Renal System and Disorders- Notes from Slideshow (quiz 3) PART 2 Flashcards
1
Q
An infection in any part of your urinary system — your kidneys, ureters, bladder and urethra
A
UTI
2
Q
What are the two types of UTIs?
A
- Pyelonephritis
- Cystitis
3
Q
What is the difference between Pyelonephritis and Cystitis?
A
- Pyelonephritis- kidney infection
- Cystitis- bladder infection
4
Q
Symptoms of UTI: Pyelonephritis
A
- Flank pain
- High fever
- Malaise
- WBCs and bacteria in urine
- Urinary symptoms similar to cystitis
5
Q
Symptoms of UTI: Cystitis
A
- Increased urinary frequency
- Urgency
- Dysuria
- Pain above the pubic region
- WBCs and bacteria in urine
- More common in women
6
Q
Are UTIs common?
A
yes
7
Q
Who is it most common to see with a UTI?
A
young females
8
Q
Who is it most uncommon to see with a UTI?
A
males under 50
9
Q
What organisms most commonly cause UTIs?
A
- E.Coli
- Staph
10
Q
Which organisms cause catheter-asscoiated UTIs?
A
Usually bacterial (gram neg)
- proteus
- pseudomonas
- kiebsiella
- seratia
11
Q
Which type of UTI is WBCs in urine more common?
A
Pyelonephritis
12
Q
Why do pts with cystitis sometimes end up with Pyelonephritis?
A
organisms can ascend up from the bladder the ureters into the urinary tract
13
Q
“backflow” or retrograde flow of urine from the bladder into the ureters, and usually up to the kidneys
A
vesicoureteral reflux (VUR)
14
Q
What is VUR a risk factor for?
A
Upper tract infection (Pyelonephritis)
15
Q
What population is VUR common in?
A
Children
16
Q
How common is VUR in children who get UTIs?
A
found in 50%
17
Q
How many children does VUR effect out of all children?
A
1%
18
Q
What gender is most at risk for VUR?
A
Female
19
Q
What gender get a worse case of VUR?
A
Male
20
Q
What is the female to male ratio of VUR
A
6:1
21
Q
What race is most likely to get VUR?
A
Whites
22
Q
What is comparisons of occurrence of VUR- whites to blacks?
A
whites 10x more likely
23
Q
Major risk factor for VUR
A
Inheritance
24
Q
What % increase does a person have if their parents had VUR? siblings?
A
parents- 50%
siblings- 22-45%
25
Why do girls get it more often than boys?
girls have longer ureters
26
What are the different types of nephritis?
1. Glomerulonephritis
2. Lupus nephritis
3. Interstitial nephritis
4. pyelonephritis
27
Inflammation of the glomeruli
Glomerulonephritis
28
Inflammation of the spaces b/w renal tubules
Interstitial nephritis
29
When a UTI has reaches the pyelum (pelvis) of the kidney
pyelonephritis
30
A disease of the immune system
Lupus nephritis
31
What usually causes Glomerulonephritis?
Strep infection that advances to kidneys and heart valves
32
When diagnosing a pt and they have a red throat be sure to think of what when thinking of differential diagnoses?
strep and Glomerulonephritis
33
If Glomerulonephritis is left untreated it can lead to...
renal failure
34
Symptoms of Glomerulonephritis
1. Headache
2. increased BP
3. Facial/periorbital edema
4. Lethargic
5. Low grade fever
6. Weight gain (edema)
7. Proteinuria
8. Hematuria
9. Oliguria
10. Dysuria
35
The antigen- antibody complex from a recent strep infection can effect the kidneys how?
They can be in the strep and Glomeruli and cause inflammation and decreased GFR causing Glomerulonephritis
36
Inflammation disrupting glomerular basement membrane
Nephritic Syndrome
37
Podocyte damage leading to glomerular charge-barrier disruption
Nephrotic Syndrome
38
Group of symptoms that occur with some disorders that cause swelling and inflammation of the glomeruli in the kidney, or glomerulonephritis.
