Pathology Test 4 Lecture 2

Front 1

function of the _ Main job—filter waste products & remove excess fluid from the blood.
Metabolic waste such as nitrogenous and acidic
Hormones, drugs, and other foreign material from the body

Back 1

kidney

Front 2

Functions of _:
Regulate water, electrolytes and acid/base balance in the body
Secrete erythropoietin (RBC producer)
Activate vitamin D
Regulate BP through the renin-angiotensin-aldosterone system

Back 2

kidneys

Front 3

_= sphincter decreased muscular control, clonnis or flacid

Back 3

incontinence

Front 4

Reabsorption of fluid and elctrolytes: _— from _ –controls reabsorption of H20 by altering permeability of distal convoluted tubule & collecting duct

Back 4

ADH
posterior pituitary

Front 5

Reabsorption of fluid and elctrolytes: _— from _—controls reabsorption of Na & H20 by exchanging Na ions for K or H ions in the distal convoluted tubule

Back 5

aldosterone
adrenal cortex

Front 6

Reabsorption of fluid and elctrolytes: _— from _—controls fluid balance by reducing Na & fluid reabsorption in the kidneys

Back 6

Atrial naturietic hormone
atria

Front 7

_ rate: By constricting or dilating the arterioles, the amount of blood in the _ capillaries is adjusted & filtration is normally maintained regardless of fluctuations in BP.

Back 7

glomerular
glomerular

Front 8

_ example: if afferent arteriole is dilated, the efferent arteriole is constricted. This results in hydrostatic pressure increase &_increases.

Back 8

GFR
GFR

Front 9

3 factors to control GFR: 1. _
running from a bear or rest & digest. If running from a bear, vasoconstriction occurs in both arterioles

Back 9

SNS

Front 10

3 factors to control GFR: 2.
_ is released from juxtaglomerular cells in the kidney when blood flow in afferent is reduced->blood to the lungs stimulates _ release (acts as a vasoconstrictor).

Back 10

Renin
angiotensin

Front 11

3 factors to control GFR: 3.
Local reflex adjustments in _ of arterioles due to changes in blood flow.

Back 11

diameters

Front 12

So think of _as the ability of the kidneys to hold onto or release more fluid as necessary.

Back 12

GFR

Front 13

Pathology involving multiple systems is going to affect _

Back 13

GFR

Front 14

If Blood pressure is too low or too high, then _ is going to either be the cause or is going to react to the cause to regulate control of the body’s fluid levels.

Back 14

GFR

Front 15

_: 6 million Americans
Usually from E. Coli
Usually ascending in origin
Patients often perceive it as “back pain”
Women > men due to urethra shortness.

Back 15

UTI

Front 16

With a UTI Teach _ ( ) and _

Back 16

Proper toileting, (wipe front to back)
Urinate after sex

Front 17

_ s and s:
frequency, urgency, dysuria, nocturia, fever, chills, malaise
Ipsilateral shoulder pain is possible when kidneys are involved

Back 17

UTI

Front 18

_ Infectious process (acute) involving the kidneys or chronic inflammatory dz affecting kidney parenchyma & renal pelvis (chronic)

Back 18

Pyelonephritis

Front 19

_ Pyelonephritis: bacteria ascending from bladder to kidneys

Back 19

acute

Front 20

_ Pyelonephritis: tubulointestinal disorder due to changes in the kidneys. Can lead to renal insufficiency

Back 20

chronic

Front 21

_ s and s

Acute=abrupt. Fever, chills, malaise, HA, flank pain. CVA pain (Murphy’s sign)
Chronic—depends on cause.

Back 21

Pyelonephritis

Front 22

_ Incidence—3-4% of all CA
Renal cell carcinoma is most common. Males>females
Etiology is linked to heredity.
Risk factors: smoking, obesity, HTN, asbestos exposure

Back 22

renal CA

Front 23

_ s and s

Classic triad—flank pain, hematuria, palpable abdominal mass
Hematuria—present in 50% of all cases

Back 23

Renal CA

Front 24

_
Incidence—5% of adults. Males>females.30-60 y/o for men, 20-30 for women.
Etiology—patients w/gout are more likely to develop uric acid derived stones. Dehydration leads to production.
Risk factors—obesity in women, excess intake of Ca, Na, sucrose, & animal protein. A lack of Ca & K.

Back 24

Nephrolithiasis

Front 25

_ s and s
Acute colicky flank pain radiating to groin or perineal areas w/hematuria. Unable to find a comfortable position. UTI symptoms are usually also present in over 90% of cases.

Back 25

Nephrolithiasis

Front 26

_ 3 most common causes are DM, HTN & glomerulonephritis

Back 26

Kidney Dz or Renal Failure

Front 27

_: ESRD is the final stage w/loss of the kidneys resulting in dialysis or kidney transplant

Back 27

Kidney Dz or Renal Failure

Front 28

_
Incidence—20 million
Risk factor to be aware of is increased analgesic use
Pathogenesis—destruction of the nephrons leads to decreased surface area available for filtration to occur. The kidneys are unable to regulate fluids, electrolytes, & pH balance or remove metabolic wastes from the blood.

Back 28

Kidney Dz or Renal Failure

Front 29

_ Numerous causes
Reduced GFR—oliguria (reduced pee) or anuria (no pee)

Back 29

acute renal failure

Front 30

_ s and s
Elevated BUN
Metabolic acidosis
Hyperkalemia

Back 30

acute renal failure

Front 31

_ HTN or DM causes it

Back 31

Chronic renal failure

Front 32

_ s and s

Early—polyuria, anorexia, nausea, anemia, fatigue, exercise intolerance, HTN
End stage—oliguria, dry pruiritic, hyperpigmented & easily bruised skin
Peripheral neuropathy
CHF
Encephalopathy

Back 32

Chronic renal failure

Front 33

_ Occurs as a result of any dz that causes damage to the nephrons
Pathogenesis—damage to the glomerular cells allows larger molecules such as proteins to escape out of the circulation & into the urine.

Back 33

Nephrotic syndrome

Front 34

_ s and s
Proteinuria, hyperlipidemia; edema (principal symptom that brings patient to the physician)

Back 34

Nephrotic syndrome

Front 35

types of urinary incontinence:
_ (leaks with sneeze, cough, exertion)
_ (Gotta go, Gotta go)
_(weakness, and urgency)
_ (involuntary dribble or leaks)

Back 35

Stress
Urge
Mixed
Overflow

Front 36

_ risk factors

Advancing age
Chronic cough
Diabetes Mellitus
Neurologic disorders
Gender: female > male
Enlarged abdomen (ascites, tumor)

Back 36

Urinary incontinence

Front 37

_ modifiable risk factors

Overweight/obese
Chronic constipation
History of urinary tract infections (UTI)
Enlarged abdomen (pregnancy, obesity)
Caffeine, alcohol intake
Medications * diuretics* (nsaids, acetomenophin)

Back 37

Urinary incontinence

Front 38

If born with a missing kidney are more likely to have a missing _

Back 38

ear