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Flashcards in TEST 3 Deck (129):
1

rate at which a substance is excreted in the urine

renal clearance measures

2

glomerular filtration rate is measures

the volume of plasma that is filtered each minute

3

what tells you when a patient is in renal failure

GFR- glomerular filration rate

4

GFR normal kidneys

anything 60 or above

5

GFR kidney disease

15-60

6

GFR kidney failure

15 or less

7

what does blood urea nitrogen BUN tell you

dehydration- the higher the number the more dehydrated the patient is

8

what does this serum creatinine tell you

how the kidney is functioning/filtering

9

wastes product from muscles

creatinine

10

comes from protein breakdown

urea

11

ratio of bun to creatinine

10:1

12

why should protein not be in the urine

protein is a big substance so for it to be filtered that means there is something wrong with the filtration rate

13

proteinuria

protein in the urine

14

osmolarity and specific gravity

tells you about particles whether the solutes in the urine are concentrated or not ; anything greater than 1.10

15

higher the specific gravity in a urine test

more dehydrated ; higher the number the more solutes than water

16

antidiuretic hormone

doesn't let you diurease ; not pee; against the release of water

17

normal pH of urine

4.5-8

18

complete absence of development of one or both kidneys (unilateral RA or bilateral RA respectively

renal agenesis

19

renal agenesis is a change in what gene

Pax2 gene- mutation

20

renal agenesis is an autosomal

dominant

21

most life threatening component of potter syndrome is

pulmonary hypoplasia; lungs not forming

22

The kidneys are small in size and have less than the normal number of calyces and nephrons

renal hypoplasia

23

Common cause for pediatric renal failure and adult onset disease

renal hypoplasia

24

enlargement of the kidney. urine collects in the infected kidney so it forms fluid like sacs

multicystic dysplastic kidney disorder

25

first thing they see in a child with multi cystic dysplastic kidney disorder is a

palpable abdomen

26

if you know they have a wilms tumor you never want to what

palpate

27

children who survive MDKD are at more risk for

hypertension and wilms tumor

28

Most common of all inherited kidney disease

Autosomal Dominant Polycystic Kidney Disease (ADPKD)

29

ADPKD manifestations

progress is slow and chronic kidney disease is uncommon before 40; hypertension (RAAS), hematuria, kidney stones; flank pain

30

characterized by cystic dilation of the cortical and medullary collecting tubules

autosomal recessive polycystic kidney disease

31

what causes the autosomal recessive polycystic kidney disease

mutation in the PKHD1 gene

32

manifestations of autosomal recessive polycystic kidney disease

excessive urine, hypertension, enlarged spleen w low rbc and high wbc/platelets, breathing problems

33

fluid-filled sacs (cysts) develop deep within the kidneys, leading to chronic kidney disease with kidney failure.

medullary cystic kidney disease / nephronophthisis

34

who does medullary cystic kidney disease affect

children

35

Excessive thirst and abnormal urine starts in which ?

nephronophthisis

36

what happens with adolescence with medullary cystic kidney disease

turns into autosomal dominant tubulointerstitial kidney disease

37

What is the main concern with Simple and Acquired Renal Cyst

differentiate them from malignancies

38

an inflammatory response in the glomeruli of the kidney

Acute Nephritic Syndrome

39

what is the most causative organism for acute nephritic syndrome

Group-A beta-hemolytic streptococci

40

what does the glomerulus do

filters waste product from the blood

41

how do you diagnose a person with acute nephritic syndrome

serum test, urinalysis

42

manifestations of acute nephritic syndrome

sudden onset of hematuria, coke urine, oliguria, diminished GFR

43

less than 400 ml in a 24 hour period

oliguria

44

how much urine per hour

30 ml per hour

45

What is the best treatment option for an individual with acute nephritic syndrome?

antibiotics
Provide supportive care

46

mishaping of the monocytes and macrophages

Rapidly Progressive Glomerulonephritis

47

manifestations for Rapidly Progressive Glomerulonephritis

progress rapidly 3 mo, weak immune system

48

Why would plasmapheresis be beneficial for the Rapidly Progressive Glomerulonephritis patient?

