front 1 Kidney and renal pain | back 1 Nephralgia |
front 2 Generally felt _________ __________; recorded as _________ _________ or ________ _______. | back 2 Costovertebral angle, CVA tenderness, flank pain Generally felt at costovertebral angle; recorded as CVA tenderness or flank pain. |
front 3 Why and how do we feel pain in the kidney | back 3 The pain can be caused by distention/inflammation of the renal capsule. Has a dull, constant character. The renal capsule is the only part of the kidney with pain receptors. |
front 4 What provides clues to intrarenal pathologies | back 4 Dipstick and microscopic urinalysis |
front 5 KUB identifies | back 5 gross abnormalities related to size, position, and shape (may show renal calculi) - Good for finding kidney stones |
front 6 Renogram/renal scan shows renal __________ and __________. | back 6 vasculature and tumors |
front 7 Name the congenital abnormalities Kidneys do not develop in the fetus. Some fetal kidney development. Genetically transmitted renal disorder resuliting in fluid-filled cysts that can expand and disrupt urine formation and flow; may be localized to one area or affect both kidneys | back 7 Agensis Hypoplasia Cystic kidney Diseases. |
front 8 True/False Bilateral agenesis is compatible with life | back 8 FALSE Bilateral agenesis is not compatible with life. |
front 9 What causes compensatory hypertrophy in the kidneys. | back 9 Unilateral agenesis compensatory hypertrophy of functional kidney. |
front 10 What are the two types of cystic kidney dieases | back 10 Autosomal recessive forms--- at birth Autosomal dominant types ---- later in life |
front 11 What are the three major risk factors for Renal Cell Carcinoma | back 11 Smoking, obesity, hypertension. |
front 12 Metastases may be particuarlary resistant to ________, ___________, and _______________. (p53 mutation) | back 12 radiation, immunotherapy, and chemotherapy |
front 13 What are the clinical manifestations of Renal Cell Carcinoma | back 13 CVA tenderness, hematuria, palpable mass |
front 14 Most common Kidney cancer in children | back 14 Nephroblastoma (Wilms Tumor) |
front 15 What are the clinical manifestation of Wilms Tumor | back 15 Palpable abdominal mass, my also have abdominal pain, hypertension, and/or hematuria |
front 16 What is the term used when you have an infection in your kidney? | back 16 Pyelonephritis |
front 17 These clinical manifestations are from what kidney disease? CVA tenderness, fever, chills, Nausea, Vomiting, anorexia, which increases fever-induced dehydration | back 17 Acute Pyelonephritis |
front 18 What is the diagnosis and treatment of Acute pyelonephritis? | back 18 Diagnosis: Presence of WBC casts indicative of upper UTI. If infection is really bad there can be hematuria and proteinuria. Treatment: Promptly managed with antimicrobials to avoid decreased renal function. |
front 19 What does the obstructive processes cause | back 19 Urine stasis
|
front 20 what are the common causes of obstruction in the kidney | back 20 Stones: most common, (composed of Calcium crystals; others include uric acid, struvite, cystine) Tumors Prostatic hypertrophy strictures of the ureters or urethra. |
front 21 Complete obstruction results in | back 21 Hydronephrosis, Decreased GFR, Ischemic kidney damage because of increased intraluminal pressure, Acute Tubular necrosis, and Chronic kidney disease. |
front 22 Acute glomerulonephritis is caused by | back 22 immune response to variety of potential triggers |
front 23 Attraction of immune cells to the area of inflammation results in __________ ____________ of the ___________ ____________ | back 23 Lysosomal degradation of the basement membrane Attraction of immune cells to the area of inflammation results in lysosomal degradation of the basement membrane |
front 24 TRUE or FALSE GFR may increase due to the dilation of mesangial cells, resulting in increased surface area for filtration | back 24 FALSE GFR may fall due to contraction of mesangial cells, resulting in decreased surface area for filtration |
front 25 Proteinuria, oliguria and azotemia, edema and hypertension are clinical manifestations of | back 25 Acute glomerulonephritis |
