Term
| Functional unit of kidney |
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Definition
NEPHRON
made up of Glomerulus, Bowman's Capsule, and collecting Tubules |
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Term
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Definition
Urine = 1 ml/min
Ultrafiltrate = 120 ml/min
(GFR) |
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Term
| What are the functions of the kidneys (5) |
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Definition
Regulate fluid volume
Help regulate acid-base balance
Help control electrolyte concentrations
Excrete nitrogenous breakdown products
Excrete toxic substances & drugs
*liver and kidney are 2 main routes of detoxification* |
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Term
| How does kidney control fluid volume? |
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Definition
Control SODIUM CONTENT***
too much sodium : hypertension, pulm edema
too little: hypotension,
only 1% of filtered load will be excreted** |
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Term
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Definition
Works with lungs to manage acid-base volumes
lungs produce |
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Term
| Electrolytes kidney is responsible for |
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Definition
Excess or deficiency of any of the above is dangerous!!
Potassium
Magnesium
Phosphate
Calcium
Chloride
Bicarbonate (HCO3-) |
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Term
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Definition
PROTEINURIA IS BAD and indicates renal disease*
measure by BUN: blood urea nitrogen
or CREATININE: metabolism byproduct (results from muscle tissue turnover) |
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Term
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Definition
Urinary Tract Infection
bacterial infection of bladder/urinary tract... could lead to kidney infection
*CAUSE PREDOMINATELY BY BACTERIA FROM COLON AND RECTUM (E.COLI IS MOST COMMON)*
- one of most common infections
- more women due to shorter urethra
urinary frequency, urgency, pain, hematuria (blood in urine)
with upper UTI= fever and flank pain |
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Term
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Definition
*ACUTE CYSTITIS*
bladder infection
MORE COMMON... bacteria from perineum gains access to urinary tract |
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Term
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Definition
ACUTE PYELONEPHRINITIS*
Kidney infection
- bacteria ascends ureters past the kidney parenchyma
most kidney infections happens like this but bacteria can also present itself in the blood |
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Term
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Definition
hydration, vitamin C, cranberry juice
antibiotics* |
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Term
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Definition
Kidney Stones
-Requires supersaturation of urine
- urine flow is low, mineral production and concentration is high
- may detach and lodge in the ureters= acute pain and leads to hydroneprhosis
- may grow to large and fill renal pelvis |
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Term
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Definition
- extensive renal calcifications
- could cause renal failure
- not common |
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Term
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Definition
Calcium Oxalate, Calcium phosphate
- uric acid is 2nd most common |
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Term
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Definition
urate, cystine, struvite,
stones too large to pass and fills the renal pelvis
- renal fxn could be ok |
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Term
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Definition
Most of the time it does lodge itself somewhere
*Causes PAIN AND HEMATURIA*
flank and colicky type pain building up over 20-60 minutes
*Can be severe pain*
causes hydronephrosis
LITHOTRIPSY: extracorporeal shock wave lithotripsy
- ultrasonic shock wave to break stones up so it will pass
most common method of stone removal*... non insvasive but may require sedation and analgesia due to pain |
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Term
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Definition
dilation of renal collecting system tdue to bostruction
*WILL RESULT IN RENAL FAILURE* |
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Term
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Definition
Urate stones: medication and dietary measures
Calcium stones: treat hypercalcemia and diuretics
*hydration* |
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Term
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Definition
continuum to severe: gradual loss of nephrons and decline of GFR
severe = END STAGE RENAL DISEASE* |
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Term
GFR
Mild, moderate, and severe levels |
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Definition
Normal = 120 ml/min
Mild: 60 ml/min: no symptoms
Moderate: 20-60 ml/min : dietary restriction is needed
Severe: less than 20 ml/min (end stage renal disease) |
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Term
ESRD (end stage renal disease)
Causes
Symptoms |
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Definition
permanent, non-reversible
requires dialysis or transplant
*Diabetes*, hypertension*, glomerulonephritis, PCrD, Miscellaneous and idioptathic (toxicity)
Fatigue, anorexia, pruritis
Signs are more specific: *ELEVATED BUN, CREATINIE* |
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Term
