Question

2019 PATH370 - causes of AKI - prerenal-injury locations, causes, signs/symptoms, GFR changes, effects of prolonged injury - postrenal-injury locations, causes, GFR changes, effects of prolonged injury intrinsic/intrarenal-injury locations, causes, vascular and tubular process changes, effects of prolonged injury - acute tubular necrosis - differentiate prodromal, oliguric, and post-oliguric phases Chronic Kidney Disease - reversible or irreversible? why? - describe progressive process - acute vs chronic kidney disease comparison money disease comparison - risk factors - amount of damage kidneys can have before they can no longer compensate - explain why each of these consequences occur: - hypertension and cardiovascular disease - bone and mineral disorders - uremic syndrome - malnutrition - metabolic acidosis - anemia - electrolyte imbalances - pain - define dialysis and differentiate between hemodialysis and peritoneal dialysis CHAPTER 29: DISORDERS OF THE LOWER URINARY TRACT - structures that are part of the lower urinary tract - define micturition - Where is it controlled, voluntary or involuntary, sympathetic or parasympathetic stimulation Voiding Dysfunctions - describe incontinence - problem associated with each type of incontinence and examples of situations/conditions when each would occur: stress incontinence, urge incontinence, overactive bladder, neurogenic bladder, overflow incontinence, functional incontinence - describe enuresis and differentiate between primary nocturnal and secondary forms Inflammation and Infection - urethritis -structure affected, causes, signs/symptoms - cystitis -structure affected, causes/predisposing factors, clinical manifestations/signs/symptoms, gender more often affected Obstruction - lower urinary tract urolithiasis vs renal nephrolithiasis - uretolithiasis - location affected, clinical manifestions (include why tachycardia, tachypnea, diaphoresis, nausea, and vomiting would be associated with a urinary tract problem -bladder urolithaisis-manifestations

Answer 1

1. The 3 pathophysiologic states of AKI are :-

Prerenal, intrarenal, and post renal

Prerenal causes of AKI :-

Prerenal causes of AKI are factors external to the kidneys. Which include: hypovolemia, decreased cardiac output, decreased peripheral vascular resistance, and decreased renovascular blood flow.

They reduce systemic circulation causing a reduction in renal blood flow, and lead to a decreased glomerular perfusion and filtration of the kidneys.

Intrarenal causes of AKI :-

Intrarenal causes of AKI include conditions that cause direct damage to the kidney tissue , resulting in impaired nephron function. Examples of intrarenal causes include: Nephrotoxic injury, interstitial nephritis, and prolonged renal ischemia, acute glomerulonephritis, thrombotic disorders, toxemia of pregnancy, malignant hepertension, and Systemic lupus erythematososus.

Post renal cause :-

Post renal causes involve mechanical obstruction in the outflow of urine. Examples include: Benign prostatic hyperplasia, bladder cancer, calculi formation, neruromuscular disorders, prostate cancer, spinal cord disease, strictures, and trauma.

2. Differentiation between prodromal , oliguric and post oliguric phase are :-

Prodromal phase :-

- injury has occurred

- normal or decreased urine output

- increased BUR and Cr

Oliguric phase :-

- oliguric

- volume overload

- hyperkalemia

- azotemia

- metabolic acidosis

Post oliguric phase :-

- fluid volume deficit

- labs begin to normalise

3. Chronic kidney disease is progressive and irreversible because the kidney can't make new nephrons once they are damaged. It only has so much reserve capacity.

The major risk factors for the progression of CKD are :-

old age - less reserve capacity

continued insults to the kidney

#. Difference between acute and chronic kidney disease are :-

Acute :-

- abrupt decline

- usually reversible

- normal structure preserved

Chronic :-

- slowly progressive

- usually irreversible

- structure replaced by scar

- leads to ESRD

#. Risk factors of chronic kidney disease :-

- Older age

-Family history

-Diabetes: overworking every organ in body

-Obesity: more nutrients kidneys have to filter

-Hypertension: if pressure is high, then volume (fluids) is high-more our kidneys have to filter every day