front 26 What are the treatments for acute glumerulonephritis | back 26 steroids, plasmapheresis, supportive measures such as dietary and fluid management, Management of systemic and renal hypertension |
front 27 Sclerosis and fibrosis of kidney is associated with? | back 27 Chronic glomerulonephritis |
front 28 present with _________ ___________, with or without hematuria, and ___________ _________ ________ ___________ | back 28 Present with persistent proteinuria, with or without hematuria, and slowly declining renal function. |
front 29 TRUE/FALSE Nephrotic Syndrome occurs due to increased glomerular permeability to proteins. | back 29 TRUE |
front 30 In acute renal failure, a sudden reduction of kidney function causes a __________ ___________ _________ _________. | back 30 Decreased glomerular filtration rate (GFR) |
front 31 If GFR is decreased what happens to urine output? | back 31 It decreases |
front 32 If GFR is decreased, what is retained? provide a common example. | back 32 nitrogenous waste products such as uric acid |
front 33 If GFR is decreased, what happens to serum creatinine? Increase or decrease? | back 33 Increase |
front 34 TRUE/FALSE If GFR is decreased, there are disruptions in fluid, electrolyte, and acid-base balances, especially potassium. | back 34 TRUE |
front 35 Renal function is monitored by ____________ _________, ______________ ________ and _____. | back 35 Serum creatinine, calculated GFR and BUN |
front 36 What syndrome produces widespread systemic effects? | back 36 Uremic syndrome |
front 37 What are the 3 sites of disruption in acute kidney injury? | back 37 Pre-renal Post-renal intrinsic/intrarenal |
front 38 In acute kidney injury: What is pre-renal disruption? ______ __________. | back 38 renal perfusion |
front 39 In acute kidney injury: What is post-renal disruption? Urine flow ________ ______ _____ _______ | back 39 distal to the kidney |
front 40 In acute kidney injury: What is intrinsic/intrarenal disruption? Circumstances within the ________ _______ _______, ________, ________, or _____________. | back 40 kidney blood vessels, tubules, glomeruli, or interstitium. |
front 41 Pre-renal kidney injuries are due to conditions that _______ _________ ____ _____ ________. EXAMPLES: hypovolemia, hypotension, HF, renal artery obstruction, fever, vomiting, diarrhea, burns, overuse of diuretics, edema, ascites, drugs such as ACE inhibitors, angiotensin II blockers, NSAIDs. | back 41 Diminish perfusion of the kidney. |
front 42 Pre-renal kidney Injury is characterized by _______ GFR, _________, _______ urine specific gravity and __________. * ______ urine sodium. | back 42 low, oliguria, high, osmolarity. * low |
front 43 Pre-renal kidney injury prolong prerenal ARF which leads to ____ ______ _______. | back 43 Acute tubular necrosis (intrinsic). |
front 44 Post-renal kidney injuries are due to ___________ _______ _____ ________ ________ _______ _______ ____ _____ ________. | back 44 Obstruction within the urinary collecting system distal to the kidney. |
front 45 Where will post-renal kidney injury cause elevated pressure, and what does it impede? | back 45 In Bowman capsule, and impedes glomerular filtration. |
front 46 Intrinsic/Intrarenal kidney injury is due to primary _______ _____ _____ ______ ____ ____ _______ _________. | back 46 dysfunction of the nephrons and the kidney itself. |
front 47 in intrinsic/Intrarenal kidney injury Most common problem within the renal tubules will result in ______ ______ _________. | back 47 Acute tubular necrosis (ATN) |
front 48 ATN causes _____________ insult and example________ _________. __________ insults and example _________. | back 48 Nephrotoxic insult, contrast media Ischemic insults, sepsis |
front 49 2 pathophysiological processes of intrinsic/intrarenal kidney injury: Vascular: ______ ________ _____ __________. which lead to ______ and _________. Tubular: _________ and ____________ ____________, causes ______ ______ ______ ________, ____________ ___________. | back 49 renal blood flow decreased, hypoxia and vasoconstriction Inflammation and reperfusion injury, causes casts, obstructs urine flow, tubular backleak. |
front 50 What are the three phases of acute tubular necrosis? | back 50 prodromal, oliguric, post-oliguric |
front 51 What is oliguria? | back 51 low urine production |
