NR507- ADVANCED
PATHOPHYSIOLOGY FINAL EXAM
Acute44renal44failure44-44answer--Reversible
Determining44prognosis-
44kidneys44respond44to44diuretic44with44good44output;44this44indicates44that44kidneys44ar
e44functioning44well
Acute44Pyelonephritis44-44answer--
Diagnosing44by44clinical44symptoms44alone44can44be44difficult;44can44be44similar44to44cy
stitis
Diagnosis44established44by:
-Urine44culture
-
Urinalysis44(WBC44casts44indicates44pyelonephritis,44but44may44not44always44be44prese
nt)
-Signs/Symptoms
-Complicated44pyelonephritis44requires44blood44cultures44and44urinary44tract44imaging
Renal44Calculi44(Renal44Stones)44-44answer--Goals44of44Treatment:
Manage44acute44pain
Promote44passage44of44stone
Reduce44size44of44stone
Prevent44new44stone44formation
Chronic44Renal44Failure44-44answer--
Chronic44Kidney44Disease44(CKD)44is44a44progressive44loss44of44renal44function44associ
ated44with44systemic44disease44such44as44hypertension,44diabetes44mellitus44(most44sig
nificant44risk44factor),44systemic44lupus44erythematosus44or44intrinsic44kidney44disease
CKD44stage44is44determined44by44estimates44of44GFR44and44albuminuria
Who44is44a44candidate44for44dialysis?44-44answer--End-
stage44renal44disease44(ESRD)44is44the44final44stage44of44CKD44with44the44number44one
44cause44being44diabetes44mellitus44combined44with44hypertension.44At44this44point,44the
44patient44is44completely44dependent44on44dialysis44to44survive.
, CKD44is44classified44into44five44stages44and44is44based44on44the44patient's44GFR44rather
44than44symptoms.
Patients44will44need44dialysis44when44the44following44symptoms44are44present:
--Metabolic44acidosis.
--Hyperkalemia:44Hyperkalemia44in44the44presence44of44EKG44changes44(peaked44T-
waves)44is44an44indication44for44dialysis.44--
Hyperkalemia44by44itself44is44not44an44indication44for44dialysis.
--
Drug44toxicity:44Drug44toxicity44due44to44the44following44drugs44is44an44indication44for44di
alysis44and44include44salicylates,44Lithium,44Isopropanol,44Methanol44and44Ethylene44gly
col).
--Fluid44volume44overload44that44is44not44responsive44to44diuretics.
--Uremic44symptoms44due44to44nitrogenous44wastes44in44the44blood44stream.
Stage44I44CKD44-44answer--
There44is44kidney44damage44with44normal44or44elevated44GFR
90-120
Stage44II44CKD44-44answer--There44is44kidney44damage44with44mild44decrease44in44GFR
60-89
Stage44III44CKD44-44answer--There44is44a44moderate44decrease44in44GFR
30-59
Stage44IV44CKD44-44answer--There44is44a44severe44decrease44in44GFR
15-29
Stage44V44CKD44-44answer--Kidney44failure-44End-stage44renal44disease
<1544(dialysis)44Once44Stage44IV44is44reached,44progression44to44Stage44V44is44inevitabl
e44as44well44as44dialysis44or44kidney44transplant
Complications44of44Decreased44GFR44-44answer--Anemia
Hypertension
Decreased44calcium44absorption
Hyperlipidemia
Heart44failure
Left44ventricular44hypertrophy
Fluid44volume44overload
Hyperkalemia
Hyperparathyroidism
Hyperphosphatemia
Metabolic44acidosis
Malnutrition44(late44complication)
GERD44-44answer--Warning44signs44include:44Symptoms44over44age44of4450:
PATHOPHYSIOLOGY FINAL EXAM
Acute44renal44failure44-44answer--Reversible
Determining44prognosis-
44kidneys44respond44to44diuretic44with44good44output;44this44indicates44that44kidneys44ar
e44functioning44well
Acute44Pyelonephritis44-44answer--
Diagnosing44by44clinical44symptoms44alone44can44be44difficult;44can44be44similar44to44cy
stitis
Diagnosis44established44by:
-Urine44culture
-
Urinalysis44(WBC44casts44indicates44pyelonephritis,44but44may44not44always44be44prese
nt)
-Signs/Symptoms
-Complicated44pyelonephritis44requires44blood44cultures44and44urinary44tract44imaging
Renal44Calculi44(Renal44Stones)44-44answer--Goals44of44Treatment:
Manage44acute44pain
Promote44passage44of44stone
Reduce44size44of44stone
Prevent44new44stone44formation
Chronic44Renal44Failure44-44answer--
Chronic44Kidney44Disease44(CKD)44is44a44progressive44loss44of44renal44function44associ
ated44with44systemic44disease44such44as44hypertension,44diabetes44mellitus44(most44sig
nificant44risk44factor),44systemic44lupus44erythematosus44or44intrinsic44kidney44disease
CKD44stage44is44determined44by44estimates44of44GFR44and44albuminuria
Who44is44a44candidate44for44dialysis?44-44answer--End-
stage44renal44disease44(ESRD)44is44the44final44stage44of44CKD44with44the44number44one
44cause44being44diabetes44mellitus44combined44with44hypertension.44At44this44point,44the
44patient44is44completely44dependent44on44dialysis44to44survive.
, CKD44is44classified44into44five44stages44and44is44based44on44the44patient's44GFR44rather
44than44symptoms.
Patients44will44need44dialysis44when44the44following44symptoms44are44present:
--Metabolic44acidosis.
--Hyperkalemia:44Hyperkalemia44in44the44presence44of44EKG44changes44(peaked44T-
waves)44is44an44indication44for44dialysis.44--
Hyperkalemia44by44itself44is44not44an44indication44for44dialysis.
--
Drug44toxicity:44Drug44toxicity44due44to44the44following44drugs44is44an44indication44for44di
alysis44and44include44salicylates,44Lithium,44Isopropanol,44Methanol44and44Ethylene44gly
col).
--Fluid44volume44overload44that44is44not44responsive44to44diuretics.
--Uremic44symptoms44due44to44nitrogenous44wastes44in44the44blood44stream.
Stage44I44CKD44-44answer--
There44is44kidney44damage44with44normal44or44elevated44GFR
90-120
Stage44II44CKD44-44answer--There44is44kidney44damage44with44mild44decrease44in44GFR
60-89
Stage44III44CKD44-44answer--There44is44a44moderate44decrease44in44GFR
30-59
Stage44IV44CKD44-44answer--There44is44a44severe44decrease44in44GFR
15-29
Stage44V44CKD44-44answer--Kidney44failure-44End-stage44renal44disease
<1544(dialysis)44Once44Stage44IV44is44reached,44progression44to44Stage44V44is44inevitabl
e44as44well44as44dialysis44or44kidney44transplant
Complications44of44Decreased44GFR44-44answer--Anemia
Hypertension
Decreased44calcium44absorption
Hyperlipidemia
Heart44failure
Left44ventricular44hypertrophy
Fluid44volume44overload
Hyperkalemia
Hyperparathyroidism
Hyperphosphatemia
Metabolic44acidosis
Malnutrition44(late44complication)
GERD44-44answer--Warning44signs44include:44Symptoms44over44age44of4450:
