Term
| For the kidney to function normally what 3 things must occur? |
|
Definition
1. Adequate blood flow thru the glomerular capillaries
2. The capillaries must be intact and filter only fluids and small STs (no protein/blood cells)
3. Tubules must be able to reabsorb essential substances from the filtrate while excreting others into the filtrate to be eliminated |
|
|
Term
|
Definition
| A condition in which the kidneys FAIL TO REMOVE the METABOLIC END PRODUCTS from the blood and to REGULATE FLUID, electrolyte and pH balance of the extracellular fluids. |
|
|
Term
| What are the underlying causes for renal failure? |
|
Definition
1. renal disease
2. Systemic disease such as Hypertension/diabetes (this accounts for 2/3 of cases) |
|
|
Term
| Renal disease can be categorized as _____________ or ____________. |
|
Definition
|
|
Term
| T/F: Chronic renal disease is progressive, slow development of renal failure and occurs over the course of the years. Because it can affect any portion of the kidney it is hard to determine the original cause as it progresses because it will all eventually become destroyed/scarred. |
|
Definition
True
(sorry guys, sometimes I just write the notecards just to make sure you got it, even tho it may seem like a duh!!) |
|
|
Term
| Diseases that primarily involve the glomerulus are called |
|
Definition
|
|
Term
| Diseases involved primarily with the renal tubules are called |
|
Definition
Pyelonephritis and
Polycyystic kidney disease |
|
|
Term
| Diseases that interfere with blood perfusion to the renal paraenchyma is called |
|
Definition
|
|
Term
| Many of chronic renal diseases are not ______________. |
|
Definition
|
|
Term
| What is acute renal failure? |
|
Definition
| A rapid decline in kidney function, resulting in an inability to maintain fluid and electrolyte homeostasis and failure to excrete nitrogenous wastes. |
|
|
Term
| What 2 things characterizes an ARF? |
|
Definition
1. Sudden drop in urine output
2. Fall in GFR |
|
|
Term
|
Definition
| A decline in urine output |
|
|
Term
| ARF is considered to be _________ unlike chronic. |
|
Definition
|
|
Term
| Dysfunction for ARF can be pre-renal (_____________), Post-renal (_____________) or renal (______________). |
|
Definition
Blood flow
Obstruction
Acute Tubular necrosis (ATN) |
|
|
Term
| What happens to the GFR as we age? |
|
Definition
| It decreases which makes the elderly more susceptible to ARF. |
|
|
Term
| ARF is most common in what kind of patients? |
|
Definition
| Seriously ill patients in ICU |
|
|
Term
| What is a common indicator of ARF? |
|
Definition
|
|
Term
|
Definition
| Refers to the retention of N2 wastes, either thru the inability of the kidney to excrete them or thru their failure to be delivered to the kidney |
|
|
Term
| Azotemia is reflected by an increase in _______________. |
|
Definition
|
|
Term
|
Definition
| A complex SYNDROME characterized by many changes that occurs when AZOTEMIA BECOMES SYMPTOMATIC- IT AFFECTS ALL ORGANS. |
|
|
Term
| What kind of changes can occur during Uremia? |
|
Definition
1. Volume
2. Electrolyte
3. Acid base
4. Endocrine |
|
|
Term
| Chronic kidney disease (CKD) accounts for 26 million/ 90,000 deaths a year. What is the leading cause? |
|
Definition
| Diabetes Mellitus and Hypertension |
|
|
Term
| ARF in ICU condition affects ______ of all hospitalized patients with a mortality rate of > ______. |
|
Definition
|
|
Term
| T/F: 5 million Americans suffer from kidney stones. Most of them are aged btwn 20-40 yo. |
|
Definition
| False; its about 1 million |
|
|
Term
| Rapidly progressing Glomerulonephritis is aka |
|
Definition
|
|
Term
| Before significant functional impairment of the kidneys is seen, as much as ________ of the nephrons must be destroyed. |
|
Definition
|
|
Term
| Renal dysfunction is ___________ until > 60% of renal function is lost. |
|
Definition
|
|
Term
| Above what amount of protein in the urine would be considered a problem? |
|
Definition
> 150 mg/dg
(Proteinuria) |
|
|
Term
| Simple dipstick test is aka |
|
Definition
|
|
Term
| Proteinuria is suggestive of a __________ |
|
Definition
|
|
Term
|
Definition
Blood in the urine
It is suggestive of a LOWER URINARY TRACT DISEASE or renal disease |
|
|
Term
|
Definition
4.5- 8