front 52 TRUE/FALSE is ATN self-limiting? (repairs itself) | back 52 True |
front 53 What ATN stage? -Oliguria/anuria -Volume overload -Hyperkalemia -Azotemia/uremia -Metabolic acidosis | back 53 Oliguric phase |
front 54 What ATN stage? -Injury has occured -Normal or low UO -High BUN and Cr | back 54 Prodromal Phase |
front 55 What ATN stage? -Fluid volume deficit -Labs begin to normalize | back 55 Postoliguric Phase |
front 56 Urine output to be considered oliguric? | back 56 <400ml per day |
front 57 Urine output to be considered anuric? | back 57 <100ml per day |
front 58 Volume overload causes _________ resulting in __________. | back 58 hypervolemia resulting in edema. |
front 59 Chronic kidney disease: Outcome of progressive and ________ ______ ______ _______ __________. | back 59 irrevocable loss of functional nephrons |
front 60 What health problems could often be linked with chronic kidney disease? | back 60 Primarily hypertension and diabetes mellitus |
front 61 Chronic kidney disease is defined as _______ ______ ________ or _______ _____ ____ _____ __________. | back 61 Decreased kidney function or kidney damage of 3 months duration. ` |
front 62 Chronic kidney disease also defined as GFR <______ml/minutes/1.73m2 for _____ months | back 62 60 3 |
front 63 What are the risk factors for chronic kidney disease? -Unfortunately there are 9 | back 63 Diabetes, hypertension, recurrent pyelonephritis, glomerulonephritis, polycystic kidney disease, family history of CKD, history of exposure to toxins, age over 65, ethnicity. |
front 64 TRUE/FALSE Chronic kidney disease is progressive and irreversible | back 64 TRUE |
front 65 What is the normal GFR? | back 65 90-120ml |
front 66 In chronic kidney disease: GFR reduction occurs with nephron loss. Kidney compensates until _____% to ______% of ________ are __________/_____________. | back 66 75%-80% of nephrons are damaged/nonfunctional |
front 67 What stage of chronic kidney disease according to nephron loss and clinical presentation? -<75% nephron loss -No signs/symptoms -BUN and creatinine normal -May not be diagnosed | back 67 Decreased renal reserve |
front 68 What stage of chronic kidney disease according to nephron loss and clinical presentation? -75%-90% nephron loss -Polyuria -nocturia -Slight elevation in BUN -Slight elevation in creatinine -May be controlled by diet and meds. | back 68 Renal insufficiency |
front 69 What stage of chronic kidney disease according to nephron loss and clinical presentation? ->90% nephron loss -Azotemia/Uremia -Fluid and electrolyte abnormalities -Osteodystrophy -Anemia -Dialysis/transplantation essential | back 69 end-stage renal disease |
front 70 What stage of chronic kidney disease according to GFR? -Kidney damage with normal or increased GFR -GFR >90ml/min/1.73m2 | back 70 Stage 1 |
front 71 What stage of chronic kidney disease according to GFR? -Mildly decreased GFR -GFR 60-89ml/min/1.73m2 | back 71 Stage 2 |
front 72 What stage of chronic kidney disease according to GFR? -Moderately decreased GFR -GFR 30-59ml/min/1.73m2 | back 72 Stage 3 |
front 73 What stage of chronic kidney disease according to GFR? -Severely decreased GFR -GFR 15-29ml/min/1.73m2 | back 73 Stage 4 |
front 74 What stage of chronic kidney disease according to GFR? -End-Stage kidney disease -GFR <15ml/min/1.73m2 | back 74 Stage 5 |
front 75 What Complications of chronic kidney disease is associated with the following: Hypervolemia escalated atherosclerotic process, heightened RAAS and SNS activity. | back 75 Hypertension and cardiovascular disease |
front 76 What Complications of chronic kidney disease is associated with the following: Retention of metabolic wastes; impaired healing, pruritus; dermatitis, uremic frost. | back 76 Uremic syndrome |
front 77 What Complications of chronic kidney disease is associated with the following: Retention of acidic waste products; hyperkalemia; kidneys lose ability to secrete H+ ions and bicarbonate. | back 77 Metabolic acidosis |
front 78 What Complications of chronic kidney disease is associated with the following: Retained potassium, phosphorus, magnesium | back 78 Electrolyte imbalances |