Nephritic Syndrome
39
Often caused by damage to small blood vessels in the kidneys that filter waste and excess water from the blood. An underlying health condition usually plays a role.
Nephrotic Syndrome
40
What is the different between nephritic and nephrotic syndrome?
Nephritic- excess blood in urine
| Nephrotic-excess proteins in urine
41
How to remember the difference
Inflammation and pOdocyte
42
What is the most common cause of Nephritic syndrom?
Berger's Disease
43
What is Berger's Disease
IgA Nephropathy
44
Symptoms of Nephritic Syndrome
1. Inflammation of the glomeruli
2. HTN
3. Oliguria
4. Cola-colored urine (hematuria)
45
Symptoms of Nephrotic Syndrome
1. Hypoalbuminemia
2. Hyperlipidemia
3. Peripheral Edema
4. Massive proteinuria
46
Hard deposits of minerals and acid salts that stick together in concentrated urine.
Kidney stones
47
Kidney stones are also known as
Renal Calculi
48
Where in the kidney can a stone lodge?
Anywhere including
inside kidney
pelvis
bladder
urethra
49
What are the majority of stone composed of?
Calcium and uric acid
50
Are kidney stones more common in males or females?
Males
51
What is the risk of stone reoccurrence for a first time stone former?
50% within 5-10 years
52
What tests should the APRN run if there is a suspected kidney stone?
1. Blood
2. Urine
3. Urine analysis
53
Flank pain caused by kidney stones may radiate to what?
1. groin
2. testicles
3. abdominal area
54
How is pain caused by kidney stones characterized ?
Can be sharp/sudden severe or intermittent depending on stone movement
55
Symptoms of Kidney Stones
1. N&V
2. Sharp/ sudden/ severe or intermittent pain in flank, groin, testicles. abdominal area
3. Hematuria
4. Dysuria
5. Urinary frequency
56
1. N&V
2. Sharp/ sudden/ severe or intermittent pain in flank, groin, testicles. abdominal area
3. Hematuria
4. Dysuria
5. Urinary frequency
Symptoms of Kidney Stones
57
What is done to diagnose kidney stones?
1. Ultrasound
2. CAT scan
3. IVP
4. Stone Analysis
5. KUB(Xray)
6. Blood test: calcium oxalate, uric acid
58
1. Ultrasound
2. CAT scan
3. IVP
4. Stone Analysis
5. KUB(Xray)
6. Blood test: calcium oxalate, uric acid
What is done to diagnose kidney stones?
59
What can be done preventatively to avoid kidney stones?
1. Avoid substances that cause stones (calcium and vitamin D)
2. Hydrate
3. Move around often
60
What population gets kidney stones often? why?
1. Pts with malignancy
| 2. Pts with gout
61
Why are pts with malignancy prone to kidney stones?
They have rapid turnover of cells
62
When kidneys don't work as well as they should
Renal Failure
63
Two types of renal failure
acute vs chronic
64
What lab values are used to differentiate acute vs chronic renal failure?
Labs cannot be used to differentiate b/w the two
65
What can be used to identify acute renal failure?
Oliguria (small amounts of urine) is characteristic of Acute renal failure
66
What can be used to identify chronic renal failure?
1. Pre existing illness (DM, HTN, age, vascular disease)
2. Uremic symptoms
3. Small kidney's by ultrasound
4. Previous record
67
Types of Acute Renal Failure
1. Prerenal
2. Postrenal
3. Intrinsic
68
Acute renal failure caused by transient renal hypoperfusion
Prerenal Acute Renal Failure
69
What causes Prerenal Acute Renal Failure
1. HTN
2. Decreased cardiac output
3. Decreased effective arterial blood volume
70
Acute renal failure caused by obstruction of the urinary tract
Postrenal Acute Renal Failure
71
What are the different types of intrinsic Acute Renal Failure?
1. Acute glomerulonephritis
2. Acute interstitial nephritis
3. Acute tubular necrosis
72
Intrinsic Acute Renal Failure that involves inflammation and damage to the glomular membrane
Acute glomerulonephritis
73
Intrinsic Acute Renal Failure that is an allergic reaction.