(it varies thruout the day) |
|
|
Term
| The pH is ______ after a meal, ______ during sleep and __________ with fever. |
|
Definition
Higher due to alkaline tide
Decreased due to hypoventilation
Decreased due to metabolic acidosis |
|
|
Term
If you have an acidic pH indicates _____________
If you have an alkaline pH indicates ____________ also suggestive for ____________. |
|
Definition
Uric Acid in gout
PO4 stones; UTI |
|
|
Term
| The usual range of specific gravity for urine is between 1.010 to 1.025; if dehydrated it can concentrate to ________. |
|
Definition
|
|
Term
| In CKD, the kidney lose the ability to _________ first and then lose the aiblity to ____________. |
|
Definition
Concentrate the urine
Dilute the urine |
|
|
Term
|
Definition
| Having to pee alot of times and indicates a tubular dysfunction |
|
|
Term
| GFR measures amount of functional renal tissue. What is the normal GFR? |
|
Definition
115-125 mL/min
(decreases with age) |
|
|
Term
| What is the best way to measure GFR? |
|
Definition
1. Inulin clearance test
2. Creatinine clearance test
3. BUN |
|
|
Term
| Creatinine is ____________, not _________ and not ___________. |
|
Definition
Filterd
Secreted
Reabsorbed |
|
|
Term
| As GFR decreases, BUN will _____________. |
|
Definition
|
|
Term
|
Definition
| Para-aminohippurate; it is filtered and excreted 92+% cleared on first pass and is a good estimate of renal plasma flow |
|
|
Term
| What are some tubular function tests? |
|
Definition
1. PAH excretion
2. Concentration and dilute tests
3. Na+ concentration test
4. Urine acidification test |
|
|
Term
|
Definition
Classified according to shape and is constituents are MUCOPROTEIN MATRIX with cells and debris
"moldings of the tubules" |
|
|
Term
| What are the different types of CAST you can have? |
|
Definition
1. Hyaline
2. RBC
3. WBC
4. Fatty
5. Broad, Granular |
|
|
Term
| Hyaline CAST is ______________. |
|
Definition
| Devoid of cells- clear cylinders of protein |
|
|
Term
| CAST of RBC leaking are a _____________ dysfunction. |
|
Definition
|
|
Term
| WBC is indicative of an infection and is often seen in ___________________ |
|
Definition
|
|
Term
| Fatty CASTS indicate ____________ syndrome |
|
Definition
|
|
Term
| Broad, Granular CASTS contain dead cells and are formed in __________- and are typical of ______________. |
|
Definition
Collecting Ducts
End Stage Renal Failure (ESRF) |
|
|
Term
| ___________________ is used to take x-rays in order to visualize the cortex of the kidney. |
|
Definition
| Intravenous Pyelogram (IVP) |
|
|
Term
| If the cortex is thin when given an IVP then it indicates _____________________ |
|
Definition
|
|
Term
| If cortex has moth-eaten appearance during IVP then it indicates _________________. |
|
Definition
| Pyelonephritis and ischemia |
|
|
Term
| With a retrograde pyelogram a _______________is advanced up the ___________. Or a contrast media is injected into the _____________. |
|
Definition
Catheter; ureter
Renal pelvis |
|
|
Term
| With a renal angiography a catheter advances via the ___________ to the level of the ___________. |
|
Definition
| Femoral artery; renal artery |
|
|
Term
| A renal angiography will determine _______________, presence of neoplasms, and arrangement of arteries and veins. |
|
Definition
|
|
Term
| This kind of ARF is due to an abnormal renal blood flow or myocardial dysfunction. |
|
Definition
|
|
Term
| This type of ARF is due to parenchymal injury(intrinsic). |
|
Definition
|
|
Term
| This type of ARF occurs with some type of tubular obstruction that interferes with elimination of urine from the kidney. |
|
Definition
|
|
Term
| __________% of ARF cases are pre-renal or renal |
|
Definition
|
|
Term
| ARF is usually manifested by a fall in urine output to less than __________. And the syndrome is characterzied by a sudden _____________ in GFR. |
|
Definition
|
|
Term
| Broad categories of causes of ARF are ____________ and __________. |
|
Definition
| Ischemic; Nephrotoxic injury |
|
|
Term
| If you have a pressure < ________ then you get severe volume depletion because autoregulation no longer works. |
|
Definition
|
|
Term
| What happens when you lose volume to make a pre-renal state? |
|
Definition
| The loss of volume causes the vessels to constrict which lowers the renal blood flow and GFR. |
|
|
Term
| What is volume shift and what can do this? |
|
Definition
| When fluid is taken out of the extracellular spaces to decrease in vascular filling. Vasodilating drugs can distribute the volume throughout the body so less is at the kidneys. |
|
|
Term
| The normal BUN:creatinine is __________ but with ARF it is closer to ____________. |
|
Definition
|
|
Term
|
Definition
| When the liver no longer makes proteins or aka hypoproteinemia. |
|
|
Term
| The tubular response of ARF is to conserve ______________ and thus reduce ___________. |
|
Definition
Water and Salt
Urine Volume |
|
|
Term
| Oliguria is due to low ____________ we know this because of the low excretion of Na+. |
|
Definition
|
|
Term
| What are some expected signs of patients with oliguria? |
|
Definition
1. Dry mucosal membranes
2. Poor skin turgor
3. Rapid pulse
4. Low B.P. |
|
|
Term
| Why would you want to avoid using NSAIDs if you have ARF? |
|
Definition
| Because they inhibit PG synthesis--which are vasodilators so the ischemia is potentiated and the prognosis worsened |
|
|
Term
| What are some potential causes of pre-renal conditions leading to ARF? |
|
Definition
1. Hypovolemia
2. Decreased vascular filling
3. Heart failure and cardiogenic shock
4. Decreased renal perfusion due to vasoactive mediators, drugs or diagnostic agents |
|
|
Term
| What is the most common underlying problem in men with post renal ARF? |
|
Definition
|
|
Term
| In post-renal ARF, if you have complete obstruction of both kidneys you get _____________ or ___________. If you have a partial obstruction then you get ______________. |
|
Definition
Oliguria; anuria
Polyuria |
|
|
Term
| Which category of ARF will have a normal urinalysis? |
|
Definition
Post-renal
(most difficult to diagnose) |
|
|
Term
| What is the treatment for post renal ARF and what does it result when relieved? |
|
Definition
Treatment is to relieve the obstruction
Causes Post-obstructive diuresis |
|
|
Term
| Why does post-obstrucitve diuresis occur upon relief of post-renal ARF? |
|
Definition
| Because there is a buildup of urea and other metabolites, and salt and water. A profound polyuria may last a few hrs or a few days. |
|
|
Term
| T/F: Renal Parenchymal Diease is caused by a varitey of mecahims that damge structures within the kidney (glomerular, tubular, or interstitial) |
|
Definition
|
|
Term
| If blood flow is reduced or blocked for over 40 mins what can result? |
|
Definition
|
|
Term
| ____________% of the cases of renal ARF fall into the category of ____________. |
|
Definition
|
|
Term
| Tubular damage triggers _______________ of preglomerular arterioles to ____________ GFR via the RAS. |
|
Definition
Vasoconstriction
Decrease |
|
|
Term
| ATN is defined as ___________potentially reversible, decrease in renal function following _________ or ____________ injury to the kidneys. |
|
Definition
|
|
Term
| ATN is characterized by destruction of ________________ with acute suppresion of renal function. |
|
Definition
|
|
Term
| What are some characteristics of ATN? |
|
Definition
1. decrease in GFR
2. Decrease in reabsorbtion by the kidney
3. BUN and creatinine is increased
4. Reduced ability to [M+] the ruine
5. Urine has epithelial casts reflectin necrosis and sloughin |
|
|
Term
| With ATN the plasma Na+ is _______________ whereas that of K+ is _______________. |
|
Definition
|
|
Term
| T/F: GFR will improve with restoration of RBF in ARF caused by ATN. |
|
Definition
| False; it will not improve cause the problems is with the tubules itself. |
|
|
Term
| What are some causes for ATN? |
|
Definition
1. Nephrotoxic drugs
2. Pre-existing renal disease
3. Systemic diseases
4. Obstruction
5. De-novo occurences |
|
|
Term
| Both ____________ and _______________ accumulate int he proximal tubules and can lead to ATN. |
|
Definition
|
|
Term
|
Definition
| Disintegration of muscle associated with increase excretion of myoglobin in urine if extensive and intense physical exertion. |
|
|
Term
| With ischemic injury that leads to ATN, the ____________________ is disrupted and regeneration is therby impaired and incomplete. |
|
Definition
|
|
Term
| What are the 4 theories that cause ATN? |
|
Definition
1. Reduced RBF
2. Obstruction of tubular lumen
3. Back leakage
4. Reduced GFR |
|
|
Term
| What are the 3 phases in the clinical course of ATN? |
|
Definition
1. Initiation phase
2. Maintenance phase
3. Recovery phase |
|
|
Term
| What occurs during the initiation phase of ATN? |
|
Definition
Oliguria is present within 24-48 hrs after injury
Azotemia accompanies oliguria
Symptoms do not appear till days after exposure to nephrotoxic chemical |
|
|
Term
| What type of effects does Gentamycin have in ATN? |
|
Definition
Tubular toxic effects
Diuretic effects- which decreases volume and further exacerbates the toxicity |
|
|
Term
| How do you distinguish ATN from pre-renal oliguria? |
|
Definition
In pre-renal the BUN: creatinine >20:1
In ATN BUN:Creatinine < 10:1 |
|
|
Term
| Pre-renal urine is ____________. Urine to plasma osmolarity is >2:1 this progresses to 1:1 in ATN. |
|
Definition
|
|
Term
| The maintenance phase of ATN is characterized by: |
|
Definition
1. Decrease in GFR
2. fluid retention
3. if prolonged can lead to hypertension
4. If untreated can lead to neurological manifestations |
|
|
Term
| What occurs during the recovery phase of ATN? |
|
Definition
1. Gradual increase in urine output and fall in serum creatinine.
2. Diuresis can occur |
|
|
Term
| T/F: If you have basement membrane damage and scarring it can still regenerate. |
|
Definition
| False; it is gone and can lead to some premanent lose of tubular function. |
|
|
Term
| CKD represents decline in kidney function due to ________________. |
|
Definition
| Permanent loss of nephrons |
|
|
Term
| How many stages of kidney diesease that are based on GFR (mL/min/1.73m2)? |
|
Definition
|
|
Term
| List the different GFR values for all 5 stages. |
|
Definition
Stage1 = > 90
Stage2 = 60-89
Stage3 =30-59
Stage4 = 15-29
Stage 5 = < 15 |
|
|
Term
| T/F: Stages 1 and 2 of CKD usually not associated with any symptoms arising from the decrement in GFR. |
|
Definition
|
|
Term
| As you progress to the more later stages of CKD which complications are most evident? |
|
Definition
1. Anemia
2. Decreased appetite
3. Abnormalities in ionic, water and acid base |
|
|
Term
| What happens if you progress to stage 5 of CKD? |
|
Definition
| Toxins build up and leads to UREMIC SYNDROME |
|
|
Term
| CKD is defined as either ___________ or a GFR less than 60 for ___________. |
|
Definition
Kidney damage
3 months or longer |
|
|
Term
|
Definition
| GFR less than 15 with signs and symptoms of uremia or condition that requires need for replacement (transplate/dialysis) |
|
|
Term
| ESRD indicates that the person is being treated with ______________ and ____________. |
|
Definition
|
|
Term
| Why cant we see symptoms for CKD until it is more advanced? |
|
Definition
| Because the kidney ADAPTS and nephrons ability to HYPERTROPHY in attempt to maintain renal function |
|
|
Term
| What is the FUNCTIONAL RESERVE? |
|
Definition
| As much as 90% of the nephrons may be destroyed before significant functional impairment is seen |
|
|
Term
| What are the 2 mechanisms of damage of CKD? |
|
Definition
1. Initiating
2. Progressive |
|
|
Term
| T/F: Mean GFR is lower in men in than woman |
|
Definition
| False; it is lower in women |
|
|
Term
| GFR declines with age. What is the GFR at its peak at age 30? What about at 70? |
|
Definition
~120 mL/min per 1.73 m2
(drops 1mL/min per year per 1.73m2)
At 70 = 70mL/min per 1.73 m2 |
|
|
Term
| The measurement of ________________ is helpful for monitoring nephron injury and the response to therapy in many CKD forms. |
|
Definition
|
|
Term
| What are the major categories of CKD? |
|
Definition
Glomerulonephritis
Pyelonephritis |
|
|
Term
| In the early stages of Tubulointersitial Disorder (of CKD) you get manifestation of fluid and electrolyte imbalances. What could you expect to see? |
|
Definition
1. inability to cocentrate urine
2. Polyuria
3. Nocturia
4. Metabolic acidosis
5. Diminished Na+ tubular reabsorption |
|
|
Term
| Pyelonephritis is an infection of kidney _________________ and _______________. |
|
Definition
|
|
Term
| Acute Pyelonephritis represents infection of ________________. |
|
Definition
Upper urinary tract
(gram -) |
|
|
Term
| Chronic Pyelonephritis leads to a loss of tubular function. With that you get ________________. |
|
Definition
|
|
