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MS2 exam1 > Renal disease > Flashcards

Renal disease Flashcards

(49 cards)

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1
Q

functions of the kidneys

A

maintain acid base balance

  • filter and excrete waste products of the body
  • control fluid and electrolyte balance
  • regulate B/P
  • excrete: bacterial toxins, water soluble drugs& metabolites, waste
  • Secrete: renin, erythropoietin
  • synthesize vit D
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2
Q

Diagnostic tests

A
  • blood urea nitrogen (BUN)
  • serum creatinine level
  • creatinine clearance test
  • urinalysis
  • specific gravity
  • uric acid test
  • KUB (kidneys, ureters, bladder)
  • bladder ultrasonography
  • intravenous pyelogram
  • renal angiography
  • renal scanning
  • cystoscopy and biopsy of kidney
  • renal biopsy
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3
Q

BUN

A

end product of protein metabolism
normal: 8-20 mg/dL
tells how much protein is in blood
could be high due to kidney issues, dehydration, high protein diet, infection, stress, muscle breakdown

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4
Q

serum creatinine level

A 
end product of muscle cell metabolism
normal: 0.7-1.4 mg/dL
only see increase once 50% of kidney function is gone
how much creatinine in blood?
increases with kidney malfunction
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5
Q

creatinine clearance test

A

evaluates how well kidneys remove creatinine from the blood
how much creatinine in urine?
decreases with renal malfunction
a decrease is unexpected with unilateral kidney disease because the other kidney takes up the slack

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6
Q

urinalysis

A
  • test for evaluation of renal system and renal disease

- can be done as dip stick test

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7
Q

specific gravity

A

measures ability of kidneys to concentrate urine

normal: 1.002 and 1.030

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8
Q

uric acid test

A

24 hour collection to diagnose gout and kidney disease

normal: 2.5-8.0 mg/dL

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9
Q

KUB

A

X-ray to detect urinary calculi

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10
Q

bladder ultrasonography

A
  • noninvasive method to measure volume of urine in bladder

- bladder scanning is a form of this

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11
Q

intravenous pyelogram

A

to visualize and identify abnormalities in the renal system

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12
Q

renal angioigraphy

A

to examine the renal blood vessels and renal arterial supply

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13
Q

renal scanning

A

visual imaging of renal blood flow, glomerular filtration, tubular function, and excretion

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14
Q

cystoscopy and biopsy of bladder

A

mucosa examined for inflammation, calculi, tumors

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15
Q

renal biopsy

A

needle sample of tissue for examination

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16
Q

Glomerular filtration rate

A
  • strong determinant of renal function
  • measures the amount of plasma volume that can be cleared of any given substance within a certain time frame
  • normal: 125mL/ minute
  • gfr formula derived from plasma creatinine, age, gender, BUN, BP- very specific
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17
Q

urinary tract infection

A
  • 2nd most common bacterial disease
  • highest percent in women
  • upper or lower
  • pyeltonephritis- upper (kidneys)
  • cystitis & urethritis- lower (bladder & below)
  • involves only bladder- uncomplicated
  • involves coexisting conditions- complicated
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18
Q

upper UTI

A
  • renal parenchyma, pelvis, ureters
  • typicaly causes fever, chills, flank pain
  • pyelonephritis
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19
Q

lower UTI

A

LUTS
emptying symptoms: hesitancy, intermittency, post-void dribble, pain on urination
-storage symptoms: urinary frequency, urgency, incontinence, nocturia

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20
Q

acute pyeonephritis

Study These Flashcards
A
  • commonely starts in renal medulla and spreads to adjacent cortex- upper uti
  • mid fatigue to chills, fever, vomiting
  • urinalysis, C&S, CBC, blood culture
  • IVP, CT
  • braod spectrum antibiotics then sensitivity guided therapy
  • fluorquinolones
    • cipro, floxin, noroxin, tequin
21
Q

chronic pyelonephritis

Study These Flashcards
A

kidneys small, atrophic, shrunken, decreased function due to scarring or fibrosis

  • AKA reflux nephropathy (backward fow), chronic atrophic pyelonephritis associated with HTN
  • often progresses to end stage renal failure
22
Q

urethritis/ cystitis

Study These Flashcards
A

lower urinary tract infections

  • inflammation of bladder wall (cystitis)
  • inflammation of urethra (urethritis)
  • bacterial or viral
  • STDs
23
Q

glomerulonephritis

Study These Flashcards
A

-immunological disorder
-3rd eadin cause of renal failure
-classifications: extent of damage( diffuse or local)
initial cause of disorder (lupus, strep)
extent of changes ( minimal or widespread)
-types: acture poststreptococcal, goodpasturesyndrome, rapidly progressive, chronic, nephrotic syndrome.

