RENAL ANATOMY- final Flashcards
(16 cards)
which kidney is lower
R kidney, displaced by liver
assessing kidney disease
- labs and imaging
- metabolic profile (basic or complete): BUN and creatinine
- CBC, culture, inflammation markers
- urinalysis: spot electrolytes, microscopy, culture
- imaging tests: US, xray, Ct w contrast, urinary cystogram
- cystoscopy
cystatin C test
protein level related to renal function
high level=dec renal function
eGFR used for
- med management
- safety during procedures
- staging diseases
- CKD (staging and planning)
xray
- AP film of abd and pelvis
- evaluate Kidneys, ureters, Bladder
(KUB xray)
renal US
renal and bladder structures
- use doppler to eval renal blood flow
cystography
- radiocontrast instilled via urinary catheter
- useful for vesicoureteral reflux eval
urinary pyelogram
- iv contrast excreted by kidneys
- xrays taken at intervals
- gives functional image of urinary system
CT w IV contrast
- use
- risks
use- eval structures of kidneys
risks- allergic rxns, adv effects to kidney function, **extravasation **
- extravasation: ice pack site, eval pain, eval for distal flow and necrosis
uteroscopy
endoscopic exam of upper GU tract
- endoscope passed through urethra to bladder
nephrotic v. nephritic (glomerulonephritis)
nephrotic: inc proteinuria, dec protein in serum, general/facial edema, inflamm leads to inc glomerular permeability (compensation for dec protein), dec oncotic pressure in blood
nephritic: hematuria, dec urine quantity (oliguria), hypertension, destroy epithelial lining of glomerulus, dec renal perfusion and HTN
nephrotic syndrome causes
minimal change disease
mc cause in children
- normal on light microscopy
- only see histo changes on electron microscope
nephrotic syndrome causes
focal segmental glomerulosclerosis
mc cause of nephrotic in ADULTS
- tissue scarring seen on microscopy
- some glomeruli scarred, others spared
nephrotic syndrome
- secondary causes
diabetic nephropathy, systemic lupus erythematous, sarcoidosis, syph, hep B/C, HIV, sjorgens syndrome, amyloidosis, multiple myeloma, cancers, vasculitis, meds (gold salts, PCN, captopril)
nephrotic syndrome
- tx for complications
- correct underlying is secondary cause is present!!!
- HLD- diet restrict, statins, fibrates
- hypercoagulability- LMWH
- edema- correct protein intake w lean protein (<1 gm/kg/day), limit water intake, limit sodium 1-2 gm/day, diuretics (LOOP)
hypoalbuminemia- dietary protein
nephritic syndrome
- causes
- post streptococcal glomerulonephritis
- focal proliferative (some glomeruli damaged) —>(alport syndrome, SLE, IgA nephropathy, chronic heaptic failure, celiac sprue)
- difuse proliferative (all glom damaged)—> membranoprolif like hep B/C, SLE, sickle cell ds