Term
| What % of Chronic Pyelonephritis is responsible for ESRD? |
|
Definition
|
|
Term
| Drug related nephropathies are those that damage the kidney by: |
|
Definition
1. Decreasing RBF
2. Obstructing urine flow
3. Damaging the tubulointerstitial structure
4. Producingg hypersensitivity rxns |
|
|
Term
| What type of drugs can reduce RBF and how? |
|
Definition
| NSAIDs, by inhibiting PG. |
|
|
Term
| How does an inflammatory response cause glomerulonephritis? |
|
Definition
1. Damage to capillary wall
2. Permins RBC/proteins to escape into the urine
3. Produces hemodynamic changes that decrease the GFR |
|
|
Term
| What is the major cause of glomerulonephritis? |
|
Definition
|
|
Term
| Glomerular antibodies are Ab against _____________ and usually form a _____________ pattern. Give an example. |
|
Definition
Glomerular basement membrane
Linear
Goodpastures----- Ab(IgG) |
|
|
Term
| Circulating Ag-Ab complexes have what kind of pattern? What typeo f injury is this? Give an example. |
|
Definition
Granular
Type 3 Hypersensitivity
Lupus |
|
|
Term
| Most glomerular disease produce mixed _________________ and ____________ syndromes so may require ______________ for a definitive diagnosis. |
|
Definition
Nephrotic; nephritic
Renal biopsy |
|
|
Term
| NEPHROTIC syndromes are disease of the ____________________. |
|
Definition
| Glomerular Basement Membrane (GBM) |
|
|
Term
| What are some characteristics of Nephrotic syndrome? |
|
Definition
1. Increased permeability to PLASMA PROTEINS
2. Generalized EDEMA
3. Decrease in colloid osmotic pressure
(+ feedback leads to more edema)\
4. HYPOABULINEMIA
5. massive PROTEINURIA > 3.5 gm/day
6. HYPERLIPIDURIA
(Increase risk for atherosclerosis) |
|
|
Term
| What are the 3 different types of Nephrotic Syndrome? |
|
Definition
1. Miminal change glomerulonephritis
2. Membraneous glomerulonephritis
3. Focal Segmental glomerulosclerosis |
|
|
Term
| Minimal chagne glomerulophritis is most common in ____________and has a good response to ______________. There is also a selective protein loss since lose the ___________ charge. |
|
Definition
children
steroid treatment (80% success)
Electronegative |
|
|
Term
| Membraneous glomerulonephritis is most common in _______________ and is caused by diffused _________________ due to ________________ deposition. |
|
Definition
Adults
Thickening of GBM
Immune Complexes |
|
|
Term
| T/F: Membraneous glomerulonephritis have non selective protein loss but responds to steriods well. |
|
Definition
| False; yes to the first part , but only 1 in 1000 respond to steroid treatment. |
|
|
Term
| Focal Segmental glomerulosclerosis is most common in _______________ and usually has the prescence of ________________. Can be treated with steroids. |
|
Definition
Hispanic and Africans
Hypertension |
|
|
Term
| Nephritic Syndrome is usually characterized by sudden onset of _______________, and ___________. |
|
Definition
|
|
Term
| An early symptom of CKD is _____________ with urine that is isotonic with plasma. |
|
Definition
|
|
Term
| In CKD you have a ________________ Na+ excretion and a _____________ K+ excretion. |
|
Definition
|
|
Term
| As kidney functions declines, mechanisms become impaired and you can develop _______________. |
|
Definition
|
|
Term
| How many people with stage 3 CKD are anemic? |
|
Definition
|
|
Term
| ______________________ is a hormone that stimulates the production of RBCs. |
|
Definition
|
|
Term
| What are some things that anemai can cause? |
|
Definition
1. Decrease in blood viscosity
2. Increase in HR
3. Limits myocardial O2 supply, predisposing to ischemic events |
|
|
Term
| What is the major cause of death in patients with CDK? |
|
Definition
|
|
Term
| Why do you have disorders of Ca2+ and PO4 with CKD? |
|
Definition
| PO4 excretion is impaired, so serum PO4 rises which causes serum Ca2+ to fall. this activates PTH release to increase Ca2+ |
|
|
Term
| What is the activated Vit. D form called and what does it suppress? |
|
Definition
|
|
Term
| People with CKD can develop secondary ____________________________ and why. |
|
Definition
Hyperparathyriodism
Because as 1, 25 levels fall, this impairs absorption of Ca2+ from intestines. And supresses PTH |
|
|
Term
| The normal BUN is 8-20 mg/dL, in CKD it can be as high as _________/ |
