Chp 22/23 - Renal and Urologic Disorders Pt 2. (slides 20-61)
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| show | It can quickly lead to damage if not caught soon enough.
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| What are the three common signs of AKI? | show 🗑
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| What are the three classifications of AKI and where are they located? | show 🗑
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| show | 1) Prerenal: decreased perfusion, most common!
2) Intrarenal: nephron damage
3) Postrenal: obstruction
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| show | it can lead to severe hypovolemia which reduces blood volume
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| Prolonged renal hypoperfusion is caused by what? | show 🗑
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| show | Acute Tubular Necrosis (ATN) which is damage to the nephron tubule epithelial cells
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| You just found out a patient is experiencing oliguria. He recently came to the hospital for severe hypovolemia and shock. What is directly causing the oliguria? | show 🗑
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| show | When prerenal injury leads to Acute Tubular Necrosis (ATN) then the prerenal injury worsens into an intrarenal injury. If this is not corrected, then the result will be nephron death and renal failure.
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| What is an indication that a patient has oliguria? (lab values) | show 🗑
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| show | 1) Trauma to kidney
2) Infection of kidney
3) Nephrotoxic drugs
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| Give two examples of diseases that cause trauma on the kidney. | show 🗑
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| show | Post-streptococcal glomerulonephritis
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| show | Any drug that reduces inflammation and isn't a steroid
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| show | ACE Inhibitor
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| What other medication can assist ACE Inhibitors in lowering BP? | show 🗑
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| Obstructive uropathy can lead to which AKI classification? | show 🗑
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| What can cause hydronephrosis to develop? | show 🗑
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| show | 1) Initial insult
2) Oliguria
3) Diuresis
4) Recovery
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| show | Initial Insult means that a disruption to the kidney has occurred and resulted in a prerenal, intrarenal, or postrenal condition.
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| Explain the Oliguria stage of AKI. | show 🗑
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| Explain the Diuresis stage of AKI. | show 🗑
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| Explain the Recovery stage of AKI. | show 🗑
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| In which stage does the GFR "reboot"? | show 🗑
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| What is the common cause of acute kidney injury? | show 🗑
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| show | Nephritic Syndrome or Nephritis
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| How does AGN cause damage to the glomerulus? | show 🗑
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| show | Infection, typically from strep (known as post-streptococcal glomerulonephritis or PSGN)
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| show | End Stage Renal Disease (ESRD)
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| show | Hyperpermeability of the glomeruli
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| There are six results of damaged glomeruli caused by AGN. what are they? | show 🗑
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| show | Since the glomerulus is damaged, it can not properly excrete creatinine in the urine, bringing its levels up in the blood. BUN would also be elevated because the GFR has decreased as a result of the glomeruli damage.
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| Would someone with AGN have low or high serum albumin? Why? | show 🗑
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| What would be present in the urinalysis of someone with AGN? | show 🗑
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| What is another way of diagnosing AGN outside of blood and urinalysis testing? | show 🗑
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| What is the main different between nephrotic syndrome and nephritic syndrome? | show 🗑
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| What are the two major signs of nephrotic syndrome? | show 🗑
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| What are the three most common causes of nephrotic syndrome? | show 🗑
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| Along with proteinuria and full body edema, what other symptoms can occur from nephrotic syndrome? | show 🗑
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| show | Hyperlipidemia is a sign of liver damage due to overproduction of albumin. The liver increases its lipid/albumin synthesis to try and compensate for the urinary loss.
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| Why is there full body edema in nephrotic syndrome? | show 🗑
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| show | Lipids are required for the process of making proteins. Since the body is losing albumin rapidly, the liver goes into overdrive to make albumin, which also requires lipids to be made.
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| What are the two types of renal calculi? | show 🗑
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| What do kidneys do to try and stop the formation of kidney stones? | show 🗑
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| Name a few risk factors of renal calculi. | show 🗑
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| Why is hyperparathyroidism a concern for renal calculi formation? | show 🗑
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| What are the four main types of renal calculi? Which one is the most common and which one is the most rare? | show 🗑
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| show | Hypercalcemia
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| What is the cause for struvite renal calculi? | show 🗑
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| show | Magnesium and ammonium phosphate
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| Who is most at risk for a struvite renal calculi? | show 🗑
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| show | 1) A diet high in purines (uric acid)
2) Gout - inflammatory arthritis in the joints caused by the accumulation of uric acid crystals
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| What causes cystine renal calculi to develop? | show 🗑
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| Describe the three types of pain that can occur from urolthiasis. | show 🗑
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| Describe what Renal Colic is. | show 🗑
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| What are three indicators of urolithiasis in the urine? | show 🗑
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| If a kidney stone causes a backup, what condition can that lead to? | show 🗑
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| show | Vomiting, nausea, and a fever
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| What is the most important aspect of diagnosing a kidney stone? | show 🗑
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| This is a type of infection that has not spread into the entire kidney yet, and is caused by an ascending UTI | show 🗑
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| show | Vesicoureteral reflux is when urine is spilling up from the bladder and into the ureters. This can cause stasis of urine or backup of urine.