front 79 What Complications of chronic kidney disease is associated with the following: Elevated phosphorus and PTH causes altered bone/mineral metabolism -Kidneys unable to produce active Vitamin D which prevent reabsorb calcium in small intestine | back 79 Bone and mineral disorders |
front 80 What Complications of chronic kidney disease is associated with the following: -lack of erythropoietin -uremia shortens RBC life -combination of worsening CKD, anemia, and heart failure (cardiorenal anemia syndrome) | back 80 Anemia |
front 81 Clinical Management for Chronic Kidney Disease: CKD causes fluid and electrolyte imbalances, what must be done if their sodium is <135mmol/L | back 81 Fluid restriction |
front 82 Clinical Management for Chronic Kidney Disease: CKD causes fluid and electrolyte imbalances, besides fluid what else must be restricted? | back 82 Protein, because they pull water into our blood vessels |
front 83 In chronic kidney disease, what should be monitored to observe bone and mineral disorders, and when? | back 83 PTH, calcium and phosphorus if GFR is less than 60ml/min/1.73m2 |
front 84 In chronic kidney disease, to avoid malnutrition what must be limited? | back 84 Limit diet factors that could increase cardiovascular risk. |
front 85 In patients with chronic kidney disease who have anemia, what should be given? | back 85 erythropoiesis-stimulating agents (ESA)/synthetic EPO such as epoetin alfa and darbepoetin alfa |
front 86 Used for ATN and CKD stage 5 in order to remove metabolic wastes and correct fluid and electrolyte abnormalities. | back 86 Dialysis |
front 87 What are the two types of dialysis | back 87 Hemodialysis and peritoneal dialysis |
front 88 What is the most frequent and initial symptom of bladder | back 88 Hematuria |
front 89 Smoking is a risk factor for? | back 89 Bladder cancer |
front 90 What can lead to recurrent cystitis? | back 90 Vesicoureteral reflux |
front 91 What is the cause for the majority of urinary tract infections? | back 91 E.Coli |
front 92 What type of incontinence may be idiopathic, due to bladder infection, radiation therapy, tumor or stones, or CNS damage? | back 92 Urge incontinence |
front 93 What type of incontinence is due to weakening of pelvic muscles or intrinsic urethral sphincter deficiency | back 93 Stress incontinence |
front 94 What is the effect of Sympathetic nervous system on urination? L1 & L2 | back 94 In charge of not voiding. It relaxes your muscles and contracts internal sphincter. |
front 95 What is the effect of parasympathetic nervous on urination? S1-S4 | back 95 In charge of voiding by contracting dentirostral muscle and relaxing sphincter. |
front 96 Can medication lead to secondary voiding dysfunction? | back 96 Yes |
front 97 Anemia in people who have end-stage chronic renal disease is caused by | back 97 decreased secretion of erythropoietin. |
front 98 The normal post-void residual urine in the bladder is | back 98 less than 100 mL |
front 99 Absence of menstruation is called | back 99 amenorrhea. |
front 100 The pathology report for a patient with penile cancer has this statement: The tumor involves the shaft of the penis. The cancer is at what stage? | back 100 Stage II Explanation: Penile carcinoma is staged as follows: Stage I: The lesion is limited to the glans or foreskin. Stage II: The tumor involves the shaft of the penis. Stage III: The inguinal nodes are involved, but the lesion is operable. Stage IV: Disseminated disease. |
front 101 Pelvic floor muscle training is appropriate for | back 101 urge incontinence. |
front 102 A patient diagnosed with a micropenis must be evaluated for | back 102 endocrine disorders. |
front 103 TRUE/FALSE The most common cause of urinary obstruction in male newborns and infants is urethral valves. | back 103 True |
front 104 Detrusor muscle overactivity can be improved by administration of | back 104 botulinum toxin. |
front 105 The HPV vaccine is recommended for 11- to 12-year-old girls, but can be administered to girls as young as _____ years of age. | back 105 9 |
front 106 The patient reports persistent pelvic pain and urinary frequency and urgency. She says the pain improves when she empties her bladder. She does not have a fever and her repeated urinalyses over the past months have been normal, although she has a history of frequent bladder infections. She also has a history of fibromyalgia and hypothyroidism. Based on her history and complaints, her symptoms are characteristic of | back 106 interstitial cystitis. |
