Acute Kidney Injury Overview

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Questions and Answers

What is the primary cause of acute tubular necrosis?

  • Ischemia
  • Nephrotoxins
  • Both Ischemia and Nephrotoxins (correct)
  • None of the above

Which of the following is the most common cause of prerenal AKI?

  • Liver Failure
  • Heart Failure
  • Volume Depletion (correct)
  • Dehydration

What are the three main types of acute kidney injury?

The three main types of acute kidney injury are prerenal, postrenal, and intrinsic/intrarenal.

What is the most common cause of acute tubular necrosis?

<p>Ischemia (D)</p> Signup and view all the answers

What is the most common cause of ischemic ATN?

<p>Sepsis (C)</p> Signup and view all the answers

What is the most common cause of prerenal AKI?

<p>Volume depletion (A)</p> Signup and view all the answers

What is the most common cause of postrenal AKI?

<p>Ureteral obstruction (C)</p> Signup and view all the answers

Acute pyelonephritis is most commonly caused by hematogenous spread.

<p>False (B)</p> Signup and view all the answers

What are the hallmark symptoms of acute pyelonephritis?

<p>Fever, chills, positive CVA tenderness, dysuria, urgency, and frequency.</p> Signup and view all the answers

What are the common causes of chronic pyelonephritis?

<p>Obstructive disorders, renal calculi, neurogenic bladder, vesicoureteral reflux, or underlying renal disease.</p> Signup and view all the answers

Which of the following is NOT a type of incontinence?

<p>Nocturnal incontinence (B)</p> Signup and view all the answers

Match the following types of incontinence with their descriptions:

<p>Stress incontinence = Occurs when urine is involuntarily lost with increases in intra-abdominal pressure. Urge incontinence = Involuntary sudden leakage of urine along with or immediately following the sensation of a need to urinate (urgency). Overflow incontinence = Bladder becomes so full that it leaks urine, or &quot;overflows&quot;. Functional incontinence = Related to physical or environmental limitations resulting in an inability to access a toilet in time.</p> Signup and view all the answers

What is the most common cause of interstitial cystitis?

<p>Unknown etiology (C)</p> Signup and view all the answers

Autosomal dominant polycystic kidney disease is a more common type than autosomal recessive polycystic kidney disease.

<p>True (A)</p> Signup and view all the answers

Benign prostatic hyperplasia is a premalignant condition.

<p>False (B)</p> Signup and view all the answers

Testicular torsion is a medical emergency.

<p>True (A)</p> Signup and view all the answers

What is the most common cause of epididymitis in men older than 35 years?

<p>Common urinary tract pathogens such as E. coli and Pseudomonas.</p> Signup and view all the answers

What is the most common type of renal cancer?

<p>Renal cell carcinoma (A)</p> Signup and view all the answers

Which of the following is NOT a risk factor for renal cell carcinoma?

<p>Low sodium diet (C)</p> Signup and view all the answers

Glomerulopathies are the most common cause of ESRD.

<p>True (A)</p> Signup and view all the answers

Which of the following is NOT a cause of secondary glomerulopathies?

<p>Polycystic kidney disease (C)</p> Signup and view all the answers

Vesicoureteral reflux is a serious congenital anomaly.

<p>True (A)</p> Signup and view all the answers

What is the most common cause of obstructive uropathy?

<p>Urinary calculi (A)</p> Signup and view all the answers

Which of the following is a hallmark feature of chronic pyelonephritis?

<p>Coarse, discrete, corticomedullary scars (B)</p> Signup and view all the answers

Acute pyelonephritis is usually unilateral.

<p>True (A)</p> Signup and view all the answers

Chronic pyelonephritis is generally caused by bacterial infection.

<p>True (A)</p> Signup and view all the answers

Acute pyelonephritis is a more severe form of pyelonephritis than chronic pyelonephritis.

<p>True (A)</p> Signup and view all the answers

Which of the following is NOT a common cause of urinary tract infections (UTIs) in women?

<p>Smoking (D)</p> Signup and view all the answers

What is the most common cause of Wilms tumor?

<p>Nephrogenic rests, persistent clusters of embryonic cells.</p> Signup and view all the answers

Nocturnal enuresis

<p>True (A)</p> Signup and view all the answers

What is the main factor that causes the basement membrane to degrade in acute glomerulonephritis?

