Exam 3: Patho/Pharm Renal

GFR

how much blood the kidneys clean per minute

90-100 mL/min

normal GFR

tubules reabsorb

what is the function of the tubule

its role is to concentrate the urine

what is the function of the loop of Henle

erythropoietin

stimulates red blood cell production in the bone marrow

not enough oxygen

what stimulates the release of erythropoietin 

kidneys

where is erythropoietin released from

GFR

what is the best indication of renal function

creatnine, age, gender, body size

how is GFR calculated

creatnine

waste product from the muscles, is filtered out of the kidneys

urinary tract obstruction

blockage of urine flow from kidneys to the urethra, causes everything to dilate can cause distended kidneys

hydroureter

dilation of the ureter from urine buildup

hydronephrosis

dilation of the renal pelvis

ureterohydronephrosis

ureter and renal pelvis dilation

tubulointerstital fibrosis

prolonged pressure and inflammation

postobstructive diuresis

sudden relief of an obstruction, high urine output causing fluid and electrolyte loss

tubulointerstital fibrosis, ureterohydronephrosis, hydronephrosis, hyrdroureter

upper urinary tract infection types

urethral stricture, prostate enlargement, pelvic organ prolapse

causes of a lower urinary tract obstruction

incomplete emptying, weak stream, nocturia, hesitancy

symptoms of a lower urinary tract obstruction

urethral stricture

narrowing of the urethra

difficulty voiding, spraying, urinary retention

what does a urethral stricture cause

overactive bladder

bladder constricts too suddenly or too often

under active bladder

bladder doesn’t contract strongly enough

pelvic organ prolapse

bladder or uterus goes into the vagina

neurogenic bladder

nerves are damaged you can’t empty you bladder, resulting from a spinal injury, can be spastic or leaky

antimuscarinics 

how is an overactive neurogenic bladder treated

a-blockers

how is an underactive neurogenic bladder treated

renal caliculi

stones form from calcium, struvite, uric acid

thiazide diuretics, allopurinol

how to treat renal calculi

staghorn calculi

large branched stones in renal pelvis from an infection

renal carcinoma

most common kidney tumor, mainly in men

UTI

bacterial infection of urinary epithelium, usually E. coli

suprapubic pain, urgency, dysuria

what does a UTI cause

uncomplicated UTI

occur in healthy individuals with normal anatomy, simple treatment

complicated UTI

more serious, more common in men and pregnant women, harder to treat

painful bladder syndrome (interstitial cystitis)

chronic inflammation without infection, can’t hold much urine for very long, pain during sex

Phenazopyridine

changes urine to a red orange color, treats UTI

no more than 2 days it can mask symptoms

how long can you take phenazopyridine

acute pyelonephritis

infection of the renal pelvis and kidney parenchyma from E. coli

costovertebral tenderness

what is a key sign of acute pyelonephritis

chronic pyelonephritis

recurrent infection or reflux leads to progressive renal scarring

acute glomerulonephritis

immune related inflammation damages the glomerular capillaries following a strep infection

dark tea/ coke colored urine

what color urine is indicative of acute glomerulonephritis

goodpasture syndrome

autoimmune disorder that attacks the vessels of the kidneys and lungs

blood in lungs, coughing up blood, hematuria

symptoms of good pasture syndrome

chronic glomerulonephritis

long term inflammation scarring glomerular and nephron loss, blood in urine

ACE/ ARBs

how is chronic glomerulonephritis treated

nephrotic syndrome

heavy protein loss in the urine

leaky and puffy, edema

signs of nephrotic syndrome

nephritic syndrome

inflammation leading to blood in the urine often following a strep infection

acute kidney injury

typically reversible

prerenal, intrarenal, postrenal

type of acute kidney injuries

prerenal AKI

reduced blood flow to the kidneys causing low GFR and concentrated urine

Iv fluids and vasopressers

how to treat an AKI

intrarenal AKI

kidney tissue in damaged from ischemia or nephrotoxins

acute tubulointerstitial nephritis

allergic reaction to drugs and can lead to an AKI

eosinophils in urine

what is a key sign of acute tubulointerstitial nephritis

postrenal AKI

starts from urinary tract obstruction below the kidneys

azotemia

elevated BUN and creatinine

uremia

symptomatic toxin buildup, causing fatigue, confusion, itching

chronic kidney disease

chronic, irreversible loss of nephron function, drop of GFR below 60 for 3 consecutive months

increased urine output

first sign of CKD

>90

what is GFR of normal kidney function

<15

what is endstage renal disease GFR

sodiuma nd water loss

Early signs of CKD

edema and water retention

late signs of CKD

bone resorption

body breaks down bones causing fractures

phosphate binders, calcium, calcitriol

how to treat Bone and mineral disorders in CKD

uremic toxins

they cause altered mental status

uremia

causes a metallic taste in the mouth, yellow-gray skin tone

hemodialysis

filters blood through an artificial membrane

peritoneal dialysis

uses abdominal lining as a filter to push fluid into the body and removes it after it was filtered

CRRT

used in hemodynamically unstable patients run continuously

phosphate binders

reduce phosphorous absorption and are given with meals

lifelong immunosuppressant therapy, tacrolimus, cyclosporine, prednisone

what medications does a kidney transplant require

potter syndrome

absent kidneys, fatal after birth

bladder exstrophy

bladder develops outside of the body

cloacal exstrophy

more severe form of bladder exstrophy

polycystic kidney disease

genetic disorder causing cysts in the kidneys

cysts replace normal kidney tissue

PCD progression

benign prostatic hyperplasia

enlargement of the prostate gland can compress the urethra

prostatic specific antigen

can show prostrate cancer

alpha blockers and finasteride

how is BPH treated

prostatitis

inflammation of the prostate

prostate cancer

most common nonskin cancer in men, more common in african american

digital rectal exam

how is prostate cancer diagnosed

renal dysplasia

kidneys didn’t fully develop, can be unilateral

prune belly

abdominal muscles are weak or missing 

hypospadias

urethral opening on the bottom of the penis

epispadias

urethreal opening on the top of the penis

posterior urethral valves

congenital obstructive membrane in male urethra impeding urine outflow

pediatric nephrotic syndrome

periorbital edema and frothy urine, treated with corticosteroids

hemolytic uremic syndrome

classic triad: hemolytic anemia, thrombocytopenia, renal failure

wilms tumor

often found when parents are changing diapers, common malignant tumor in children

enuresis

bedwetting, involuntary bedwetting after age 5

chlamydia/ gonorrhea

STI may cause permanent damage to womans reproductive system without treatment 

syphilis

starts with a chancre that can come and go with no pain often missed

penicillin

how is syphilis treated

genital herpes HSV

recurrent painful vesicular lesion

acyclovir

how is HSV treated