a process that filters the blood and removes harmful antibodies; immunosuppressed so dont have anything to fight off

49

What organs does Goodpasture syndrome affect?

basement membrane; lungs and kidneys

50

#1 risk factors for good pasture

smoking

51

an increase in the glomerular permeability causing albumins (plasma proteins) to be excreted in the urine.

nephrotic syndrome

52

damages clusters of small blood vessels; lose filtration, waste, and excess water

nephrotic syndrome

53

manifestations of nephrotic syndrome

massive proteinuria, dyspnea, lipiduria, Hypoalbuminemia, Pleural effusion, Hyperlipidemia

54

hallmark sign of nephrotic syndrome

generalized edema happens due to decrease in plasma proteins

55

edema in nephrotic syndrome usually begins where

lower extremities. as it worsens it becomes more generalized

56

why would you give diuretic for nephrotic syndrome

removes excess fluid

57

diuretic that would help in lope of henle

lasix

58

treatment of nephrotic syndrome

diuretic, statin, pril, beta-blocker slide56

59

difference between nephritic and nephrotic

nephrotic you are losing large amounts of protein

60

frothy urine means what

spilling proteins

61

All persons with systemic lupus Erythematous Glomerulonephritis should undergo routine urinalysis to monitor for

hematurina and proteinuria

62

first signs of systemic lupus erythematous glomerulonephritis is

in the urine test

63

Renal disease affecting the tubules, interstitium, and pelvis of the kidney

acute pyelonephritis

64

two types of pyelonephritis

acute-bacterial
chronic-couldve been bacterial followed by viral

65

ascending infection

pyelonephritis

66

causative organism of acute pyelonephritis

e. coli

67

main clinical manifestation of acute pyelonephritis

malaise, moderate to high fever, nausea/vomitting, Painful palpation over the on the infected side (CVA), pyuria

68

how to stop pyelonephritis

teach girls to wipe back to front

69

Painful palpation over the on the infected side

costovertebral angle

70

positive CVA (painful) what does it indicate

pyelonephritis

71

The common factors in acute uncomplicated pyelonephritis included

healthy young women; no structural problems, lack of structural and urinary tract obstructions, lack of predisposing medical conditions

72

acute complicated pyelonephritis

children or adults with structural defects

73

most common cause of upper urinary tract obstruction

kidney stones ; urinary calculi

74

-acute, intermittent, excruciating
-stones 1 to 5 mm
-causes stretch of collecting system or ureter
-skin cool and clammy

renal colic pain- kidney stones

75

-dull, deep, aches in back
-stones produce distention of renal calyces or renal pelvis
-intensity of pain varies from mild to severe
-pain exaggerated by drinking large amounts of water

renal noncolicky pain-kidney stones

76

#1 causative factor of a kidney stone

calcium oxalate

77

lithotripsy

crushing of the kidney stones by shock sound waves

78

4 types of kidney stones

magnesium ammonium phosphate
uric acid
cystine stones
calcium

79

The rapid loss of kidney function from renal cell damage

acute kidney injury

80

acute kidney injury can be

reversible but has high mortality rate

81

prerenal acute kidney injury

Hypovolemia
Decreased cardiac output
Decreased peripheral vascular resistance
Decreased renovascular blood flow

82

intrarenal

Nephrotoxic injury
Interstitial nephritis
all diseases that are discussed

83

postrenal

BPH-benign prostatic hypertrophy
Bladder Cancer
Prostate Cancer
Calculi
Neuromuscular disorders
Spinal cord disease
Strictures
Trauma
slide 87

84

outflow problem

postrenal

85

use NSAIDS with caution why

aleve. ibuprofen are metabolized in the kidney.