<p>Immune cells.</p> Signup and view all the answers

Chronic glomerulonephritis is generally caused by lesions and sclerotic injury.

<p>True (A)</p> Signup and view all the answers

Prostatitis is an inflammation of the prostate gland.

<p>True (A)</p> Signup and view all the answers

What is the most common cause of acute bacterial prostatitis?

<p>E. coli (B)</p> Signup and view all the answers

Which of the following is NOT a common symptom of chronic prostatitis?

<p>Urethral discharge (B)</p> Signup and view all the answers

What is the most common cause of Peyronie's disease?

<p>Trauma (A)</p> Signup and view all the answers

Cryptorchidism is a condition in which one or both testicles fail to descend into the scrotum.

<p>True (A)</p> Signup and view all the answers

Which of the following is NOT a risk factor for testicular cancer?

<p>Obesity (C)</p> Signup and view all the answers

What is the most common type of endometrial cancer?

<p>Endometrioid carcinoma (A)</p> Signup and view all the answers

Which of the following HPV types is MOST associated with cervical cancer?

<p>HPV-16 (C)</p> Signup and view all the answers

All cases of cervical cancer are caused by HPV infection.

<p>True (A)</p> Signup and view all the answers

Cervical cancer is the most common type of cancer in women.

<p>False (B)</p> Signup and view all the answers

What is the most effective way to prevent cervical cancer?

<p>HPV vaccination and regular cervical cancer screenings.</p> Signup and view all the answers

Which of the following is a common symptom of endometriosis?

<p>All of the above (D)</p> Signup and view all the answers

What is the most common site of endometriosis?

<p>The peritoneum.</p> Signup and view all the answers

What is the most common cause of dysfunctional uterine bleeding (DUB)?

<p>Hormonal imbalances (A)</p> Signup and view all the answers

Endometriosis is a common cause of infertility.

<p>True (A)</p> Signup and view all the answers

Leiomyomas are a type of cancer.

<p>False (B)</p> Signup and view all the answers

Uterine fibroids are hormonally sensitive.

<p>True (A)</p> Signup and view all the answers

Fibroadenomas are a type of cancer.

<p>False (B)</p> Signup and view all the answers

Fibroadenomas are more common in women in their 20s and 30s.

<p>True (A)</p> Signup and view all the answers

Cervicitis is an inflammation of the cervix.

<p>True (A)</p> Signup and view all the answers

Lactobacilli play a role in preventing vaginal infections.

<p>True (A)</p> Signup and view all the answers

Polycystic ovary syndrome (PCOS) is the most common cause of dysfunctional uterine bleeding.

<p>True (A)</p> Signup and view all the answers

Which of the following is NOT a characteristic of PCOS?

<p>Increased secretion of follicle-stimulating hormone (FSH) (C)</p> Signup and view all the answers

Pelvic inflammatory disease (PID) is an infection of the fallopian tubes and ovaries.

<p>True (A)</p> Signup and view all the answers

PID is most commonly caused by sexually transmitted infections.

<p>True (A)</p> Signup and view all the answers

Endometriosis is a common cause of pelvic pain.

<p>True (A)</p> Signup and view all the answers

Endometriosis is more common in women who have never had children.

<p>False (B)</p> Signup and view all the answers

Lichen sclerosus is a premalignant condition.

<p>True (A)</p> Signup and view all the answers

Endocervical polyps are always benign.

<p>False (B)</p> Signup and view all the answers

The menstrual cycle is regulated by hormones.

<p>True (A)</p> Signup and view all the answers

Ovulation occurs on day 14 of the menstrual cycle.

<p>False (B)</p> Signup and view all the answers

The corpus luteum produces progesterone.

<p>True (A)</p> Signup and view all the answers

Metrorrhagia is abnormal bleeding between menstrual periods.

<p>True (A)</p> Signup and view all the answers

Oligomenorrhea is infrequent menstruation.

<p>True (A)</p> Signup and view all the answers

Dysmenorrhea is painful menstruation.

<p>True (A)</p> Signup and view all the answers

Primary dysmenorrhea is caused by a underlying medical condition.

<p>False (B)</p> Signup and view all the answers

Secondary dysmenorrhea is caused by an underlying medical condition.

<p>True (A)</p> Signup and view all the answers

Ovarian cysts are always cancerous.

<p>False (B)</p> Signup and view all the answers

Follicular cysts are the most common type of ovarian cyst.

