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Exam (elaborations)

NR507 CHAMBERLAIN ADVANCED PATHO FINAL EXAM

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Institution
NR507 CHAMBERLAIN ADVANCED PATHO
Course
NR507 CHAMBERLAIN ADVANCED PATHO

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Uploaded on
September 7, 2024
Number of pages
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2024/2025
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NR507 CHAMBERLAIN ADVANCED PATHO FINAL
EXAM 2024-2025


Acute renal failure causes sudden loss of kidney function and is reversible.


What is the strongest predictor of a good outcome from acute renal failure?

The kidneys respond effectively to furosemide.


Acute Pyelonephritis: Pathophysiology

"Upper UTI"

- Bacteria invade and colonize the urethra and bladder.

- Inflammation and immunological reactions

- Bacteria proliferate, rise to the kidneys and colonize.

- If left untreated, bacteria can migrate into circulation via renal veins, resulting in
bacteremia and septic shock.


Acute Pyelonephritis: Assessment

- Diagnosing just on clinical symptoms can be challenging (similar to cystitis in the
lower tract).

- Signs and symptoms include flank pain, stomach tenderness, and fever.

- Severe infection: systemic symptoms include high fever, chills, and tachycardia.


Acute Pyelonephritis: Diagnosis

,- Urinalysis revealed a positive urine culture with severe bacteriuria and pyuria.
WBC casts indicate pyelonephritis but are not always present.

- A CBC can reveal an increased WBC count, indicating infection.

- Imaging examinations, such as a renal ultrasound or CT scan, can aid in the
identification of structural abnormalities and problems such as abscess formation or
blockage.


Acute Pyelonephritis: Treatment

- Antibiotics

- Supportive care: sufficient water, analgesics (NSAIDs)

- Hospitalization: Severe cases, pregnant women, people with underlying
comorbidities, or those who cannot tolerate oral intake may need IV antibiotics and
intensive monitoring.

- Follow-up is essential for monitoring treatment ANSWER, completing the full
course of antibiotics, and ensuring infection clearance through follow-up visits and
repeated urine cultures.


Renal calculi (kidney stones): Pathophysiology

- Supersaturation: Urine becomes oversaturated with certain chemicals, such as
calcium.

- Nucleation: Crystals serve as nucleation sites, where more crystal deposition can
take place.

- Crystal retention: Urinary stasis or insufficient urine flow causes crystals to stay
in the urinary system.

- Stone growth and composition: Over time, crystals aggregate and form stones.


Renal Calculi: Assessment

, - Medical hx: determine the risk.

- Physical examination: flank or stomach discomfort, costovertebral angle (CVA)
tenderness, and hematuria.

- Imaging examinations, such as a CT scan, renal ultrasonography, or X-ray, are
critical for determining the existence, size, location, and composition of stones.

- Lab tests include urinalysis (blood, crystals, or infection) and blood tests, which
assess renal function and detect metabolic abnormalities.


Renal Calculi: Treatment

- Conservative treatment for stones under 5mm that are asymptomatic or cause
moderate symptoms.

- Medical treatment includes thiazide diuretics (calcium stones) or allopurinol (uric
acid stones).

- Lithotripsy is used to remove bigger stones (>5mm) or those that cause significant
symptoms.


Renal calculi: Treatment Goals

- Manage acute pain.

- Encourage the flow of stone

- Reduce the size of stones that have already developed.

- Prevent new stone development.


Chronic Kidney Disease(CKD)

- Progressive, irreversible loss of renal function.

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