86

which ones can be resolved

pre and postrenal ; internal is a longer recovery

87

Patients with AKI progress through phases

oliguric, diuretic, and recovery

88

AKI labs

proteinura and hematuria, cbc (4-12), serum increases creatinine , BUN

89

urine in the blood

uremia

90

signs of uremia

epistaxis, frost, red eye

91

classification staging for acute kidney injury

RIFLE; Risk
injury
failure
loss
ESKD

92

peaked T wave means

hyperkalemia

93

U wave means

hypocalcemia

94

AKI you should monitor which electrolyte

K+

95

treating hyperkalemia

Dietary restriction- limit intake to 40 mEq day of potassium rich foods and drink

96

give insulin to hyperkalemia why

potassium follows glucose back into rbc

97

hyperkalemia can cause

muscle cramps, EKG changes, oliguria, drowsiness, abdominal cramping

98

more susceptible to aki

elders;dehydrated, hypotensive, heart problems

99

nephrotoxic medications

Aminoglycosides- MYSIN
Amphotericin B
NSAIDs
ACE inhibitors
ARBs
IV contrast dye

100

nephrotoxic medications

Aminoglycosides- MYCIN
Amphotericin B
NSAIDs
ACE inhibitors
ARBs
IV contrast dye

101

two major side effects of aminoglycosides

ototoxicity and nephrotoxicity - IRREVERSIBLE

102

vancomyin side effect

infusing it too fast and they turn red

103

foods high in potassium

avocado
banana
potatoes
spinach
beans
citrus juices
fish

104

foods high in phosphorus

meat
fast food
cheese
seeds
milk
canned foods
cola

105

serious syndrome due to a direct or indirect muscle injury. It results from the death of muscle fibers and release of their contents into the bloodstream.

rhabdomyolysis

106

a hormone secreted by the kidneys that increases the rate of production of red blood cells in response to falling levels of oxygen in the tissues.

Erythropoietin

107

which genes are infected in autosomal dominant polycystic kidney disease

PKD1 and PKD2

108

Excessive thirst and urination start in childhood or adolescence for and in adolescence or adulthood for autosomal dominant tubulointerstitial kidney disease.

Nephronophthisis

109

gene problem for Nephronophthisis

NPHP

110

why would plasmapheresis be a treatment for rapid progressive glomerulonephritis

gets rid of toxins and antigens; macrophages become misshaped so this gets rid of them

111

treatments for rapid progressive glomerulonephritis

plasma
transplant
dialysis

112

treatments for nephrotic syndrome

Diuretic- remove excess fluid (edema)
”-statin”- treat hyperlipidemia
Ace-Inhibitor “-pril”- lower BP & restrict adrenal cortex from secreting aldosterone
Low sodium diet
Beta-Blocker- lower BP (decrease filtration rate)

113

blood is filtered through the

glomerulus of the kidney

114

treatment for lupus

oral corticosteriods
ace I
immunosuppressives

115

someone with SLE should get what test first

urine analysis

116

gene problems in medially cystic kd

MCKD1 and 2

117

3 main symptoms for nephron and medullary cystic kidney

polyuria, polydipsia, enuresis (bed wetting); treat with desmopressin

118

hallmark sign for pyelonephritis

significant malaise

119

is acute tubular necrosis reversible

yes if caught early enough

120

LES is suppose to relax and when it doesn’t its called

achalasia

121

hallmark sign for gerd

barrett cells

122

food relieves pain in

duodenal ulcers

123

food does not relieve pain in

gastric ulcers

124

ulcerative colitis eventually turns into

cancer

125

Carbohydrate metabolism glycogenesis, glycogenolysis

Protein metabolism-synthesis of nonessential amino acids, clotting factors, urea formation

Fat metabolism-synthesis of lipoproteins, synthesis of fatty acids, breakdown of cholesterol

Detoxification drugs/harmful substances

liver

126

what phase does distaste of smoking in hep happen

prodomal; first stage

127

treatment for fulminant hep

supportive care and liver transplant

128

triad for acute cholecystitis

constant pain in URQ
tenderness in URQ
inflammatory response

129

Rhabdomyolysis- triad

darkened ua(coke colored urine), myalgia (muscle aches), weakness