<p>True (A)</p> Signup and view all the answers

A luteal cyst is a type of ovarian cyst that forms after ovulation.

<p>True (A)</p> Signup and view all the answers

Polycystic ovary syndrome is a common cause of infertility.

<p>True (A)</p> Signup and view all the answers

Which of the following is NOT a characteristic of polycystic ovary syndrome (PCOS)?

<p>Increased secretion of follicle-stimulating hormone (FSH) (D)</p> Signup and view all the answers

Fibroadenomas are more likely to be found in women who are taking hormone replacement therapy.

<p>True (A)</p> Signup and view all the answers

Fibroadenomas typically grow rapidly.

<p>False (B)</p> Signup and view all the answers

Fibroadenomas are always benign.

<p>False (B)</p> Signup and view all the answers

Most cases of cervical cancer are caused by HPV infection.

<p>True (A)</p> Signup and view all the answers

HPV vaccination is a very effective way to prevent cervical cancer.

<p>True (A)</p> Signup and view all the answers

Regular cervical cancer screenings can help to detect early signs of cervical cancer.

<p>True (A)</p> Signup and view all the answers

Endometriosis is a condition in which the lining of the uterus grows outside of the uterus.

<p>True (A)</p> Signup and view all the answers

Endometriosis is a common cause of pelvic pain.

<p>True (A)</p> Signup and view all the answers

Flashcards

Acute Kidney Injury (AKI)

Sudden decline in kidney function, causing waste buildup in the blood and fluid/electrolyte imbalance.

Prerenal AKI

AKI caused by reduced blood flow to the kidneys, often due to low blood volume or severe dehydration.

Intrinsic/Intrarenal AKI

AKI due to direct damage within the kidney itself; often from inflammation or obstructed blood vessels within the kidney.

Postrenal AKI

AKI caused by an obstruction in the urinary system after the kidney, preventing urine flow.

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Acute Tubular Necrosis (ATN)

The most common cause of intrinsic AKI; damage to the kidney's tubules, usually from lack of blood flow or toxins.

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Nephrotic Syndrome

Kidney disorder causing protein loss in the urine leading to fluid buildup and other complications.

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Nephritic Syndrome

Kidney disorder causing inflammation of the glomeruli, blood in urine.

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Pyelonephritis

Infection of the kidney and renal pelvis, usually from a bladder infection spreading upward.

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Polycystic Kidney Disease (PKD)

Inherited disorder marked by fluid-filled cysts on the kidneys, often leading to kidney damage.

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Benign Prostatic Hyperplasia (BPH)

Noncancerous enlargement of the prostate gland, commonly affecting older men and causing urinary problems.

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Testicular Torsion

Twisting of the spermatic cord, cutting off blood supply to the testicle, a urologic emergency.

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Epididymitis

Infection of the epididymis, often from a urinary tract infection spreading upward.

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Phimosis

Inability to retract the foreskin of the penis due to a tight preputial opening.

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Paraphimosis

Condition where foreskin is pulled back too tightly and can't return to normal position.

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Wilms tumor

Most common childhood kidney cancer, appearing as a large, potentially growing mass in the abdomen.

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Nocturnal enuresis

Bedwetting during sleep in children of an appropriate age after a period of expected dryness.

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Glomerulonephritis

Inflammation of the glomeruli, the filtering units of the kidneys, usually related to an immune response.

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Prostatitis

Inflammation of the prostate gland, often due to bacterial infection, presenting with urinary symptoms, pain.

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Peyronie's Disease

Connective tissue disorder causing hard lumps in the penis, often leading to curvature and pain during erection.

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Renal Cell Carcinoma

Most common type of kidney cancer in adults, often originating in the kidney's cortex, which can sometimes spread to other regions of the body.

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Glomerulopathies

Disorders affecting the glomeruli of the kidneys, including both primary & secondary conditions, and contributing to kidney failure.

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Vesicoureteral Reflux (VUR)

Backflow of urine from the bladder into the ureters, a serious condition often leading to kidney infections.

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Obstructive Uropathy

Blocking of urine flow anywhere in the urinary tract, causing swelling in the kidneys, infections, and potentially permanent damage.

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Nephrolithiasis

Kidney stones, solid masses formed from urine minerals and salts, potentially causing blockages and pain.

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Breast Cancer

Cancer that develops within the breast tissue of women.

