NR507- ADVANCED
PATHOPHYSIOLOGY FINAL EXAM
Acuteyorenalyofailureyo-yoans--✔✔Reversible
Determiningyoprognosis-
yokidneysyorespondyotoyodiureticyowithyogoodyooutput;yothisyoindicatesyothatyokidneysyoareyofu
nctioningyowell
AcuteyoPyelonephritisyo-yoans--
✔✔Diagnosingyobyyoclinicalyosymptomsyoaloneyocanyobeyodifficult;yocanyobeyosimilaryotoyocy
stitis
Diagnosisyoestablishedyoby:
-Urineyoculture
-Urinalysisyo(WBCyocastsyoindicatesyopyelonephritis,yobutyomayyonotyoalwaysyobeyopresent)
-Signs/Symptoms
-Complicatedyopyelonephritisyorequiresyobloodyoculturesyoandyourinaryyotractyoimaging
RenalyoCalculiyo(RenalyoStones)yo-yoans--✔✔GoalsyoofyoTreatment:
Manageyoacuteyopain
Promoteyopassageyoofyostone
Reduceyosizeyoofyostone
Preventyonewyostoneyoformation
ChronicyoRenalyoFailureyo-yoans--
✔✔ChronicyoKidneyyoDiseaseyo(CKD)yoisyoayoprogressiveyolossyoofyorenalyofunctionyoassoci
atedyowithyosystemicyodiseaseyosuchyoasyohypertension,yodiabetesyomellitusyo(mostyosignifi
cantyoriskyofactor),yosystemicyolupusyoerythematosusyooryointrinsicyokidneyyodisease
CKDyostageyoisyodeterminedyobyyoestimatesyoofyoGFRyoandyoalbuminuria
Whoyoisyoayocandidateyoforyodialysis?yo-yoans--✔✔End-
stageyorenalyodiseaseyo(ESRD)yoisyotheyofinalyostageyoofyoCKDyowithyotheyonumberyooneyoca
useyobeingyodiabetesyomellitusyocombinedyowithyohypertension.yoAtyothisyopoint,yotheyopatie
ntyoisyocompletelyyodependentyoonyodialysisyotoyosurvive.
CKDyoisyoclassifiedyointoyofiveyostagesyoandyoisyobasedyoonyotheyopatient'syoGFRyoratheryoth
anyosymptoms.
Patientsyowillyoneedyodialysisyowhenyotheyofollowingyosymptomsyoareyopresent:
--Metabolicyoacidosis.
, --Hyperkalemia:yoHyperkalemiayoinyotheyopresenceyoofyoEKGyochangesyo(peakedyoT-
waves)yoisyoanyoindicationyoforyodialysis.yo--
Hyperkalemiayobyyoitselfyoisyonotyoanyoindicationyoforyodialysis.
--
Drugyotoxicity:yoDrugyotoxicityyodueyotoyotheyofollowingyodrugsyoisyoanyoindicationyoforyodialys
isyoandyoincludeyosalicylates,yoLithium,yoIsopropanol,yoMethanolyoandyoEthyleneyoglycol).
--Fluidyovolumeyooverloadyothatyoisyonotyoresponsiveyotoyodiuretics.
--Uremicyosymptomsyodueyotoyonitrogenousyowastesyoinyotheyobloodyostream.
StageyoIyoCKDyo-yoans--✔✔ThereyoisyokidneyyodamageyowithyonormalyooryoelevatedyoGFR
90-120
StageyoIIyoCKDyo-yoans--✔✔ThereyoisyokidneyyodamageyowithyomildyodecreaseyoinyoGFR
60-89
StageyoIIIyoCKDyo-yoans--✔✔ThereyoisyoayomoderateyodecreaseyoinyoGFR
30-59
StageyoIVyoCKDyo-yoans--✔✔ThereyoisyoayosevereyodecreaseyoinyoGFR
15-29
StageyoVyoCKDyo-yoans--✔✔Kidneyyofailure-yoEnd-stageyorenalyodisease
<15yo(dialysis)yoOnceyoStageyoIVyoisyoreached,yoprogressionyotoyoStageyoVyoisyoinevitableyo
asyowellyoasyodialysisyooryokidneyyotransplant
ComplicationsyoofyoDecreasedyoGFRyo-yoans--✔✔Anemia
Hypertension
Decreasedyocalciumyoabsorption
Hyperlipidemia
Heartyofailure
Leftyoventricularyohypertrophy
Fluidyovolumeyooverload
Hyperkalemia
Hyperparathyroidism
Hyperphosphatemia
Metabolicyoacidosis
Malnutritionyo(lateyocomplication)
GERDyo-yoans--✔✔Warningyosignsyoinclude:yoSymptomsyooveryoageyoofyo50:
-Dysphagiayo(difficultyyoswallowing)
-Odynophagiayo(painyoonyoswallowing)
-Nauseayoandyovomiting
-Weightyoloss
-Melena
-Earlyyosatietyyo(feelingyofullyoafteryoeatingyoveryyolittleyofood
