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Patho Chap 4, 22, 23
Stress, Renal & urological disorders
| Question | Answer |
|---|---|
| catecholamines | epinephrine and norepinephrine |
| where are catecholamines released from ? | adrenal medulla by the sympathetic nervous system |
| stages of stress | alarm, resistance, exhaustion |
| neurotransmitters released in resistance stage | serotonin and tryptophan |
| allostatic load | when stress over whelmes the body so much it becomes ill |
| allostatic overload | cumulative stress in addition to poor adaptability -- causes chronic illness |
| HPA AXIS | stress --> hypothalamus (CRH) --> anterior pituitary --> (ACTH in bloodstream) --> (ACTH receptors) --> adrenal gland & kidneys --> cortisol --> rises in blood and created negative feedback |
| what do kidneys do for the body | glucose homeostasis, acid base balance, waste elimination, secretory function, vitamin D synthesis, calcium absorption |
| functional unit of the kidneys | nephrons |
| GFR | tells you the health of the kidney filter |
| normal GFR | 90 -120 mL/ min |
| 3 functions of the nephron | filtration (glomerulus folds), reabsorption (tubules), secretion (collecting duct) |
| blood filtration | blood pressure regulates this process, beginning of urine formation, a process that is used to filter excess fluids waste products, and solutes out of the blood and into the urine collecting tubules to be excreted from the body in urine |
| blood reabsorption | in proximal convoluted tubule, filtrate is reabsorbed back into the capillaries that surrounds the tubules, kidneys asses the need for solutes and water and putting it back in the blood |
| blood secretion | in distal convoluted tubule, filtrate that is not reabsorbed into the blood is delivered to the collecting ducts where it mixes with urea and taken to the bladder where itll be eliminated from body as urine |
| waste products | urea, uric acids, creatinine, and drug metabolites |
| hormones that the kidneys regulate | erythropoietin: creating RBCs |
| how do kidneys get ischemic injury? | sloughing of nephron tubule cels into the nephron lumen --> lumen becomes blocked, kidneys can't filter blood = urosepsis |
| clinical manifestations of kidney issues | abdominal pain, CVT, hematuria, cola colored urine, proteinurea |
| urinalysis | looking at appearance, concentration and content |
| normal UA | 1.005- 1.030 |
| if you see abnormal UA values, what does that mean? | something is wrong with the filter |
| urine culture looks for | bacteria- most be done clean catch or sterile |
| describe BUN | composite of nitrogenous waste that needs to be secreted |
| 4 ways to elevate BUN | decrease in GFR, dehydration, extremely muscular people, high protein diet |
| serum creatinine | kidneys dysfunciton |
| 2 ways to collect serum creatinine | 24 hour urine or blood |
| what is better to measure kidney function .. BUN or serum creatinine | serum creatinine |
| urosepsis | serious complication of UTI |
| uropathy | obstruction of blood flow |
| hematuria | blood in urine |
| azotemia | increase of BUN in blood |
| uremia | urine in the blood |
| creatinine | chemical waste product of creatine/ muscle breakdown |
| intravenous pyelography | injection of contrast material to elevate kidneys, ureter, bladder |
| diuresis | large unconcentrated urine outflow |
| oliguria | low urine out put -- <400 ml/24 hour or < 30ml/ 1 hour |
| vesicoureteral reflex | pee moves backward from bladder to kidney |
| neurogenic bladder | lack bladder control due to a brain or spinal disorder |
| hydronephorosis | urine/ water back up in the kidney |
| hydrourter | water back up in the urter |
| causes of acute kidney injury | abrupt insult to the kidney |
| prerenal injury | comes from a decrease in perfusion of the kidney |
| intrarenal injury | damage to the nephron -- drugs, post streptococcal glomerulonephritis, lupus |
| post renal injury | occurs from the blockage of the flow of urine out of the kidney -- from collecting ducts forward |
| 4 phases of acute kidney injury | initial insult, oliguria, diuresis, recovery |
| acute tubular necrosis | ischemia and hypoxia damage to nephron |
| nephritic syndrome | same as acute glomerulonephritis; it's an infection, primary cause streptococcal |
| how AGN affects glomerulus patho | antigen antibody reaction damaged glomeruli leading to hyper mobility |
| symptoms of AGN | protein loss, facial edema, oliguria, strep infection, dark urine |
| diagnose AGN | high serum creatnine and BUN, UA: protein and WBCS |
| nephrotic syndrome | damage to the glomeruli that causes a massive leakage of protein in the urine (protein is albumin) |
| nephrotic signs/ syndrome | massive albuminiurea, hematuria, hyperlipidemia |
| renal caliculi | kidney stones due to dehydration and high calcium |
| symptoms of renal caliculi | extreme pain, hematuria, crystalluria |
| pyelonephritis | infection in kidney |
| signs/ symptoms of pyelonephritis | flank pain, tenderness, chills, fever |
| UA of pyelonephritis | WBCs in urine, microscopic hematuria |
| polyscistic kidney disease | fluid filled cysts in kidneys -- a genetic autosomal dominant genetic disorder |
| causes of end stage renal disorder or CKD | diabetes mellitus, hypertension, polysistic kidney disorder |
| cystitis | bladder infection |
| signs/ symptoms of cystitis | comes with painful urination and frequency |
| treatment options for ESRD | kidney transplant |
| stage 1 of ERSD | kidney damage with normal or increased GFR (> 90 ml/min) |
| stage 2 of ERSD | mild reduction of GFR (60-89) |
| stage 3 of ERSD | moderate reduction (30-59) symptoms occur, serum CR & BUN increase |
| stage 4 of ERSD | severe reduction in GFR (15-29) |
| stage 5 of ERSD | kidney failure (<15) |
| bladder holds how much urine | 300- 400 mL |
| common causes of urological disorders | UTI, overactive disorder, enlarged prostate, pregnancy |
| most common cause of hydronephrosis | dilation of structures due to obstruction (kidney stone) |
| UTI in women | more common, due to E. Coli, because urethera and anus are so close |
| UTI in men | will be more common at age 60, due to enlargement of prostate |
| causes of hospital acquired UTI | catherization, multi drug resistant pathogens, polymicrobial infection |
| types of urinary incontinence | stress, overactive bladder, overflow incontinence, neurological bladder, functional incontinence |
| risks factors and symptoms of urinary incontinence | age, obesity, stroke, neurological impairement |
| eustress | good stress/ stress that is normal for the body |
| distress | stress that stimulates a person negatively |
| functions of cortisol | metabolize glucose, fat and amino acids to enhance muscle strength, stimulates WBC relrease from bone marrow initially, potent anti inflammatory effects, diminsihes immunity over long term |
| actions of epinephrine | increase HR, BP, vasoconstriction of peripheral arteries and bronchodialation |
Created by:
sammy.e7
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