|
Definition
|
|
Term
| What is uremia and when does it occur? |
|
Definition
| It means urine in the blood and occurs during kidney failure due to build of organic waste products in the blood. |
|
|
Term
| What are some neuromuscular manifestations of CKD? |
|
Definition
1. Peripheral neuropathy- both motor and sensory nerves
2. CNS disturbances |
|
|
Term
| What are some GI manifestations of CKD? |
|
Definition
1. Anorexia
2. Nausea, vomitting
3. METALLIC TASTE
4. Ulceration/ bleeding of mucosa |
|
|
Term
| T/F: With CKD an infection is common cuz all aspects of Immune and Inflammation are altered by high levels of urea and waste. |
|
Definition
|
|
Term
| What happens to the sexual function in patients with CKD? |
|
Definition
1. Impotence in 56% of men on dialysis
2. Loss of libido
3. Amenorrhea for women on dialysis |
|
|
Term
| What are some characteristics of the skin and nails in peeps with CKD? |
|
Definition
1. Skin/mucos membranes are dry, bruising is common
2. Pruritus is common due to high serum PO4
3. Nails are brittle and thin |
|
|
Term
| Why do you want to reduce the insulin dosage for diabetics who have CKD? |
|
Definition
| Because the kidneys lost its ability to eliminate drug so it accumulates. |
|
|
Term
| T/F: Many drugs are bound to plasma proteins. With a decrease in them there is more free drug which can result in complications like drug overdosing, change its half life. |
|
Definition
|
|
Term
| What is cystic disease of the kidney? |
|
Definition
| Fluid or semisolid-filled sacs or segments of a dilated nephron |
|
|
Term
| What are some causes for cystic disease of the kidney? |
|
Definition
1. tubular obstructions that increase intratubular pressure
2. Changes in the BASEMENT MEBRANE of the renal tubules that predispose to cystic dilation |
|
|
Term
| Polycystic kidney disease is an ______________, _____________ disorder that have their origin in the tubular structures of the kidney. |
|
Definition
|
|
Term
| This form of PCKD is most common in adults and have thousands of large cysts frome very segment of the nephron. The cysts are closed off fromt he tubule of origin. |
|
Definition
|
|
Term
| This form of PCKD is most common in children and have cysts that are derived from the collecting tubules that remain connected to the nephron. |
|
Definition
|
|
Term
| Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a _______________ disorder and can develop cysts in other tissues. |
|
Definition
|
|
Term
| Polycystin 1 and 2 are found in the primary _____________ that line the apical surface of the tubular epithelium. |
|
Definition
|
|
Term
| ADPKD have cells that have an increase in intracellular ____________ and ___________. |
|
Definition
|
|
Term
| What are some clinical features for ADPKD? |
|
Definition
1. Hypertension due to increase Na+ reabso., Decrease in NO synthe., Increase RAAS, more contractions of muscle to increase pressure
2. Proteinuria
3. Large kidney volume = 1500 mL (norrm = 100mL)
4. Hematuria
5. Infections
6. Kidney stones
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Term
| Kidney stones aka ______. |
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Definition
| Nephrolithiasis (15-20% of cases) |
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Term
| One common characterisitc of medullary cystic disease is ____________. |
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Definition
| Small and shrunken kidneys with variable number of cysts. |
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Term
| The initial insult for medullary cystic disease is in the _________ with progressive tubular atrophy involving both medulla and cortex. |
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Definition
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Term
| Simple and acquired renal cysts usually occur over the age _______ and are usually confined to the ________ region. |
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Definition
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Term
| What are some causes for urinary tract obstructions? |
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Definition
1. Developmental defects
2. Calculi (stones)
3. Prego
4. Prostatic Hyperplasia
5. Scar tissues
