Patho/Phys: Exam 3 Sherpath

Which disorders would affect the renal system’s ability to rid the body of blood urea nitrogen (BUN) and creatinine?

shock, dehydration, hemorrhage, congestive heart failure

Which electrolytes affect the functioning of the cardiac system if they cannot be properly maintained by the renal system?

calcium and potassium

Which abnormal electrolyte level can cause osteodystrophy in a person with renal disease?

low calcium levels

Which factors explain the significance of a urine culture?

It can specifically identify bacteria.

Why is residual urine measured after voiding?

To determine if the bladder is able to empty normally

Which imaging study would be the best choice for a person with kidney failure?

Antegrade pyelogram is the best choice because it can visualize with direct injection of contrast into the renal flank. The contrast does not enter the bloodstream, so the kidney filtration is bypassed and toxicity is averted.

Which imaging study requires a person to undergo general anesthesia?

Retrograde pyelogram

A cystoscope is inserted through the abdomen, catheters are inserted into the opening of the ureters through the bladder, and contrast is injected. The insertion of the cystoscope requires general anesthesia.

does not require the use of contrast

Kidney, ureter, bladder (KUB) x-ray

Invasive procedure done under local anesthesia

Antegrade pyelogram

Provides specific information about renal vasculature

Renal arteriogram

Magnetic Resonance Imaging

Uses a magnet and radio waves to produce images

Which imaging study is used to provide an initial assessment of the urinary tract?

Kidney, ureter, bladder (KUB)

A KUB is a simple, flat plate x-ray that is done on initial assessment for patients complaining of urinary tract pain. It is able to visualize kidney stones as well as measure the size and shape of the kidneys.

Which imaging study gives a transplant surgeon a precise view of the preoperative renal vasculature?

Renal arteriogram

Renal arteriogram provides specific information about the renal blood vessels. It helps assess for renal artery stenosis, malformations of vessels, aneurysms, and can assess renal blood so a transplant surgeon can avoid problem areas during the transplant.

insertion of an IV catheter and injection of radioisoptopes

renal scan

Thin needle into the kidney under ultrasound guidance to extract tissue

Renal biopsy

Which conditions make a person completely ineligible for a renal biopsy?

Bleeding disorders, Having only one kidney, Uncontrolled hypertension

Which is the reason why urine is collected using the midstream method?

To prevent bacterial contamination from the vagina or penis

Which factors can cause an increased level of blood urea nitrogen (BUN)?

infection (produces ammonia), kidney disease, GI bleeding, excessive muscle breakdown

How should a quantitative protein test be collected?

By collecting urine for 24 hours for analysis

Which electrolyte is implicated in the formation of kidney stones?

Calcium

Why would a blood creatinine level be elevated?

The glomeruli cannot effectively clear the blood.

Which statement describes the use and purpose of kidney, ureter, and bladder (KUB) x-ray?

It visualizes kidney stones as well as the size and shape of the kidneys with an x-ray.

Which is the reason why a cystogram is ordered?

To diagnose vesicoureteral reflux

Which factors represent advantages of ultrasound imaging of the urinary tract?

• It is non-invasive.

• It is safe and risk free.

• It is able to visualize many abnormalities.

Which is a major disadvantage of an intravenous pyelogram (IVP) for a patient with renal disease?

It uses contrast dye.

Which imaging study is considered to pose little to no risk in a patient with kidney disease?

Ultrasound imaging

Which statements are correct regarding urinary tract infections (UTIs)?

• UTIs are more common in females.

• Urinary tract infections affect 6 million people annually.

Which are accurate statements about urinary tract obstructions?

• There is often a genetic predisposition to kidney stones.

• Urethral strictures may result from genital trauma or infections.

• Kidney stones may be triggered in patients by dehydration.

• There is often a genetic predisposition to benign prostatic hypertrophy.

Which is the most common cause of bladder and kidney cancer?

