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Terms in this set (139)

Reflux nephropathy

Pt's recurrent fevers and abdominal pain along with imaging finding consistent iwith rennal scarring indicate recurrent pyelonephritis
- resuts from retrograde flow of infected urine from bladder into ureter
- normally: ureters travel through bladder at oblique angle -> when baldder fills intramural ureter becomes compressed -> flap valve mechanism prevents retrograde flow of urine but this does not work if ureter enter the bladder at a perpendicular angle -> vesicoureteral reflux

VUR pts at higher risk for chronic pyelonpehritis
- inflammation can occur from pyelonephritis or from VUR itself due to hyodrstatic pressure on papillae
- ongoing injury -> renal scarring -> commonly at upper and lower poles of kidney in which compound papillae are found -> always open unlike simple papillae n mid kiney and are therefore more susceptible to dialtion and subseuqnet injury
- can laed to loss of nephroons and subsequent HTN

a. AD PKD presents in adulthood with hematura, HTN and renal insufficiency
b. malignant HTN refers to high BP that develops and causes end organ damage
- vision change, encephalopathy, renal failure
- no evidence of acute end organ dysfunction and imaging is more consistent with VUR and chronic pyelonephritis
c. multicystic dysplastic kidney - nonhereditary renal malformation with multuple noncommunicating cysts with intervening dysplastic tissue
- unilateral MCDK is silent but bilateral has early severe renal insuff. due to absence of functional renal tissue
d. posterior u rethral valves - bilateral hydronephrosis with calyceal dilation due to obstruction of urine flow in the urthra
- posterior urethral valves result from malformation of wolffian duct and only occur in males

Review pgs 562 and 563