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Fibrocystic Breasts

Common benign breast condition involving cysts and fibrosis, often causing tenderness or pain, especially linked to hormones.

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STI (Sexually Transmitted Infection)

Infection spread through sexual contact, with many types presenting varying symptoms or being asymptomatic.

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Dysfunctional Uterine Bleeding (DUB)

Abnormal uterine bleeding not caused by a specific disease, due to hormone imbalances, often linked to ovulation issues.

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Endometriosis

Condition where endometrial tissue grows outside the uterus, potentially causing pain, irregular periods, infertility.

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Uterine Fibroids

Noncancerous tumors in the uterine wall

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Cervical Cancer

Cancer affecting the cervix, often due to persistent HPV infections.

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Septate Vagina

Rare condition where the vagina is divided by a wall. It can result from developmental issues in early fetal life.

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Dysmenorrhea

Painful menstrual periods, having varying causes.

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PCOS (Polycystic Ovary Syndrome)

Hormonal disorder affecting ovulation and related to insulin resistance, often in women of reproductive age, characterized by cysts on the ovaries.

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PID (Pelvic Inflammatory Disease)

Infection of organs in the female reproductive system, often starting in the cervix and spreading, potentially leading to infertility.

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Acute Kidney Injury (AKI)

Sudden kidney function decrease, causing waste buildup and fluid imbalance.

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Prerenal AKI

AKI due to reduced blood flow to the kidneys.

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Intrinsic/Intrarenal AKI

Kidney damage directly within the kidney.

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Postrenal AKI

AKI caused by blockage after the kidney.

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Acute Tubular Necrosis (ATN)

Tubule damage in the kidney, common AKI cause.

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Nephrotic Syndrome

Kidney disorder causing protein loss & fluid buildup.

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Nephritic Syndrome

Kidney inflammation, blood in urine.

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Pyelonephritis

Kidney infection, often from bladder infection.

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Polycystic Kidney Disease (PKD)

Inherited cysts on the kidneys.

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Benign Prostatic Hyperplasia (BPH)

Non-cancerous prostate enlargement.

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Testicular Torsion

Twisted testicle, cutting off blood flow.

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Epididymitis

Infection of the epididymis.

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Phimosis

Tight foreskin, can't retract.

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Paraphimosis

Foreskin pulled back too tight.

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Wilms Tumor

Childhood kidney cancer.

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Nocturnal Enuresis

Bedwetting during sleep in children.

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Glomerulonephritis

Inflammation of the glomeruli (kidney filters).

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Prostatitis

Prostate gland inflammation.

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Peyronie's Disease

Penile plaques & curvature.

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Renal Cell Carcinoma

Kidney cancer, often in adults in the cortex

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Glomerulopathies

Kidney filter disorders, often leading to kidney failure.

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Vesicoureteral Reflux (VUR)

Urine backflow to the ureters.

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Obstructive Uropathy

Blocked urine flow, kidney swelling, damage.

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Nephrolithiasis

Kidney stones.

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Breast Cancer

Cancer in the breast tissue.

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Fibrocystic Breasts

Breast condition with cysts and tissue changes.

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Sexually Transmitted Infections (STIs)

Infections spread through sexual contact.

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Dysfunctional Uterine Bleeding (DUB)

Abnormal uterine bleeding, not caused by disease.

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Endometriosis

Endometrial tissue outside the uterus.

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Uterine Fibroids

Noncancerous tumors in the uterine wall.

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Cervical Cancer

Cancer of the cervix.

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Septate Vagina

Vagina divided by a wall.

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Dysmenorrhea

Painful menstrual periods.

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Polycystic Ovary Syndrome (PCOS)

Hormonal disorder, often with cysts on the ovaries.

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Pelvic Inflammatory Disease (PID)

Infection of female reproductive organs.

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Endometrial Cancer

Cancer of the lining of the uterus.

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Metrorrhagia

Bleeding between menstrual periods.

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Hypomenorrhea

Deficient amount of menstrual flow.

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Oligomenorrhea

Infrequent menstruation.

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Polymenorrhea

Increased frequency of menstruation.

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Study Notes

Acute Kidney Injury (AKI)

  • AKI (formerly ARF) is a sudden reduction in kidney function.
  • It causes accumulation of waste in the blood (BUN), and a disruption of fluid, electrolyte, and acid-base balances.
  • Increased serum creatinine and decreased GFR are also observed.
  • Classified by pathophysiology: prerenal, postrenal, and intrinsic/intrarenal.

