Patho Exam 2-Renal/Urinary

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  1. Normal range for BUN? What does it measure
    • 10-20mg/dL
    • Measures concentration of urea in the blood
  2. BUN level during dehydration, ARF, and CHF
    >20mg/dL (increase)
  3. What is a by-product of muscle metabolism
  4. Creatinine normal range
    0.1-1.2 mg/dL
  5. As creatinine levels rise, what falls
  6. If creatinine is double in the blood, what is renal function
    1/2 of nL functioning
  7. What is the essential part of examination in renal disease
  8. What is abnormal in a urine test
    RBC,s elevated WBC, bacterial protein, glucose, ketones
  9. What is obstructive uropathy
    anatomical or functional defect causing blockage
  10. Complete obstruction of upper urinary tract, dilates ureter
  11. Dilation of renal pelvis and calyces
  12. collagen and proteins deposited in the kidney
    Tubulointerstitial Fibrosis
  13. What forms of Obstructive Uropathy predispose pt to HTN b/c renin cascade is activated
    • Hydroureter
    • Hydronephrosis
    • Tubulointerstitial Fibrosis
  14. What causes unobstructed kidney to increase in size of individual gloemruli and tubules but not total number of nephrons
    Compensatory hypertrophy and hyperfunction
  15. Two types of calculi or urinary stones
    • Struvite
    • Uric Acid
  16. What are 70-80% of stones composed of
  17. What stones consist of Mg+, NH3, PO4
  18. What is struvite stones caused by
  19. what gender is struvite more common in
  20. What stones are seen with gout
    Uric acid
  21. What are symptoms of calculi or urinary stones
    • Pain in groin (renal pelvis, proximal ureter)
    • Lower abd (mid ureter)
    • urgency or incontinent (lower ureter)
  22. What occurs when neurogenic bladder disrupts nL bladder filling/emptying
    Lower Urinary Tract Obstruction
  23. What causes lower urinary tract obstruction
    interruption of nerve supply to bladder
  24. What are common lower urinary tract obstructions
    • Overactive bladder syndrome (OAB)
    • Urethral strictures
    • Prostatic enlargement
    • pelvic organ prolapse
  25. What is detrusor overactivity that causes urgency, retention, or incontinence
    Overactive bladder syndrome
  26. 3 types of Renal/Bladder tumors
    • Renal adenoma
    • Renal cell carcinoma
    • Bladder tumors
  27. What renal/bladder tumor is most common, usually in men, r/t tobacco, obesisty, analgesics
    Renal Cell Carcinoma
  28. Where does renal cell carcinoma occur and where can it spread
    • unilateral
    • lungs, liver, bones
  29. What tumor is r/t smoking, working in chemical, rubber, or textile industries
  30. Sx of bladder cancer
    asymptomatic or hemouria
  31. Difference between Cystitis and Pyelonephritis infection
    • C-bladder, lower tract
    • P-kidney/pelvis/interstitial-upper tract
  32. Pt presents to clinic with low back, suprapubic pain with painful, burning urination. BP is 156-90. He c/o needing to pee really bad all the time and noticed blood in his cloudy urine. WHat do u suspect he has
  33. Pt presents to the clinic with fever, chills, backache and pain, n/v, needing to pee real bad all the time, and has CVA tenderness. What do u suspect he has
  34. What is Cystitis caused by
    urinary obstruction, prostatitis, ascending infection with ecoli
  35. What causes Pyelonephritis
    Inflammation or scarring of tubules, ascending infection with Ecoli, fungi, virus, or obstruction
  36. What causes urine reflux or residual urine
  37. What is glomerulonephritis
    glomeular damage caused by immune response, toxins/drugs, vascular disorders, DM, LE
  38. When does glomerulonephritis begin
    After antibodies against glomeular basement membrane have localized in glomerular capillary wall
  39. How does glomerulonephritis change membrane action? What are the consequences?
    Decreases membrane permeability leading to passage of protein and RBCs into urine
  40. Most common cause of Glomerulonephritis
    Poststreptococcal groupn(group A beta-hemolytic strep)
  41. What is increased permeability in glomeruli and protein leakage
    Nephrotic syndrome
  42. When reviewing a pt's urine test, you notice there is protein. Upon looking at his bloodwork, there is an increase in lipids (tryglercerides) and decreased albumin (protein). What do you suspect he has, and what 3 causes could occur with this disease?
    • Nephrotic Syndrome
    • Genetic Defects
    • DM
    • SLE
  43. What is rapid deterioration of renal function
    Acute renal failure
  44. What causes decrease in glomerular filtration, elevated BUN and Creatinine, and oliguria
    Acute kidney failure
  45. Name 3 types of renal failure
    • Prerenal
    • Intrarenal
    • Postrenal
  46. What type of acute kidney failure occurs due to hypoperfusion of the kidney and name two examples
    • Prerenal
    • Cardiac failure-hypovolemia
  47. What type of acute kidney failure is caused by nephrotoxic drugs such as antibiotics causing acute tubular necrosis
  48. What type of acute renal failure follows an obstruction of urinary flow and give some examples
    • Postrenal
    • edema, tumors, stones, clots, prostatic hyperplasia, urethral strictures
  49. Stages of Acute renal failure
    • Oliguria
    • Diuresis
    • recovery of renal function
  50. What is uremia
    chronic kidney disease
  51. When do s/s present during chronic renal failure
    GFR and renal function decline to 25%
  52. What type of renal failure is associated with HTN, DM, or intrinsic kidney disease
    Chronic Renal Failure
  53. What contributes to tubulointerstitial injury leading to fibrosis
  54. What is characterized by a decline in renal function and accumulation of toxins in the blood.
    Uremic State
  55. What results from a uremic state
    • Electrolyte imbalances, volume depletion, and metabolic acidosis
    • BUN and Creatinine Increase
  56. Pt presents to clinic with BP of 170/98, preicarditis, bone deminarelization, attention deficit, anemia, bleeding, n/v/d, prutitis, pigrmantation, infertility, decreased libido, and A WHOLE LOT MORE
    Uremic State
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Patho Exam 2-Renal/Urinary
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