Acute interstitial nephritis
74
What causes an allergic reaction in Acute interstitial nephritis?
Can be caused by a variety of drugs
75
Intrinsic Acute Renal Failure that accounts for more than 50% of cases of acute renal failure
Acute tubular necrosis
76
What causes Acute tubular necrosis ?
1. Nephrotoxic agents
| 2. Prolonged renal hypoperfusion
77
“Transient renal hypoperfusion” means what?
before blood gets there
78
What is an example of Prerenal Acute Renal Failure?
1. Someone bleeds from a trauma
2. loses blood
3. blood cant get to kidney
79
Example of nephrotoxins that can cause Acute tubular necrosis?
A lot of antibiotics are nephrotoxic
80
What is an example of a postrenal Acute kidney failure?
A kidneys stone blocking the urinary tract and limiting urinary flow.
81
Pathogenesis of CKD
1. Half nephrons are lost
2. Hyperfiltration occurs
3. RAAS is activated
4. Causes proteinuria
5. Angiotensin 2 and proteins uptake at tubules
6. Causes inflammation and fibrosis of glomerulus and tubules
7. Progressive decline in GFR
8. Systemic complications
82
1. Half nephrons are lost
2. Hyperfiltration occurs
3. RAAS is activated
4. Causes proteinuria
5. Angiotensin 2 and proteins uptake at tubules
6. Causes inflammation and fibrosis of glomerulus and tubules
7. Progressive decline in GFR
8. Systemic complications
Pathogenesis of CKD
83
Stages of CKD
Stage 1-Kidney damage with normal function
Stage 2- Kidney damage mild loss of function
Stage 3- Moderate to severe loss of function
Stage 4- Severe loss of function
Stage 5- Kidney failure need treatment to live
84
% of working kidney function/GFR at each CKD stage
```
Stage 1->90%
Stage 2- 60-89%
Stage 3- 30-59%
Stage 4- 15-29%
Stage 5- <15%
```
85
What should you measure in CKD pts?
GFR
86
Why do we need to know Stages of CKD?
To properly recoup money for procedures for the organization we work for.
87
What does GFR tell you?
Amount of kidney function the pt has
88
Symptoms of Chronic Renal Failure- Renal Insufficiency
1. Headaches
2. Decreased ability to concentrate urine
3. Increased BUN and serum creatinine
4. Edema
5. GFR progressively decreases
6. Mild Anemia
7. Increased Serum K
8. Increased BP
9. Weakness and fatigue
89
1. Headaches
2. Decreased ability to concentrate urine
3. Increased BUN and serum creatinine
4. Edema
5. GFR progressively decreases
6. Mild Anemia
7. Increased Serum K
8. Increased BP
9. Weakness and fatigue
Symptoms of Chronic Renal Failure- Renal Insufficiency
90
Symptoms of Chronic Renal Failure- ESRD
1. Neurological weakness/ Fatigue/confusion
2. Increased BP
3. Pitting Edema
4. Periorbital Edema
5. Increased CVP
6. Pericarditis
7. SOB
8. Depressed cough
9. Thick sputum
10. Ammonia odor breath
11. Metallic taste
12. Mouth/gum ulceration
13. Anorexia
14. N&V
15. Withdrwan
16. Behavior changes
17. Depression
18. Anemia
19. Bleeding tendencies
20. Increased serum K
21. Dry flaky skin
22. Pruritis
23. Ecchymosis
24. Purpura
25. Yellow-grey skin
26. Cramps
27. Renal osteodystrophy
28. Bone pain
91
Pheochromocytoma
1. Kidney tumor on top of adrenal galnds
| 2. Refractory to HTN meds
92
Kidney Trauma Grades
1. Subcapsular Hematoma
2. Laceration <1 cm
3. Laceration >1cm
4. Laceration into collection system, ernal artery injury or blood clot
5. Kidney shattered, avulsion my hilum