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Definition
oral input restricitons: limit protein, sodium, and other electrolyte, and water restriciton
- control hypertension
- limit nephron loss
- dialysis
- transplant |
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Term
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Definition
1-3 L of dextrose solution instilled than drained after 2-8 hours
main issue/risk = infection
- just a method to tide someone over until they receive a transplant
-*QUALITY OF LIFE IS MUCH IMPROVED BY DIALYSIS*
2/3 use unrelated donors
-HLA typing for good match
- Immunosuppression is required |
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Term
Benign Prostatic Hypertrophy (BPH)
Symptoms (2 types) |
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Definition
prostate becomes enlarged and presses on ureter
*BPH IS NOT A PRECANCEROUS CONDITION*
obstructive and irritative |
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Term
| Irritative Symptoms of BPH |
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Definition
| urgency, frequency, nocturnal voiding, all due to bladder pressure |
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Term
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Definition
decreased force and caliber of stream
difficulty initiating
incomplete voiding
strain to urinate
post-void dribbling
*can be enough to cause renal damage* |
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Term
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Definition
Meds: alpha sympathetic blocker drugs
5- alpha reductase inhibitors
Surgical Treatment |
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Term
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Definition
Transurethral (TURP)
Retropubic
Perineal
Laparoscopic |
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Term
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Definition
75-96% chance of improvement
main complication: incontinence, impotence, retrograde ejaculation |
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Term
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Definition
Second leading cause of cancer death in males
- in older individuals you almost always see little localized islands of prostate cancer
NONE IN EARLY STAGES... BPH is NOT a precancerous condition
late stages: Pain and urinary obstruction |
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Term
| Prostate Specific Antigen (PSA) |
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Definition
increased levels seen in prostatis, BPH, and prostate cancer
- its a normal antigen until it's produced a lot
*not a great way though because sometimes poeple with cancer will have normal PSA levels
*Initial screening at age 50 |
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Term
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Definition
Watchful Waiting
Prostatectomy
Radiation Therapy: Implants
Medical: Endocrine to reduce testosterone
Cytotoxic Chemotherapy |
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Term
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Definition
Most are transitional cell carcinoma
*MULTI-CENTRIC ORIGIN*
males > females
mostly due to smoking or exposure to industrial dyes
DX with cystoscopy |
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Term
| Symptoms of Bladder Cancer |
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Definition
HEMATURIA= BLOOD IN URINE
- presenting symptom
- irritative voiding symptoms
- pain masses with advanced disorders |
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Term
Treatment of Bladder Cancer
BCG |
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Definition
Ileum Resection and turned into portion of bladder
- transurethral resection
- chemotherapy and immunotherapy
- intravesicular = we can do treatment inside the uretrea or ureter
Bacille Calmette- Guerin: vaccine derived from weakened strain of mycobacterium bovix and insert into bladder "Immune stimulant" |
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Term
"Kidney Cancer" = Renal Cell Carcinoma
risk factors
symptoms |
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Definition
More common in men
- more aggressive than bladder cancer
smoking, obesity, genetics
hematuria, flank pain, weight loss, anemia, palbable mass |
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Term
| Treatment for Renal cell CA |
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Definition
it is not amenable to radiation, chemo, or immunotherapy so
SURGERY is the only option* |
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Term
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Definition
stage 1: at or below 7 cm
stage 2: at or above 7 cm
Stage 3: invades venous return of kidney and extends into vena cava
stage 4: everything above and lymph nodes |
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Term
Testicular Cancer
2 main types |
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Definition
not common and not that lethal
*Germ cell tumor* = shows up early in life
1. *Seminomas*
2. Non- seminomas
Embryonal Cell, Teratoma, Choriocarcinoma |
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Term
| Risk factors of testicular cancer |
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Definition
Cryptorchism: undescended testes
- orchiopexy: recommended for treatment of undescended testes
maybe estrogen exposure? = bad luck |
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Term
Symptoms of Testicular Cancer
biochemical markers |
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Definition
PAINLESS TESTICULAR MASS
rare= systemic symptoms like weight loss, fever, malaise
*Many testicular cancers will secrete one or more of the folllowing = HCG (human chorionic gonadotropin), alphafetoprotein (AFP), lacatate dehydrogenase (LDH) |
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