front 107 Cervical cancer can be detected in the early, curable stage by the ________ test. | back 107 Papanicolaou |
front 108 The most commonly ordered diagnostic test for evaluation of the urinary system is | back 108 ultrasonography. |
front 109 The condition in which the urethra opens on the dorsal aspect of the penis is known as | back 109 epispadias. |
front 110 It is true that fibrocystic breast disease: -commonly progresses to breast cancer -may be exacerbated by methylxanthines. -is characterized by painless breast lumps. -is a contraindication for progesterone birth control pills. | back 110 may be exacerbated by methylxanthines. |
front 111 A breast lump that is painless, hard, and unmoving is most likely | back 111 carcinoma |
front 112 Uterine prolapse is caused by a relaxation of the | back 112 cardinal ligaments. |
front 113 A patient who has difficulty walking without assistance is incontinent of urine when help doesn’t get to her quickly enough. The term for this type of incontinence is | back 113 functional. |
front 114 TRUE/FALSE Hypotension is both a cause of chronic kidney disease and a result of chronic kidney disease. | back 114 False, Hypertension is both a cause of chronic kidney disease and a result of chronic kidney disease. |
front 115 The most common types of uterine tumors are known as | back 115 leiomyomas. |
front 116 The expected treatment of a pregnant woman with hyperemesis gravidarum is | back 116 intravenous therapy. |
front 117 The individual at highest risk of pyelonephritis who requires monitoring for signs of its occurrence is woman who is paraplegic. woman who is pregnant. man who has glomerulonephritis. man who has chronic urinary tract infections. | back 117 man who has chronic urinary tract infections. |
front 118 The main clinical manifestation of a kidney stone obstructing the ureter is | back 118 renal colic. |
front 119 What is renal colic? | back 119 Renal colic is the flank pain that occurs with obstruction of the proximal ureter or renal pelvis. |
front 120 Glomerular disorders include | back 120 nephrotic syndrome. |
front 121 Appropriate management of end-stage renal disease includes | back 121 erythropoietin administration. |
front 122 The major underlying factor leading to the edema associated with glomerulonephritis and nephrotic syndrome is | back 122 proteinuria. |
front 123 A patient with gouty arthritis develops renal calculi. The composition of these calculi is most likely to be | back 123 uric acid crystals. |
front 124 Osteoporosis commonly occurs in patients with end-stage renal disease because of | back 124 hyperparathyroidism. |
front 125 One of the most frequent causes of chronic kidney disease is | back 125 hypertension. |
front 126 Which condition is caused by a genetic defect? | back 126 Polycystic kidney disease |
front 127 The oliguric phase of acute tubular necrosis is characterized by | back 127 fluid excess and electrolyte imbalance. |
front 128 Individuals with end-stage chronic renal disease are at risk for renal osteodystrophy and spontaneous bone fractures, because | back 128 They are deficient in active vitamin D. |
front 129 The patient most at risk for postrenal acute kidney injury is a(n) | back 129 elderly patient with hypertrophy of the prostate. |
front 130 In patients with polycystic kidney disease, renal failure is expected to progress over time as the cystic process destroys more nephrons. At what point will a patient reach end-stage renal disease? | back 130 Greater than 90% nephron loss |
front 131 One of the most common causes of acute tubular necrosis (ATN) is | back 131 Ischemic conditions. |
front 132 The organism most commonly associated with acute pyelonephritis is | back 132 Escherichia coli. |
front 133 Gastrointestinal drainage, perioperative and postoperative hypotension, and hemorrhage may all contribute to renal failure by causing | back 133 acute tubular necrosis |
front 134 The condition characterized by oliguria and hematuria is | back 134 acute glomerulonephritis. |