PATHOPHYSIOLOGY FINAL EXAM
Acuteyorenalyofailureyo-yoans--✔✔Reversible
Determiningyoprognosis-
yokidneysyorespondyotoyodiureticyowithyogoodyooutput;yothisyoindicatesyothatyokidneysyoareyofu
nctioningyowell
AcuteyoPyelonephritisyo-yoans--
✔✔Diagnosingyobyyoclinicalyosymptomsyoaloneyocanyobeyodifficult;yocanyobeyosimilaryotoyocy
stitis
Diagnosisyoestablishedyoby:
-Urineyoculture
-Urinalysisyo(WBCyocastsyoindicatesyopyelonephritis,yobutyomayyonotyoalwaysyobeyopresent)
-Signs/Symptoms
-Complicatedyopyelonephritisyorequiresyobloodyoculturesyoandyourinaryyotractyoimaging
RenalyoCalculiyo(RenalyoStones)yo-yoans--✔✔GoalsyoofyoTreatment:
Manageyoacuteyopain
Promoteyopassageyoofyostone
Reduceyosizeyoofyostone
Preventyonewyostoneyoformation
ChronicyoRenalyoFailureyo-yoans--
✔✔ChronicyoKidneyyoDiseaseyo(CKD)yoisyoayoprogressiveyolossyoofyorenalyofunctionyoassoci
atedyowithyosystemicyodiseaseyosuchyoasyohypertension,yodiabetesyomellitusyo(mostyosignifi
cantyoriskyofactor),yosystemicyolupusyoerythematosusyooryointrinsicyokidneyyodisease
CKDyostageyoisyodeterminedyobyyoestimatesyoofyoGFRyoandyoalbuminuria
Whoyoisyoayocandidateyoforyodialysis?yo-yoans--✔✔End-
stageyorenalyodiseaseyo(ESRD)yoisyotheyofinalyostageyoofyoCKDyowithyotheyonumberyooneyoca
useyobeingyodiabetesyomellitusyocombinedyowithyohypertension.yoAtyothisyopoint,yotheyopatie
ntyoisyocompletelyyodependentyoonyodialysisyotoyosurvive.
CKDyoisyoclassifiedyointoyofiveyostagesyoandyoisyobasedyoonyotheyopatient'syoGFRyoratheryoth
anyosymptoms.
Patientsyowillyoneedyodialysisyowhenyotheyofollowingyosymptomsyoareyopresent:
--Metabolicyoacidosis.
, --Hyperkalemia:yoHyperkalemiayoinyotheyopresenceyoofyoEKGyochangesyo(peakedyoT-
waves)yoisyoanyoindicationyoforyodialysis.yo--
Hyperkalemiayobyyoitselfyoisyonotyoanyoindicationyoforyodialysis.
--
Drugyotoxicity:yoDrugyotoxicityyodueyotoyotheyofollowingyodrugsyoisyoanyoindicationyoforyodialys
isyoandyoincludeyosalicylates,yoLithium,yoIsopropanol,yoMethanolyoandyoEthyleneyoglycol).
--Fluidyovolumeyooverloadyothatyoisyonotyoresponsiveyotoyodiuretics.
--Uremicyosymptomsyodueyotoyonitrogenousyowastesyoinyotheyobloodyostream.
StageyoIyoCKDyo-yoans--✔✔ThereyoisyokidneyyodamageyowithyonormalyooryoelevatedyoGFR
90-120
StageyoIIyoCKDyo-yoans--✔✔ThereyoisyokidneyyodamageyowithyomildyodecreaseyoinyoGFR
60-89
StageyoIIIyoCKDyo-yoans--✔✔ThereyoisyoayomoderateyodecreaseyoinyoGFR
30-59
StageyoIVyoCKDyo-yoans--✔✔ThereyoisyoayosevereyodecreaseyoinyoGFR
15-29
StageyoVyoCKDyo-yoans--✔✔Kidneyyofailure-yoEnd-stageyorenalyodisease
<15yo(dialysis)yoOnceyoStageyoIVyoisyoreached,yoprogressionyotoyoStageyoVyoisyoinevitableyo
asyowellyoasyodialysisyooryokidneyyotransplant
ComplicationsyoofyoDecreasedyoGFRyo-yoans--✔✔Anemia
Hypertension
Decreasedyocalciumyoabsorption
Hyperlipidemia
Heartyofailure
Leftyoventricularyohypertrophy
Fluidyovolumeyooverload
Hyperkalemia
Hyperparathyroidism
Hyperphosphatemia
Metabolicyoacidosis
Malnutritionyo(lateyocomplication)
GERDyo-yoans--✔✔Warningyosignsyoinclude:yoSymptomsyooveryoageyoofyo50:
-Dysphagiayo(difficultyyoswallowing)
-Odynophagiayo(painyoonyoswallowing)
-Nauseayoandyovomiting
-Weightyoloss
-Melena
-Earlyyosatietyyo(feelingyofullyoafteryoeatingyoveryyolittleyofood
