Patho Exam #3 Renal, Urinary and Male Reproductive

How many nephrons are in each kidney?
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pediatric renal functions are different than adults in what aspects?-decreased ability to remove excess water and solutes -decreased concentrating ability -narrow margin for fluid and electrolyte balance -increased risk of drug toxicityan interference with the flow or urine at any site along the urinary tracturinary tract obstructionexample of urinary tract obstructionkidney stone/ renal calculithe distention of the ureter with urine that cannot flow because the ureter is blocked; fluid buildup in ureterhydroureterthe dilation (swelling) of one or both kidneys due to fluid buildup in the kidney; kidney cannot filter bloodhydronephrosishydronephrosis leads torenal failureenlargement of the prostate due to an obstruction in both upper urinary tracts (only in men)prostate hypertrophymasses of crystals, protein or other substances that form within and may obstruct the urinary tractcalculi or urinary stonesmost at risk for kidney stones/ renal calculi gender-menmost at risk for kidney stones/ renal calculi race-caucasians and African Americansmost at risk for kidney stones/ renal calculi season-summermost at risk for kidney stones/ renal calculi fluid intake-low fluid intake, dehydrationmost at risk for kidney stones/ renal calculi diet-high in purinesmost at risk for kidney stones/ renal calculi occupation-working outside in heat (causes dehydration)kidney stones/renal calculi are classified according to theminerals that make up the stonemajor manifestation of kidney stones/renal calculirenal colic kidney pain (felt in back)involuntary loss of urineincontinenceinvoluntary loss of urine associated with abrupt and strong desire to void; often associated with involuntary contractions of detrusorurge incontinenceinvoluntary loss of urine during coughing, sneezing, laughing, or other physical activity associated with increased abdominal pressurestress incontinencestress incontinence is most common inwomen over 60, women who have had children, and men who have had prostate surgeryinvoluntary loss of urine with overdistention of bladder; associated with neurological lesions below S1, polyneuropathies, and urethral obstructionoverflow incontinencecombination of both stress and urge incontinencemixed incontinenceinvoluntary loss of urine attributable to dementia or immobilityfunctional incontinencea urinary problem caused by interference with the normal nerve pathways associated with urinationneurogenic bladdermost common bladder cancertransitional cell carcinomainflammation of the bladdercystitisacute cystitis isomer common in women because they have ashorter urethraurinary tract infections can becomekidney infectionsacute cystitis is also known as aurinary tract infectionUTI medications turn urine, saliva, and tearsorangeinflammation of the urinary epithelium caused by bacteriaUTImost common pathogen to cause a UTIEscherichia coliwhat makes kids at risk for UTIs- taking baths instead of showers - wiping from back to frontUTIs are common in7-11 year old girlspyelonephritis is akidney infectioninterstitial cystitis isNONBACTERIAL cystitis due to inflammation of inner lining of bladderacute infection of the renal pelvis interstitiumAcute pyelonephritispersistent or recurring episodes of acute pyelonephritis that lead to scarringchronic pyelonephritisrisk of chronic pyelonephritis increases in individuals with renal infections and some type ofobstructive pathologic condition2 symptoms of pyelonephritis that differ from symptoms of a UTI `flank pain and high feverinflammation of the glomerulusglomerulonephritismajor cause of glomerulonephritisantigen/antibody complex from strep is trapped in kidneys; history of cold or strepSigns and Symptoms of glomerulonephritis includehypertension fever weight gain headache hematuria fatigue oliguriaexcretion of 3.5 grams or more of protein in the urine per daynephrotic syndromeprotein excretion in nephrotic syndrome is caused by aglomerular injuryfindings in nephrotic syndrome-hypoalbuminemia (low protein in blood) -edema -hyperlipidemia -lipiduria -vitamin D deficiencyrapid loss of renal function due to damage to the kidneys; formerly called acute renal failureAcute Kidney InjuryAre men or women more likely to get a uric acid stone?menAre men or women more likely to get a calcium kidney stone?womentype of acute kidney injury: most common cause of ARF; caused by impaired renal blood flow; GFR declines because of the decrease in filtration pressurePrerenaltype of acute kidney injury: acute tubular necrosis (ATN) is the most common cause of this; postischemic or nephrotoxic; oliguriaintrarenaltype of acute kidney injury: occurs with urinary tract obstructions that affect the kidneys bilaterally; example=prostate enlargementpostrenalwhat happens during the initiation phase of an AKIthe injury is occurring, injury