Renal/Urologic Disorders

Question 1

Doctor that cares for the kidney system

Answer 1

Nephrologist

Question 2

Doctor that cares for the whole kidney system (renal, kidney, nephro)

Answer 2

Urologist

Question 3

One of the most common urologic problems
- due to stones
- enlarged prostates in male (bening prostatic hypertrophy)
- can lead to hydronephrosis and hydroureter

Answer 3

Obstructive urologic disorder

Question 4

• can result from obstruction of urinary pathway
• instrumentation
• infection can ascend up from bladder
• symptoms: fever, chills, and pain, CVA tenderness (pain when palpating area of kidney), frequency, dysuria
• look sick because other body system are affected

Answer 4

Nephritis - infection of kidney

Question 5

• caused: bacteria enters bladder
• common in females since urethra is shorter
• in older men due to BPH
• common bacteria: E. coli, Proteus, Pseudomonas
• more common in diabetes
• can be hospital acquired due to cauterization
• look annoyed and frequent urination

Answer 5

Cystitis - infection of the bladder

Question 6

• involves bladder
• symptoms: dysuria, urgency, frequency, bladder pain, incontinence, hematuria
• findings: pos leukocyte esterase, nitrates, cloudy urine, bacteria in culture

Answer 6

Lower UTI: bladder infection

Question 7

• involves the kidney
• symptoms are systemic: flank pain, chills, malaise
• findings: fever, pos CVA tenderness, pos UA, bacteria in culture

Answer 7

Upper UTI: Pyelonephritis

Question 8

In elderly, UTIs often present with

Answer 8

Confusion, disorientation, and hypotension

Question 9

• arise from UTI/Nephritis > bacteria spread through blood stream and affects the whole body
• seen more often in elderly or those who are physically vulnerable
• symptoms caused by bacterial endotoxins
• fever, chills, confusion, hypotension
• if not treated: death

Answer 9

Urosepsis - septic infection

Question 10

UA findings of:
- bacteria, WBCs (pyuria), hematuria (blood present), leukocyte esterase (WBC products), nitrites (bacteria present)

Answer 10

UTI

Question 11

• inflammation of the bladder not associated with known bacteria
• symptoms similar to UTI/Nephritis, but not associated with bacteria: painful bladder, frequency/urgency
• caused from infections (previous), autoimmunity, neurogenic sensitivity

Answer 11

Interstitial cystitis - painful bladder syndrome

Question 12

Interstitial cystitis that shows small tears and hemorrhages of a thinning bladder wall

Answer 12

Non-ulcerative

Question 13

Interstitial cystitis where bladder shows one or more ulcers (called Hunner ulcers)
- ulcers only seen with over-distention of the bladder

Answer 13

Ulcerative

Question 14

Pelvic floor isn’t stable
- common with women who gave birth
- jumping = bladder leak

Answer 14

Stress - urinary incontinence

Question 15

Muscle in bladder is spastic or overreactive

Answer 15

Urge or overactive bladder (OAB) - urinary incontinence

Question 16

Over lapping of different types of urinary incontinence

Answer 16

Mixed

Question 17

Can’t fully empty the bladder

Answer 17

Overflow - urinary incontinence

Question 18

Caused by spinal cord injury and client isn’t able to hold or release urine

Answer 18

Neurogenic bladder - urinary incontinence

Question 19

Client isn’t taking care of their needs to void, avoiding their bladder

Answer 19

Functional - urinary incontinence

Question 20

What does kidney release

Answer 20

Erythropoietin and VitD

Question 21

Filtration system order

Answer 21

Bowman’s capsule > glomerulus > proximal tube > loop of Henle > distal tubule

Question 22

Blood begins process of filtration, pushed through with force of hydrostatic pressure

Answer 22

Bowman’s capsule

Question 23

Amount of blood filtered by the glomerulus per min - gradually decreases after age 30

Answer 23

Glomerular filtration rate

Question 24

Term indicating filtration system where waste is exchanged and fluid retained or excreted
- body is fine tuning absorption needs and getting rid of waste
- working part of kidney

Answer 24

Nephrons

Question 25

More water is absorbed than electrolytes

Answer 25

Proximal tubule

Question 26

- most water and salt is reabsorbed - where urea (nitrogenous waste) is excreted - levels of urea are measured by BUN

Answer 26

Loop of Henle

Question 27

High BUN

Answer 27

Azotemia

Question 28

More electrolyte absorption than water

Answer 28

Distal tubule

Question 29

- breakdown product of muscle - excreted by kidneys - when blood level increase = kidneys not functioning properly

Answer 29

Blood creatinine

Question 30

- UA - 24 hr test decrease creatinine in urine = decrease in renal function

Answer 30

Urine

Question 31

- breakdown of purine - increased levels = poor kidney function

Answer 31

Uric acid

Question 32

- amount of blood filtered by the glomerulus per minute - decreased GFR = decrease renal function

Answer 32

GFR

Question 33

- urea is waste product - blood level increases = decrease renal function

Answer 33

BUN

Question 34

- increase blood creatinine - decrease creatinine in urine - increase uric acid - decrease GFR - increase BUN

Answer 34

Renal function decreased and not functioning properly

Question 35

Protein in urine

Answer 35

Proteinuria - protein shouldn't be there

Question 36

- caused by calcium struvite (caused by upper UTI), uric acid, and cystine - severe pain from the costovertebral angel of back to abdomen and lower groin

Answer 36

Nephrolithiasis

Question 37

- formation of stone (calculi) in the kidney - risk for developing: dehydration, hypercalcemia, hyperparathyroidism (release more calcium), gout (precipitation of uric acid), high purine intake (can't process uric acid) - deep visceral pain

Answer 37

Nephrolithiasis

Question 38

Can lead to obstruction, back up of urine in kidney (hydronephrosis), edema in renal pelvis, restricted blood flow, compression of kidney tissue, ischemia, and renal failure

Answer 38

Nephrolithiasis

Question 39

- caused: glomerulonephritis, diabetes, autoimmune - patho: endothelia cell and basement membrane damage leading to loss of protein (albumin), leading to edema because of decrease oncotic pressure - clinical presentation: albuminuria, low blood albumin level, edema - decrease albumin = dec fluid into vascular = fluid moves to tissues = edema

Answer 39

Nephrotic syndrome

Question 40

Abrupt insult to the kidney that leads to rapid decrease in renal filtration and an accumulation of nitrogenous waste in body - can lead to end stage renal disease

Answer 40

Acute kidney injury

Question 41

3 major causes od AKI

Answer 41

pre, intra, and post renal

Question 42

- issue happens before kidney - sudden and severe drop in BP or interruption of blood flow to the kidneys from severe injury or illness - affect perfusion to kidney

Answer 42

Prerenal

Question 43

Direct damage to the kidneys by inflammation, toxins, drugs, infection, or reduced blood flow

Answer 43

Intrarenal

Question 44

- urine back flows to kidney, and kidneys don't like urine - sudden obstruction of urine flow due to enlarged prostate, kidney stones, bladder tumor, or injury

Answer 44

Postrenal