6. Tumors
7. Neurologic disorders like spinal cord injury |
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Term
| Urinary calculi (stones) are usually caused by staph_______ which is a _____________ organism. |
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Definition
Proteus
Urea-splitting (increase NH3) |
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Term
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Definition
| Urine filled dilation of renal pelvis associated with atrophy of the kidney due to obstruction |
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Term
| Complete bilateral obstruction can result in ____________, __________ and renal failure. |
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Definition
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Term
| With Partial bilateral obstruction you have an inability to _________, so you tend to develop ________________ and ___________. |
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Definition
Concentrate Urine
Polyuria
Nocturia |
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Term
| What is the most common cause for a upper urinary tract obstruction? |
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Definition
| A urinary calculi (stone) |
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Term
| What is the nucleus of the kidney stones called? |
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Definition
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Term
| _____________ binds to Ca2+ and prevents stone formation |
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Definition
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Term
| What things reduce the # of citrate thus allows for stone formation to occur becuz there is more Ca2+ available? |
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Definition
1. Metabolic acidosis
2. Fasting
3. Hyperkalemia |
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Term
| What are the 4 types of kidney stones that you can get? |
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Definition
1. Ca2+ (most common)
2. MgNH4PO4
3. Uric Acid
4. Cystine |
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Term
| MgNH4PO4 stones form in ____________ urine where as Ca2+ stones occur with renal tubular ___________. |
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Definition
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Term
| What is the most common type of bacterial infection seen? What is the second most common? |
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Definition
1. Respiratory infection
2. UTI |
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Term
| What hormone plays a role in mucin formation. |
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Definition
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Term
| In men there are ______________ that have antibacterial properties that prtoect from colonization thus reduce incidence of UTIs. |
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Definition
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Term
| Most uncomplicated UTI is caused by _____________. |
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Definition
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Term
| When does Urethrovesical reflux occur? |
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Definition
| When urine from the urethra moves into the bladder. Occurs with interrupted voiding, coughing and squatting |
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Term
| When does Vesicoureteral reflux occur? |
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Definition
| At the level of bladder and ureter (pyelonephritis) |
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Term
| What are some clinical manifestations of UTIs? |
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Definition
1. frequent peeing
2. dysuria
3. cloudy and smelly urine on occasion
4. Lower back and ab pain |
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Term
| Women 16-35 yos are _______ more prone to get an UTI than are men of the same age. |
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Definition
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