can be preventedwhat happens during the maintenance phase of an AKI-damage to kidney has already been done -serum creatinine and blood urea nitrogen levels increase -urine output is lowest during this phasewhat happens during the recovery phase of an AKI-injury is repaired and kidney function is reestablished -diuresis common -decline in serum creatinine and urea -increase in creatinine clearanceprogressive loss or renal function that affects nearly all organ systemschronic kidney disease (CKD)CKD is associated withhypertension, diabetes, and intrinsic kidney diseasenormal GFR is above90 mL/minsevere GFR is15-29 mL/minend stage GFR is less than15 mL/minwhich Is more important to monitor in CKD (serum creatinine or BUN)serum creatinine because BUN can spike just with dehydration and is not a true sign of kidney failurehow do we determine the severity of chronic kidney diseaseby evaluating the glomerular filtration phasewhat are the changes with CKD- potassium skyrockets - decreased synthesis of vitamin D, calcium - anemia (bc no erythropoietin)kidneys fuse creating one large kindeyhorseshoe kidneyabnormal congenital opening of the male urethra on the undersurface/inferior surface of the penishypospadiasmalformation of of where penis should be curvedchordeecongenital disorder charcterized by the penile urethral opening being located on the dorsal surfaceepispadiasCongenital anomaly occurring when the bladder everts itself, or turns inside out, through an absent part of the lower abdominal and anterior bladder walls with incomplete closure of the pubic bone.exstrophy of the bladderwhat happens in ureteropelvic junction obstructionthere is an obstruction where the renal pelvis meets the ureter and it causes hydronephrosisabsence of one or both kidneysRenal agenesiskidney is too small but perfectly functionalhypoplastickidney is deformed internally and is nonfunctionaldysplasticwhat is the most common cause of renal failure in kidshemolytic uremic syndrome HUSendothelial lining of the glomerulus becomes swollen and occluded with fibrin clots; caused by E.colihemolytic uremic syndromemanifestations of HUS-pallor - severe anorexia - seizures - lethargyinflammation of the urethra usually, but not always, caused nu a sexually transmitted disease; nonsexual origins can be caused by urologic procedures, insertion of foreign objects, anatomic abnormalities, or traumaurethritisfibrotic narrowing of the urethra caused by scarring; commonly a result of trauma or untreated or severe urethral infectionsurethral stricturesinability to retract foreskin from the glans of the penis (distal to proximal); frequently caused by poor hygiene or chronic infectionsphimosisinability to replace or cover the glans with the foreskin (proximal to distal); frequently caused by poor hygiene or chronic infectionsparaphimosis"Bent nail syndrome;" slow development of fibrous plaques (thickening) in the erectile tissue of the corpus cavernosa, causing a lateral curvature of the penis during erection; occurs in middle aged men and causes painful erections and intercoursePeyronie diseaseCondition of prolonged penile erection; urologic emergencypriapismcarcinoma of the penis israrepenile cancers are mostlysquamous cell carcinomassurvival rate of people with penile cancer5 year survival rate of 50%inflammation of the glans penis; usually associated with foreskin inflammationbalanitisinflammation/dilation of veins in the spermatic cord caused by inadequate or absent valves in the spermatic veinsvaricocelescrotal swelling caused by collection of fluid within the tunica vaginalis ; imbalance between fluid secretion and reabsorptionhydrocelepainless diverticulum of the epididymis located between the head of epididymis and the testis; contains milky fluid that contain sperm and does no cover the entire anterior scrotal surfacespermatocelefailure of one or more of the testes to descend from the abdominal cavity into the scrotumcryptorchidismtreatment for cryptorchidismhormone therapy or surgery (orchiopexy)acute inflammation of the testis; complication of the systemic disease or related to epididymitisorchitismost common cause of orchitismumpsrotation of the testis that causes the twisting of blood vessels in the spermatic cordtorsion of the testisamong the most curable of cancers; common in men between ages 15 and 35; causes painless testicular enlargementtesticular cancerinflammation of the epididymis; common in sexually active men; pathogen reaches epididymus by ascending the vas deferens from anslready infected bladder or urethraepididymitisenlargement of the prostate gland due to an increase in the number of cellsBenign Prostatic Hyperplasia (BHP)symptoms of BHP are associated withurethral compressionBHP has a relationship toaginghow to diagnose BHP-digital rectal exam -prostate specific antigen monitoring -PSAD levelsinflammation of the prostateprostatitisoverdevelopment of breast tissue in malesgynecomastia