Chapter 18 - Urinary System Disorder

Front 1

glomerulonephritis pathology:

Back 1

anti streptococcal antibodies formes as usual from strep infection, creating an antigen antibody complex (type 3 hypersensitivity) that lodges on the glomerular capillaries and activates the complement system cause an inflammatory response in both glomeruli of kidney. This leads to increased capillary permeability and cell proliferation and results in leakage of some protein and large number of erythrocyte into the filtrate. Immunoglobulin and complement C3 is present.

If severe, congestion and cell proliferation interferes with flirtation causing a decreased GFR and retention of fluid and waste. Acute renal failure can occur if blood flow is sufficiently impaired. Decreased blood flow can likely trigger increase renin which leads to elevated blood pressure and edema.

Front 2

glomerulonephritis sign and symptom:

Back 2

-urine is dark and cloudy cause of protein and blood cell.

-facial and preorbital edema.

-blood pressure is elevated owing it to increased renin secretion and decreased GFR.

-flank or back pain

-general sign of inflammation including malaise, fatigue, headache, anorexia, and nausea.

-urine output decrease (oliguria)

Front 3

glomerulonephritis diagnostic test:

Back 3

-blood test for elevated urea and creatinine

-blood levels of anti DNase B, streptococcal antibodies, and ASK are elevated.

-complelement level is decreased

-metabolic acidosis.

-urinalysis

Front 4

glomerulonephritis treatment:

Back 4

-sodium restriction

-glucocorticoids

-antibiotics

Front 5

nephrotic syndrome pathology:

Back 5

1. abnormality in glomerular capillaries & increased permeability that allows large amounts of proteins, albumin to escape filtrate.

2. hypoalbuminemia with decreased plasma osmotic pressure and edema.

3. blood pressure may remain low or normal because of hypovolemia

4. decreased blood volume increases aldosterone secretion leading to severe edema

5. high levels of cholesterol in blood and lipoprotein

Front 6

nephrotic syndrome sign and symptoms:

Back 6

-proteinuria, lipiduria

-urine is frothy

-anasarca associate with weight gain and pallor

-excessive fluid impaired appetite, breathing, and activity

-skin breakdown and infection

Front 7

nephrotic syndrome treatment:

Back 7

-glucocorticoids

-angiotensin converting enzyme inhibitor drug

-antihypertensive

-cytotoxic therapies

Front 8

acute renal failure pathology:

Back 8

kidney may fail to function for different reasons. Either directly reduced blood flow or inflammation or necrosis of tubules cause obstruction or back pressure leading to decreased GFR, oliguria, or anuria. Both kidneys are involved and dialysis may be used for this period.

Front 9

acute renal failure etiology:

Back 9

-kidney disease such as glomerulonephritis

-circulatory shock or heart failure resulting in tubule necrosis

-nephrotoxins causes necrosis and obstructions of blood flow

-mechanical obstruction such as calculi, blood clots, or tumors

Front 10

acute renal failure sign and symptom:

Back 10

-elevated levels of serum urea nitrogen (BUN) and creatinine as well as metabolic acidosis and hyperkalemia

Front 11

acute renal failure treatment:

Back 11

-dialysis

Front 12

chronic renal failure pathology:

Back 12

in the early stage of decreased reserve (60% nephron lost), there is a decreased GFR, serum creatinine levels that are consistently higher than average but within normal range, & no apparent clinical sign.

Second stage (75% nephron lost) or renal insufficiency is indicated by a change in blood chemistry and manifestation. GFR is decreased by 20%, there is retention of nitrogen waste (urea and creatinine). This stage is marked by excretion of large volumes of dilute urine. Erythropoiesis is decreased and the patient's blood pressure is elevated.

Uremia or end stage renal failure occurs when GFR is negligible. Fluid, electrolytes, and wastes are retained in the body. Oliguria or anuria develops. Dialysis or transplant is required.

Front 13

chronic renal failure sign and symptom:

Back 13

early sign:

-increased urinary output (polyuria) as nocturne

-anorexia, anemia, nausea, fatigue, exercise intolerance.

-bone marrow depression

-high blood pressure

end stage:

-oliguria

-dry, pruritic and hyper pigmented skin, easy bruising

-peripheral neuropathy

-decreased libido in men and menstrual irregularities in women

-encephalopathy

-congestive heart failure

-failure of kidney to activate vitamin D

-uremic frost on skin and urinelike breath odor

-systemic infection like pneumonia

Front 14

chronic renal failure diagnostic test:

Back 14

-anemia, acidosis, and azotemia are the key indicators for chronic renal failure

-metabolic acidosis becomes decompensated (ph below 7.35)

-azotemia refers to presence of nitrogen waste in blood

-anemia becomes severe

-electrolyte may vary depending on amount of water retained. Usually hyponatremia occurs or hyperkalemia.