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63 Cards in this Set

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what is Wilms' tumor?
A neoplasm of the kidneys that typically occurs in children.

Most cases present with abdominal mass, hematuria, and fever
What is renal tubular acidoses (RTAs)?
They are a group of disorders in which there is a failure of the kidney to either resorb bicarbonate or excrete hydrogen ions. They are a cause of a normal anion gap acidosis.
which syndrome is characterized by massive loss of protein(>3.5 g/day)and lipiduria along with an assoc. hypoalbuminemia in the urine?
nephrotic syndrome
what is the leading cause of chronic renal failure accounting for 50% of pts with end-stage renal desease?
Glomerulonephritis
What is azotemia?
presence of nitrogenous wates in the blood
What is the nephritic syndrome characterized by?
hematuria
<GFR
azotemia
oliguria
HTN
what causes glomerulonephritis?
It is caused by diseases that provoke an inflammatory response (usually immune origin) of the endothelial, mesangial or epithelial cells of the glomeruli

SLE and strep are often assoc.
how are most UTIs acquired?
they ascend from the urethra and bladder
what is the second most common type of bacterial infection seen?
UTIs
who is at increased risk for UTIs?
urinary obstruction and reflux
impaired bladder emptying
women who are sexually active
use of diaphragm as contraceptive
postmenopausal women
men with prostate disease
elderly persons
what organism is assoc. with uncomplicated UTIs?
E. coli

others: Staph saprophyticus
which type of kidney stone is assoc. with UTIs?
magnesium ammonium phosphate(struvite) stones
what are the 4 types of kidney stones?
Calcium (oxalate and phosphate)
magnesium ammonium phosphate(struvite)
uric acid
Cystine
what is the most common cause of upper UTIs?
kidney stones
what are the most causative agents of pyelonephritis?
E. coli
Proteus
Klebsiella
Enterobacter
Pseudomonas
what are the 2 major groups of renal neoplasms?
Embryonic (Wilm's Tumor)
Renal cell carcinoma
Name the causes of prerenal failure
Hypovolemia
< vascular filling (shock)
Heart failure
< renal perfusion due to drugs
Name causes of intrarenal failure
Acute tubular necrosis
renal ischemia
exposure to nephrotoxic drugs
Intratubular obstruction
Name causes of postrenal failure
Bilaterial ureteral obstruction
Bladder outlet obstruction
How is end-stage renal disease defined?
when the GFR is less than 5% of normal
what is one of the earliest symptoms of renal insufficiency? (GFR at 20% to 50% of normal)
Isosthenuria or polyuria with urine that is almost isotonic with plasma
what are some causes of metabolic acidosis?
M- methanol poisoning
U- Uremia
D- Diabetic ketoacidosis
S- Salicylate poisoning
L- Lactic acidosis
I-
D- Dehydration
E-
define metabolic acidosis
a decrease in plasma bicarb and pH caused by an excess production or accumulation of fixed acids or loss of bicarb.
define metabolic alkalosis
an increase in plasma bicarb and pH that is caused by excess H+ ion loss or bicarb gain
how do you calculate the anion gap?
Na+ - (Cl + HCO3)
Characteristics of diabetes insipidous
excessive urine production due to low ADH
what are the osmotically active particles in ECF?
Na+
Cl-
HCO3-
These account for 95% of osmotic pressure.

BUN and Glucose 5%
name some causes of edema
Increased capillary pressure
(increased vascular volume; ie HF, kidney failure, Na retention)

Decreased colloidal osmotic pressure
(loss of plasma proteins, protein losing renal diseases, burns)

Increased capillary permeability

obstruction to lymphatic flow
what does edema represent?
an increase in interstitial fluid volume
What does atrophic gastritis cause?
causes a deficiency on intrinsic factor production
which type of DM is related to an autoimmune process
Type I DM- not enough insulin is produced due to immune complexes
what is type II DM?
obstruction of insulin to the cells, mainly due to life style factors
what is anasarca?
Generilized edema
S/Sx of Nephrotic syndrome
Gen. Edema
Xerosis-due to loss of protein
loss of protein >3.5 g/day
hypoalbuminemia < 3 g/dl
Cholesterol >300 mg/dl
what is acute tubular necrosis
ischemia and inflammation leading to necrosis of the glomerulus
what are the causes of metabolic acidosis?
M- methanol
U- uremia
D- diabetic ketoacidosis
S- salicylates
L- lactic acidosis
I- infections
D- dehydration/diarrhea
E- ethanol
what are some manifestations of kidney failure?
azotemia and uremia
what is the respiratory compensation in metabolic acidosis
hyperventilation to decrease PCO2
what is the renal compensation in metabolic acidosis
if no renal disease, increased H+ excretion and increased HCO3 reabsorption
what is the primary disturbance in metabolic acidosis
Decrease in bicarbonate
Name 4 things that cause metabolic acidosis
1.increased production of nonvolatile metabolic acids
2.decreased acid secretion by the kidneys
3.excessive loss of bicarb
4.an increase in chloride
what are some causes of UT obstruction
renal calculi
papillary necrosis
pregnancy
tumors that compress the ureter
what are the S/Sx of pyelonephritis
abrupt onset with chills, fever headache, back pain, CVAT, general malaise, dysuria
the most common presenting signs in Wilm's tumor
large abdominal mass
hypertension
what characterizes prerenal failure
a decrease in renal blood flow due to a depletion of vascular volume
what are some conditions that cause prerenal failure
hemorrhage
heart failure
shock
what are some causes fo postrenal failure
obstruction of renal outflow due to calculi, structures, tumors, BPH
what causes intrinsic renal faiulure
ischemia
acute tubular necrosis (MC)
acute glomerulonephritis
pyelonephritis
what does the axial skeleton consist of?
The axial skeleton forms the central axis of the body. It consists of the skull, the vertebral column, the ribs and the sternum or breastbone
what is the physiologic role of Vit D
increases calcium absorption in the GI tract and helps regulate calcium deposition in bone
what is osteoarthritis
degeneration and progressive loss of cartilage within the joints
what is podagra
condition in gout in which uric acid crystals are deposited i the big toe
what is the HPA axis?
it plays a primary role in the body's reactions to stress by balancing hormone releases from the adrenaline-producing adrenal medulla, and from the corticosteroid-producing adrenal cortex.
in which disease is PND most commonly seen?
PND is a sign of severe heart failure, it is most common with CHF
Describe Hemophilia
Hemophilia is an X-linked disorder affecting blood clotting
what form from the ectoderm?
skin and nervous system
what forms from the endoderm
glandular tissue of the liver and pancreas
name 2 common second messengers
cAMP and Calcium
what is the function of the rought ER?
manufacturing and transporting proteins
what are the 4 basic types of tissue
epithelial
connective
muscle
nerve
what is the major cell involved in cell-mediated immunity?
T-cell

B-cell in Humoral-mediated immunity
what do megakaryocytes differentiate into?
platelets
what regulates blood cell production?
cytokines and growth factors