24
Q

obstructive uropathies

Study These Flashcards
A
  • urinary tract calculi
  • stricture
  • renal trauma
25
urolithiasis (kideny stones)
- causes by urinary stagnation or supersaturation of urine with poorly soluble crystalloids - most stones originate in the kidney and move distally before becoming lodged in narrow areas
26
types of kideny stones
-calcium (75%) struvite (15%) uric acid(6%) cystine (2%)
27
nephrosclerosis
-renal vascular problem -sclerosis of small arteries and arterioles of kidneys decreases blood flow resulting in patchy necrosis of renal parenchyma
28
renal artery stenosis
- partial occlusion of one or both renal arteries - abrupt hypertension - renal vascular problem
29
renal vein thrombosis
unilateral or bilateral - trauma, renal cell carcinoma, nephrotic syndrome, extrinsic compression - flank pain, hematuria, fever - anticoagulation - renal vascular problem
30
polycystic kidney disease (PKD)
-most common life- threatening genetic diease in the world no specific treatment -dialysis and transplant to treat
31
medullary cystic disease (autosomal dominant)
hereditary polyuria, progressive renal failure, severe anemia, metabolic acidosis -genetic counselling -ESRD treatment
32
alport syndrome
``` kidney, hearing loss, eye abnormalities -chronic hereditary nephritis -inherited sex linked disorder or inherited as autosomal trait -treatment supportive does not recur after transplantation ```
33
renal failure: end-stage renal disease (ESRD)
southern states hardest hit: diabetes, obesity | -chronic or acute
34
acute kidney failure
- develops within hours or days, includes chance of kidney function recovery - possible causes: traumatic, acute intoxication, part of multiorgan failure, various other disease (infections, etc)
35
chronic kidney failure
develops over years, irreversible at the end. -causes: secondary to hypertension, diabetes; chronic bacterial inflammation of the kidneys; cystic kidneys; various autoimmune disorders
36
acute kidney injury
rifle criteria -S/S of acute renal injury are primarily caused by the retention of nitrogenous wastes and fluids, and the inability of the kidneys to regulate electrolytes
37
AKI description
-rapid loss of kidney function from renal cell damage -occurs abruptly and can be reversed -leads to hypoperfusion, cell death, decomposition of renal function -prognosis depends on cause and condition of client -near normal or normal kidney function may resume gradually can be pre-renal, intrarenal, or post renal
38
pre-renal
before the kidney causes: intravascular fluid depletion, dehydration, decreased cardiac output, decreased vascular resistance, decreased renovascuar blood flow(thrombosis or drug-related), prerenal infection or obstruction, hypotension
39
Intra-renal (intrinsic)
the kidney -causes: tubular necrosis, prolonged renal ischemia, intrarenal infection or obstruction, nephrotoxicity, primary renal diseases
40
post-renal
-after the kidney mechanical obstruction of urinary outflow causing reflux and damage to renal tissue causes: bladder neck obstruction, bladder cancer, calculi, post-renal infection
41
acute tubular necrosis (ATN)
AKI - risk factors for ischemic ATN - hypovolemia - major surgery - sepsis - trauma- FLUIDS (NS) - burns * *ischemia lasting more than 2 hrs leads to severe, irreversible damage to kidney tubules
42
AKI phases
-initiation (hours to days) -maintenance (significant fall in GFR) recovery (may take 1 year to recover)
43
initiation phase
- often symptomatic - may last hours- days - ends when tubular injury occurs - if recognized and treated prognosis is good
44
maintenance phase
- significant fall in GFR - oliguria may develop - azotemia(high nitrogen content in blood) - fluid retention - metabolic acidosis - electrolyte imbaances: hyperkalemia, hyponatremia, hypocalcemia
45
recovery phase
increased GFR - diuresis - stabilization/ continual decline in BUN and serum creatinine levels toward normal - renal function improve rapidly during first 5-25 days of recovery phase - full recovery may take 1 year
46
clinical manifestations/ therapies for ARF
- anemia: iron supplement/ epoetin/ blood transfusion - fluid volume excess: fluid/sodium restrictions/ diuretics/ dialysis - hyperkalemia: decrease potassium (dietary, IVF, admin, meds such as glucose and insulin [drive K+ into cells])
47
Chronic renal failure
-slow, progressive, irreversible loss in kidney function -affects all major body systems and requires dialysis/transplant to maintain life -GFR = 60 mL/min for 3 months or longer occurs i stages -results in uremia or end-stage renal disease -hypervolemia- kidneys unable to excrete Na+ or H20
48
causes of CRF
- AKI - DM or other metabolic disorders - chronic hypertension - chronic urinary obstruction - recurrent infections - renal artery occlusion - autoimmune disorders
49
uremic syndrome
accumulation of nitrogenous waste products in the blood | uremic frost

MS2 exam1 (10 decks)

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