Renal Pathophysiology and Treatment

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Questions and Answers

What is a direct consequence of hypocalcemia in renal failure?

  • Increased renal tubule cell activity
  • Increased 1-alpha-hydroxylation of vitamin D
  • Decreased phosphate excretion
  • Decreased calcium absorption (correct)

What is one significant risk associated with cyst formation in end-stage kidneys during dialysis?

  • Formation of renal stones
  • Development of osteoporosis
  • Persistent hyperphosphatemia
  • Increased risk for renal cell carcinoma (correct)

Which condition is NOT directly caused by renal osteodystrophy?

  • Secondary hyperparathyroidism
  • Hypocalcemia
  • Chronic renal failure (correct)
  • Osteomalacia

What is the treatment option for renal failure that involves replacement of kidney function?

<p>Dialysis or renal transplant (D)</p> Signup and view all the answers

Which of the following is a feature of hyperphosphatemia in renal failure?

<p>Decreased vitamin D synthesis (C)</p> Signup and view all the answers

What is the gold standard method for confirming a diagnosis of cystitis?

<p>Urine culture greater than 100,000 colony forming units (B)</p> Signup and view all the answers

Which organism is responsible for the majority of cystitis cases?

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

Which of the following symptoms is typically NOT associated with cystitis?

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

What is a common risk factor for developing a urinary tract infection (UTI)?

<p>Use of catheters (B)</p> Signup and view all the answers

Why might Klebsiella pneumoniae and Proteus mirabilis notably impact urinary tract infections?

<p>They are both commonly found in alkaline urine (D)</p> Signup and view all the answers

What condition is suggested by the presence of sterile pyuria?

<p>Urethritis due to <em>Chlamydia trachomatis</em> or <em>Neisseria gonorrhoeae</em> (B)</p> Signup and view all the answers

Which of the following is NOT a common symptom of pyelonephritis?

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

What is a key feature of chronic pyelonephritis?

<p>Cortical scarring with blunted calyces (B)</p> Signup and view all the answers

What is a major risk factor for nephrolithiasis?

<p>High concentration of solute in urinary filtrate (B)</p> Signup and view all the answers

Which pathogen is most commonly associated with pyelonephritis?

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

What condition can lead to atrophic tubules containing eosinophilic proteinaceous material in the kidney?

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

Which of the following complications is associated with chronic renal failure?

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

Which symptom is typically associated with increased nitrogenous waste products in the blood?

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

Flashcards

Urinary Tract Infection (UTI)

An infection of the urethra, bladder, or kidneys.

How UTIs usually happen

Ascending infection that is more common in females due to a shorter urethra.

Cystitis

Inflammation of the bladder.

Dysuria

Painful urination.

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Urinary frequency and urgency

Increased frequency and urgency of urination.

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Hypocalcemia

A condition where calcium levels in the blood are low, often caused by issues with vitamin D activation in the kidneys.

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Hyperphosphatemia

High phosphate levels in the blood. Often occurs alongside low calcium levels in renal failure.

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Renal Osteodystrophy

Bone disease caused by impaired kidney function, leading to weakened bones. Can involve increased parathyroid hormone, softening of bones, and osteoporosis.

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Dialysis

A treatment for end-stage kidney failure, where a machine filters the blood.

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Renal Transplant

A surgical procedure where a healthy kidney from a donor is transplanted into the recipient.

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Sterile Pyuria

Presence of white blood cells in urine (pyuria) with a negative urine culture. Suggests urethritis caused by Chlamydia trachomatis or Neisseria gonorrhoeae. The main symptom of urethritis is dysuria (painful urination).

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Pyelonephritis

Inflammation of the kidney, typically caused by an ascending infection. Increased risk with vesicoureteral reflux (urine flowing back to the kidneys).

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E. coli and pyelonephritis

Most common cause of pyelonephritis, responsible for 90% of cases.

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Chronic Pyelonephritis

A type of kidney infection caused by multiple episodes of acute pyelonephritis, leading to scarring and atrophy of kidney tissue.

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Nephrolithiasis (Kidney Stones)

A condition where kidney stones form due to precipitation of urinary solutes.

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Chronic Renal Failure

End-stage kidney failure that can result from various causes, including diabetes, hypertension, and glomerular diseases.

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Uremia

Increased nitrogenous waste products in the blood, a hallmark of chronic renal failure, leading to symptoms like nausea, anorexia, and mental confusion.

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Anemia in Chronic Renal Failure

Anemia in chronic renal failure is caused by decreased erythropoietin production by the kidneys.

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Study Notes

  • Hypocalcemia is caused by decreased 1-alpha-hydroxylation of vitamin D by proximal renal tubule cells and hyperphosphatemia
  • Renal osteodystrophy results from secondary hyperparathyroidism, osteomalacia, and osteoporosis
  • Treatment involves dialysis or renal transplant
  • Cysts often develop within shrunken end-stage kidneys during dialysis, increasing the risk for renal cell carcinoma

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