Causes of AKI

  • Prerenal:
    • Hypovolemia (most common)
    • Heart failure
    • Hepatorenal syndrome
    • Decreased cardiac output
    • Cardiogenic shock, dysrhythmias, heart failure, MI
    • Renal artery occlusion (large or medium vessel)
    • Renal vein thrombosis
  • Postrenal:
    • Bladder outlet obstruction, tumors
    • Renal calculi (kidney stones)
    • Papillary necrosis
    • Retroperitoneal fibrosis
  • Intrinsic/Intrarenal:
    • Small vessel disease
    • Thrombotic microangiopathy
    • Renal atheroembolism
    • Small vessel vasculitis
    • Glomerular disease (Anti-GBM disease, Lupus nephritis, Postinfectious glomerulonephritis, Infective endocarditis, Membranoproliferative glomerulonephritis, Cryoglobulinemia, IgA nephropathy/Henoch-Schönlein)
    • Acute tubular necrosis (ATN) – Ischemia, Nephrotoxins, Rhabdomyolysis, Radiocontrast agents
    • Acute interstitial nephritis (AIN) – Drugs, Infection, Systemic disease, Intratubular obstruction (casts, drugs)

Acute Kidney Injury - Prerenal AKI

  • Reduced blood flow to kidneys.
  • Volume depletion is the most common cause (hemorrhage, dehydration, burns).
  • Decreased cardiac output can also cause prerenal AKI (cardiogenic shock, dysrhythmias, heart failure, MI).
  • Other causes include occlusion/stenosis of renal artery, renal vein thrombosis, and certain drugs.

Acute Tubular Necrosis (ATN/ATI)

  • Most common cause of acute kidney injury.
  • Caused by ischemia or nephrotoxic substances (e.g., sepsis, drugs, contrast, rhabdomyolysis).
  • Manifestations include reduced urine output, increased BUN/Cr, and oliguria.

Chronic Kidney Disease (CKD)

  • Gradual loss of kidney function over months or years, eventually resulting in end-stage kidney disease.

Pyelonephritis

  • Infection of the kidney's renal pelvis and parenchyma.
  • Typically caused by ascending urinary tract infections (UTIs) with bacteria (often E. coli) or other microorganisms.
  • Predisposing factors include vesicoureteral reflux, urinary obstruction, and immunocompromised states.

Acute Pyelonephritis

  • Symptoms include sudden onset, fever, chills, pain, urinary urgency, and frequency

Nephrotic Syndrome

  • Damage to the glomeruli increasing glomerular permeability to proteins.
  • Most common cause in adults is DM.
  • Characterized by marked proteinuria, hypoalbuminemia, hyperlipidemia, and edema.

Nephritic Syndrome

  • Most common causes are immunologic diseases impacting the glomeruli.
  • Characterized by hematuria, proteinuria, reduced glomerular filtration, azotemia, and hypertension.

Other Renal Conditions

  • Postrenal failure
  • Polycystic kidney disease (PKD)
  • Interstitial cystitis
  • Wilms tumor (kidney cancer in children)
  • Testicular torsion
  • Epididymitis (inflammation of the epididymis)
  • Phimosis (tight foreskin, difficult retraction)
  • Paraphimosis (foreskin trapped behind the penis)
  • Renal cell carcinoma

Incontinence

  • Stress incontinence: urine loss with increased intra-abdominal pressure
  • Urge incontinence: Sudden leakage of urine, often with a sensation of urgency
  • Mixed incontinence: Combination of stress and urge incontinence
  • Overflow incontinence: Fluid buildup in the bladder and spontaneous leakage
  • Functional Incontinence: Inability to reach the toilet in time

Pyelonephritis

  • Inflammation of the tubules and interstitium and renal pelvis.
  • Can develop from a UTI or other urinary tract problems.

Prostate conditions

  • Benign Prostatic Hyperplasia (BPH): Non-cancerous enlargement of the prostate, frequently leading to urinary obstruction.
  • Prostatitis: Inflammation of the prostate, often caused by infection.

Additional Information

  • The provided notes contain a mixture of acute and chronic kidney conditions, which suggests a broader study resource, potentially part of a medical curriculum or exam preparation.
  • A more detailed understanding of these conditions may require additional review of specific cases, treatments, and diagnostic factors to better analyze individual patient data.

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