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| Along with obstruction, vesicoureteral reflux, and pregnancy, what is another factors in developing pyelonephritis? | show 🗑
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| What is a distinguishing symptom between a lower UTI and Pyelonephritis? | show 🗑
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| show | Microscopic hematuria and pyuria (elevation of WBCs)
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| What is the most common cause of Pyelonephritis? | show 🗑
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| show | CECT, CT scan, ultrasound
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| What genetic disorder results in cyst formation and 6-8% of patients on dialysis in the United States? | show 🗑
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| show | Autosomal Dominant PKD (ADPKD)
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| What are the four common symptoms of PKD? | show 🗑
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| How is PKD diagnosed? | show 🗑
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| show | Chronic Renal Failure (CRF)
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| show | ESRD
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| What treatment is needed if CRF progresses to ESRD? | show 🗑
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| What are the four leading causes of CRF? | show 🗑
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| show | five
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| show | [greater than 90 mL/min]
kidney is damaged but has normal or increased GFR
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| show | [60 to 89 mL/min]
mild reduction
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| What is the GFR value for stage 3 CRF and what does this mean for kidney function? | show 🗑
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| show | [15 to 29 mL/min]
severe reduction
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| What is the GFR value for stage 5 CRF and what does this mean for kidney function? | show 🗑
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| Name some complications of CRF. | show 🗑
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| show | blood work, BUN and CR serum levels, renal imaging
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| show | When their GFR is less than 10 to 20 mL/min.
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| show | The extra amount of cells presses on the ureter, causing dysuria and backup of urine.
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| show | Women have much less anatomy separating themselves from the outside than men
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| show | The sympathetic nervous system relaxes the detrusor while tightening the internal sphincter.
The parasympathetic nervous system contracts the detrusor while relaxing the internal sphincter.
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| How much urine does the bladder usually hold and what amount triggers the urge to pee? | show 🗑
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| What is the micturition reflex and what triggers it? | show 🗑
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| show | Obstructive uropathy
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| What is the most common obstruction? | show 🗑
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| show | Benign prostate hyperplasia (BPH)
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| What does prolonged obstruction result in? | show 🗑
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| Is hydronephrosis reversible? | show 🗑
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| show | Hydroureter is the dilation of the ureters due to an obstruction.
Hydronephrosis is the dilation/expansion of the renal pelvis due to obstruction.
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| A proteus infection is more commonly associated with ____________________ or the use of another urinary instrument. | show 🗑
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| Why are lower UTI's most commonly caused by E.coli? | show 🗑
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| Why is diabetes a risk factor for a lower UTI? | show 🗑
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| show | ASB is the presence of bacteria in the urine without any UTI symptoms. This most common cause of ASB is pregnancy.
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| What are the 5 male risk factors for lower UTI? | show 🗑
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| What is CAUTI? | show 🗑
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| Hospital-acquired UTI's are from these three causes: | show 🗑
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| What are the four main symptoms of a lower UTI? | show 🗑
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| What three things in a urinalysis would indicate a UTI? | show 🗑
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| What would the urine culture of a lower UTI produce? | show 🗑
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| show | Urosepsis (UTI spreads to bloodstream)
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| What symptoms does the acute, severe urosepsis produce? | show 🗑
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| What urine culture confirms an ASB diagnosis? | show 🗑
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| show | E.coli
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| What are the five types of urinary incontinences? | show 🗑
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| Which incontinence is due to the loss of strength and elasticity in the detrusor muscle? | show 🗑
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| show | Functional incontinence
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| show | Stress incontinence
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| show | Overactive bladder (OAB)
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| There are many ways to diagnose a urinary incontinence. Which four are most commonly associated with urinary incontinence and no other illness? | show 🗑
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