Smoking

How do infectious bacteria get into the urinary system?

• Through the urethra

• Through the blood stream

Which statements about kidney stone disease are correct?

• Stones tend to form when there is supersaturation of the urine.

• Stones begin as tiny crystals and deposits build up on them, making them grow.

Which pathophysiologic characteristics do kidney and bladder cancer have in common?

Both can metastasize to the liver.

Which symptoms would be suggestive of pyelonephritis?

• Flank pain

• Hematuria

• Fever and chills

• Nausea and vomiting

in a patient with urinary obstructive disease, which symptom is suggestive of kidney stones?

Testicular or labial pain

Which symptoms are seen in a person with bladder cancer?

• Hypertension

• Early cancer is often asymptomatic

Which bacteria are common causative organisms in infections of the urinary system?

• E. coli

• Serratia

• Pseudomonas

Which statements about benign prostatic hypertrophy (BPH) are correct?

• BPH affects about 50% of men.

• BPH may be related to a hormonal imbalance.

• BPH can lead to obstruction of urinary flow.

Which occupations are more at risk for the development of bladder or renal cell cancer?

• Mechanics

• Hair dressers

• Rubber workers

• Leather (including shoe) workers

trait: multiple tumors

disease: bladder cancer

trait: can cause urinary outflow obstruction

benign prostatic hyperplasia

trait: primary tumor arises from epithelium of tubules

disease: renal cell cancer

How is the pathophysiology of a urinary tract infection reflected in a patient’s symptoms?

• Inflammation of the kidneys in pyelonephritis results in pain and bleeding.

• Systemic infection is more common with kidney infections than bladder infections.

• Inflammation and ulceration of the bladder wall in cystitis results in pain and bleeding.

Which processes are involved in the pathophysiology of urinary obstruction related to prostatic hypertrophy?

• There is a hormonal imbalance between estrogen and testosterone.

• The urine continues to be produced, and pressure builds up, leading to hydronephrosis.

Which conditions are likely to be present with pain?

• Acute cystitis

• Kidney stones

• Pyelonephritis

Why is pyelonephritis potentially more serious than cystitis?

Kidney infection can lead to sepsis and bacteremia.

A man goes to his doctor with severe flank and testicular pain, nausea, vomiting, profuse sweating, pacing in the room, and blood in his urine. Which factor is likely causing his discomfort?

Kidney stone

A man goes to his doctor with flank pain, fever, chills, nausea, and blood in his urine. He is sitting as still as possible. Which is likely the cause of his discomfort?

Acute pyelonephritis

for which complication should a woman with genital herpes be screened?

Cervical cancer

steps involved in the occurrence of pelvic inflammatory disease (PID).

1. female develops vaginitis or cervicitis

2. microorganisms ascend into the uterus and up to the fallopian tubes.

3. Early stage of inflammation promotes invasion of bacteria into the mucosa, making tubal walls edematous

4. lumen is filled with purulent exudate

5. Tubes become obstructed, which prevents drainage into uterus.

6. Exudate drips from fimbriae onto ovary and surrounding tissue.

A person is diagnosed with genital herpes and asks what complication can occur from the infection. Which complication may occur as a result?

Cervical cancer

Which are risk factors for the development of pelvic inflammatory disease?

• Multiple sexual partners

• Prior occurrences of vaginitis

• Being under the age of 24 years old

Which findings suggest a person is in the acute stage of genital herpes?

• Penile lesions surrounded by redness

• Tingling and burning sensation before lesions appear

For which complications would a person with pelvic inflammatory disease (PID) need to be examined?

• Peritonitis

• Abscesses

• Septicemia

A person with a new diagnosis of genital herpes develops fevers, headaches, and lymphadenopathy. Which statement explains the rationale for these symptoms?

These signs occur as a result of a generalized systemic infection.

Which characteristic is common in pelvic inflammatory disease?

Scar tissue and adhesions develop.