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Patho Ch. 29
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48
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Undergraduate 4
04/25/2012

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Term
hydronephrosis
Definition
obstruction of urine flow causing dilatation of the pelvis and calyces of the kidney and atrophy of kidney parenchyma
Term
Hydroureter
Definition
obstruction occuring in ureter so it is dilated above the point of obstruction
Term
What does reduced urine flow lead to?
Definition
calculus formation and infection
Term
pyelonephritis
Definition
infection extending to renal tubules
Term
What does infection cause?
Definition
flank pain, fever, and pus in urine
Term
How are renal stones formed?
Definition
salts in urine form a percipitate
Term
What is the most common renal stone?
Definition
calcium stones
Term
What are uric acid stones caused by?
Definition
gout
Term
staghorn calculus
Definition
large stone that fills the renal pelvis completely blocking the flow of urine
Term
What are the manifestations of renal stones?
Definition
pain, frequently accompanied by nausea and vomiting
hematuria may be present
Term
What can partially dissolve renal stones?
Definition
medication
Term
Lithotripsy
Definition
crushing of kidney stones with a laser is preferred method today
Term
acute renal failure
Definition
refers to an acute suppression of renal function
mortality about 60%
Term
What are possible causes of acute renal failure?
Definition
hypovolemia, septicemia, heart failure, interruption of renal blood flow due to surgery
Term
postrenal conditions
Definition
obstruction of the urinary system at any point from the renal calyces to the urinary meatus
Term
What is the most frequent problem with postrenal conditions?
Definition
prostatic hypertrophy (in males)
Term
What else can cause postrenal conditions?
Definition
ureteral obstruction in persons with only one functioning kidney
Term
What's acute renal failure mark?
Definition
impairment in elimination of nitrogenous wastes, water, and electrolytes
Term
decreased renal reserve
Definition
damage is marginal and kidneys remain functional
clinical symptoms may be detected only at times of stress
renal function declines to 75%
Term
renal insufficiency
Definition
75% of functional renal tissue has been destroyed
glomerular filtration rate is decreased approximately 25% accompanied by increases in BUN and serum creatinine
Term
What does tubular-interstitial damage often cause?
Definition
increase in elimination of urine as ability to conserve water and sodium declines
increase in noturnal output of urine to 700 ml or more
Term
pyelonephritis
Definition
inflammatory disease of kidney pelvis and parenchymal area that is ususally caused by bacterial infection
Term
What is the organisms that causes pyelonephritis?
Definition
gram-negative rod (coliform) bacteria
Term
glomerulonephritis
Definition
inflammation of glomerulus
most significantly affected in basement membrane, resulting in alterations in filtration of blood to form tubular fluids
Term
polyarteritis nodosa
Definition
inflammatory and necrotizing disease involving medium-sized and small arteries throughout the body
Term
progressive systemic sclerosis
Definition
characterized by diffuse sclerosis of skin and other organs
Term
polycystic kidney disease
Definition
characterized by presence of bilaterally enlarged and cyst-filled kidneys
Term
infantile polycystic kidney disease
Definition
inherited as autosomal recessive trait
kidneys are nonfunctional at birth and fetuses are stillborn
Term
adult polycystic kidney disease
Definition
fiarily commong, affecting 1 in 500 persons
autosomal dominant trait
Term
What adult polycystic kidney disease characterized by?
Definition
enlarged, palpable, cyst-filled kidneys which can reach size of football
usually gives rise to signs of renal failure during 30s and 40s
Term
What's a common early symptom of adult polycystic kidney disease?
Definition
dull, aching pain of abdomen or back
Term
renal tubular acidosis
Definition
systemic acidosis due to inability to excrete an acid urine
may result from disease of proximal tubual or distal tubule
autosomal dominant inheritance
Term
What are symptoms of renal tubular acidosis?
Definition
bone pain due to osteomalacia, renal colic due to nephrocalcinosis or calculi, and weakness due to hypokalemia
Term
uremia
Definition
urine in the blood
Term
What are the primary symptoms of uremia?
Definition
noted when kidneys are unable to sustain their critical role in maintanence of homeostasis
Term
What's hyperkalemia further aggravated by?
Definition
development of acidosis
as plasma concentration of hydrogen ions increases, hydrogen shifts into tntracellular fluid in exchange for potassium
Term
What the accumulation in ECF of fluids often aggravated by?
Definition
release of renin from juxtaglomerular cells
Term
What is progressively lost as normal functioning is diminished?
Definition
ability to selectively monitor acid-base balance
Term
hyperuricemia
Definition
uric acid accumulates excessively in the plasma
unable to be excreted, uric acid will often be deposited abnormally as salt crystals in joints and soft tissue (gout)
Term
azotemia
Definition
inability to efficiently excrete wastes of nitrogen metabolism is accompained by characteristic increase in plasma levels of urea, creatinine, phenols, and guanidines
Term
What are the secondary symptoms of uremia?
Definition
generally develop in response to fluid-electrolyte and acid-base imbalances
Term
What's anemia caused by?
Definition
largely by inabiliy of diseased nephron to produce sufficient erthropoietin
condition is enhanced by existing toxic fluid environment, which promotes early breakdown of rbcs
Term
Cardiovascular system
Definition
arise secondary to fluid retention
associated elevations in ECF volume can increase workload of heart
Term
What will happen if myrocardial muscle is sufficiently stressed?
Definition
congestive heart failure
Term
osteomalacia
Definition
disorder due to inadequte deposit of calcium in bone tissue
Term
What's osteomalcia caused by?
Definition
deficiency of vitamin D normaly activated by kidney
Term
What is Vitamin D essential for?
Definition
absorption of calcium out of GI tract into blood
Term
osteosclerosis
Definition
manifested as banded or striped appearance of vertebrae on x-ray due to alternate bands of decreased and increased bone density
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