinsic urinary tract obstruction

A

inside ureter

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17
Q

extrinsic urinary tract obstruction

A

outside ureter

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18
Q

obstructive uropathy

A

anatomic changes in urinary system d/t obstruction

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19
Q

upper urinary tract obstruction

A

obstruction affecting one or both kidneys

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20
Q

lower urinary tract obstruction

A

aka outlet obstruction, affects urine storage/emptying

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21
Q

tubulointerstitial fibrosis

A

deposition of excess ECM that can occur when upper urinary tract obstruction is not fixed quickly

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22
Q

neurogenic bladder

A

different sites in nervous system that control sensory/motor bladder function are acting funny

affected sites: detrusor, sphincter

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23
Q

kidney obstruction

Study These Flashcards
A

calculi or urolithiasis with renal colic, n/v, gross or micro hematuria

24
Q

renal colic

Study These Flashcards
A

moderate to severe pain in flank radiating to groin

25
ureter obstruction
upper urinary tract obstruction - stricture, congenital compression, aberrant vessel, tumor, inflammation, stone
26
bladder obstruction
partial obstruction of bladder outlet r/t deposition of collagen within smooth muscle bundles of detrusor causes increased force of contraction
27
urethra obstruction
stricture: narrowing of lumen d/t infection, injury, surgical manipulation, scar (rare in women), proximal is more severe
28
urine pH and kidney stones
alkaline = significantly increased risk for Ca stone acidic = increased risk for uric acid stone
29
pyelonephritis
infection of one or both upper urinary tracts acute vs chronic
30
most common causative organisms of acute pyelonephritis
E Coli Proteus, Pseudomonas - esp after urethral instrumentation
31
vesicoureteral reflux
backward flow of urine from bladder into ureters/kidneys
32
chronic pyelonephritis & common causes
persistent/recurrent infection resulting in scarring can also be d/t drug toxicity (analgesics - NSAIDS), ischemia, irradiation, immune-complex disease
33
acute pyelonephritis - common causes
kidney stones, vesicoureteral reflux, pregnancy, neurogenic bladder, instrumentation, female sexual trauma
34
glomerulonephritis
inflammation of glomerulus caused by primary glomerular injury including: - immunologic responses - ischemia - free radicals - drugs - toxins - vascular disorders - infection significant cause of CKD & ESRD acute v chronic
35
significant cause of CKD & ESRD
glomerulonephritis
36
acute glomerulonephritis
includes renal disease in which glomerular inflammation is caused by immune mechanisms damaging glomerular capillary filtration membrane
37
nephrotic syndrome s/s
massive proteinuria: 3.0+ g/day hypoalbuminemia: lt 3.0 g/dL peripheral edema
38
nephritic syndrome s/s
microscopic hematuria, RBC casts, proteinuria (NOT severe) smoky, brown-tinged urine can occur simultaneously with nephrotic syndrome!!
39
renal insufficiency
decrease of fxn ~25% normal OR GFR 25-30 ml/min + mild increase creat + uria
40
uremia
syndrome of renal failure with MANY s/s increased urea + creat, fatigue, anorexia, n, v, itching, neuro changes related to FAILURE: retention of toxic waste, deficiency, electrolyte disorder, immune activation = proinflammatory state
41
azotemia
increased serum urea, often increased creat d/t insuffiency OR failure
42
classic s/s postrenal AKI
several hours anuria + flank pain followed by polyuria
43
ESR
non-specific measure of inflammation
44
most common cause of intrarenal AKI
acute tubular necrosis
45
acute tubular necrosis: postischemic
persistent hypotension, hypoperfusion, hypoxemia = ischemia + decreased ATP & oxygen free radicals resulting in cell swelling, injury, necrosis
46
acute tubular necrosis: nephrotoxic
big player: aminoglycosides (gent, tobramycin) - accumulate, can lead to failure radiocontrast media, cisplatin enhanced by dehydration, adganced age, concurrent insufficiency, DM
47
chronic kidney disease
progressive loss of fxn associated with systemic disease GFR lt 60ml/min for 3+ mo
48
2 consistently recognized contributing factors to CKD
proteinuria - hyperfiltration - increased permeability - inflammatory process activated - fibrosis angiotensin II - promotes hyperfiltration (eff art constriction) - promotes systemic htn - proteinuria leading to inflammation leading to fibrosis
49
acute kidney injury
sudden loss of function and glomerular filtration, plus accumulation of nitrogenous waste products (creat, BUN)
50
should raise suspicion for polycystic kidney disease in young person
hypertension
51
frequent initial presentation polycystic kidney disease
flank or abdomen pain
52
polycystic kidney disease etiology
genetically acquired, autosomal dominant most common
53
most common kidney cancer
renal cell carcinoma, clear cell type
54
renal cell carcinoma, clear cell type
mutation of von Hippel-Lindau gene on chromosome 3P + better prognosis compared to others 2x men v women between 50-60 common metastasis to lung, lymph nodes, liver, bone, thyroid, CNS
55
most common bladder cancer
urothelial transitional cell carcinoma (arising from bladder lining) most common men 60+ cause of death usually metastasis (high grade muscle invasive)
56
papillary growth pattern (tuftlike lesion + stalk)
common for transitional cell carcinoma
57
renal vascular resistance determined by x3
interlobular arteriole afferent arteriole efferent arteriole

x 6102 Pathophys (6 decks)

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