front 135 It is true that polycystic kidney disease is always rapidly fatal. caused by a streptococcal infection. associated with supernumerary kidney. genetically transmitted. | back 135 genetically transmitted. |
front 136 The most common direct cause of acute pyelonephritis is | back 136 infection by E. coli. |
front 137 The condition associated with end-stage chronic renal disease that is the most immediately life threatening is | back 137 hyperkalemia. |
front 138 The defining characteristic of severe acute kidney injury is | back 138 oliguria |
front 139 The most frequent initial symptom of bladder cancer is | back 139 hematuria |
front 140 A potential risk factor for breast cancer includes | back 140 early menarche and late first pregnancy. |
front 141 Treatment of a uterine prolapse may involve the insertion of a(n) ________ to hold the uterus in place. | back 141 pessary. |
front 142 TRUE/FALSE The best intervention for acute kidney injury (AKI) is prevention. | back 142 TRUE |
front 143 Dysfunctional uterine bleeding (DUB) is caused by | back 143 absent or diminished levels of progesterone. |
front 144 A patient being treated for acute tubular necrosis (ATN) develops mild polyuria. The nurse responds to questions about why this occurring by stating | back 144 “His renal tubules are recovering, so he is making more urine, but he is not able to concentrate urine well, because he is not fully recovered.” |
front 145 A person is unaware that his bladder is full of urine, but complains that he is leaking urine almost constantly. The most accurate term for this type of incontinence is | back 145 overflow. |
front 146 A patient has ureteral colic. The manifestation that requires immediate notification of the physician is | back 146 chills and fever. |
front 147 Sexual impotence is rarely because of | back 147 Primary causes |
front 148 A 52-year-old female had a surgical procedure in which the breast, lymphatics, and underlying muscle were removed. The procedure performed was a | back 148 radical mastectomy. |
front 149 In addition to renal colic pain, signs or symptoms of ureteral stones may frequently include | back 149 hematuria. |
front 150 Excessive vomiting in pregnant women is known as | back 150 hyperemesis gravidarum. |
front 151 The most helpful laboratory value in monitoring the progression of declining renal function is | back 151 serum creatinine. |
front 152 The consequence of an upper urinary tract obstruction in a single ureter is | back 152 hydronephrosis. |
front 153 The most common agent resulting in nephrotoxicity and subsequent acute tubular necrosis (ATN) in hospitalized patients is | back 153 contrast media. |
front 154 Nephrotic syndrome does not usually cause | back 154 hematuria. |
front 155 The most common type of renal stone is | back 155 calcium. |
front 156 The most likely cause of acidosis in a patient with end-stage renal disease is | back 156 insufficient metabolic acid excretion resulting from nephron loss. |
front 157 One cause of an extrinsic renal system obstruction is | back 157 pelvic tumor. |
front 158 Signs consistent with a diagnosis of glomerulonephritis include | back 158 proteinuria. |
front 159 At his most recent clinic visit, a patient with end-stage renal disease is noted to have edema, congestive signs in the pulmonary system, and a pericardial friction rub. Appropriate therapy at this time would include | back 159 initiation of dialysis. |
front 160 A patient with renal disease is at risk for developing uremia as the nephrons progressively deteriorate, because | back 160 GFR declines. |
front 161 Scrotal pain in males and labial pain in females may accompany renal pain as a result of | back 161 associated dermatomes. |
front 162 A patient who reported a very painful sore throat 3 weeks ago is now diagnosed with acute post-streptococcal glomerulonephritis. When asked, “Why is my urine the color of coffee?”, the nurse responds | back 162 “Your immune system was activated by your sore throat and has caused some damage in your kidneys that allows red blood cells to leak into the fluid that becomes urine and make it coffee-colored.” |
front 163 The pathophysiologic basis of acute glomerulonephritis is | back 163 an immune complex reaction. |