1|Page
NR507 / NR 507 (Latest Update
) Advanced
Pathophysiology | Exam Review
Questions With Verified
Answers| 100% Correct | Grade
A - Chamberlain
Acute Renal Failure
- Sudden loss of kidney function.
- Reversible.
What is the best indicator of a good prognosis for recovery from acute renal
failure?
Kidneys respond well to Furosemide
Acute Pyelonephritis- Pathophysiology
"Upper UTI"
- Bacteria enter & colonize in urethra and bladder
- Inflammation and immune response
- Bacteria multiply and ascend to kidneys and colonize
- If still untreated: bacteria can spread into circulation via renal veins causing
bacteremia & septic shock
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Acute Pyelonephritis- Assessment
- Diagnosing by clinical symptoms alone can be difficult (similar to cystitis- lower
tract).
- S/S: flank pain, abdominal tenderness, fever.
- Severe infection: systemic signs: high fever, chills, tachycardia.
Acute Pyelonephritis- Diagnosis
- Urinalysis: positive urine culture with significant bacteriuria and the presence of
pyuria. WBC casts indicates pyelonephritis, but may not always be present.
- CBC: can show an elevated WBC, indicating infection.
- Imaging studies: renal ultrasound or CT scan, can help identify structural
abnormalities and complications like abscess formation or obstruction.
Acute Pyelonephritis- Treatment
- Antibiotics
- Supportive care: adequate hydration and analgesics (NSAIDs)
- Hospitalization: severe cases, pregnant women, individuals w/underlying
comorbidities, or those unable to tolerate oral intake may require hospitalization
for IV antibiotic therapy and close monitoring.
- Follow-up: crucial to monitor treatment response, complete full course of
antibiotics, and ensure resolution of infection through follow-up visits and repeat
urine cultures.
Renal Calculi (kidney stones)- Pathophysiology
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- Supersaturation: urine becomes oversaturated with certain substances like
calcium.
- Nucleation: crystals act as nucleation sites, where further crystal deposition can
occur.
- Crystal retention: urinary stasis or inadequate urine flow allows crystals to remain
in the urinary tract.
- Stone growth and composition: overtime, crystals accumulate and grow into
stones.
Renal Calculi- Assessment
- Medical hx: identify risk.
- Physical exam: flank or abdominal pain, costovertebral angle (CVA) tenderness,
hematuria
- Imaging studies: crucial for assessing the presence, size, location, and
composition of stones: CT scan, renal ultrasound, or X-ray.
- Lab tests: urinalysis (blood, crystals, or infection), blood tests evaluate renal
function and identify metabolic abnormalities.
Renal Calculi- Treatment
- Conservative treatment for stones <5mm that are asymptomatic or causing mild
symptoms.
- Medical management: thiazide diuretics (calcium stones) or allopurinol (uric acid
stones).
- Stone removal (lithotripsy) for larger stones (>5mm) or stones causing severe
symptoms.
, 4|Page
Renal Calculi: Goals of Treatment
- Manage acute pain
- Promote passage of stone
- Reduce the size of stone already formed
- Prevent new stone formation
Chronic Kidney Disease (CKD)
- Progressive, irreversible loss of kidney function.
- Associated with systemic diseases such as hypertension, diabetes mellitus (most
significant risk factor), systemic lupus erythematosus, or intrinsic kidney disease.
- Once stage IV is reached, progression to stage V is inevitable (plus dialysis or
kidney transplant).
CKD- Candidates for Dialysis
- Based on symptoms, kidney function, overall health status, and individual
circumstances.
- Symptomatic uremia.
- Fluid overload and hypertension.
- Hyperkalemia.
- Acid/base imbalances.
- Progressive loss of kidney function.
NR507 / NR 507 (Latest Update
) Advanced
Pathophysiology | Exam Review
Questions With Verified
Answers| 100% Correct | Grade
A - Chamberlain
Acute Renal Failure
- Sudden loss of kidney function.
- Reversible.
What is the best indicator of a good prognosis for recovery from acute renal
failure?
Kidneys respond well to Furosemide
Acute Pyelonephritis- Pathophysiology
"Upper UTI"
- Bacteria enter & colonize in urethra and bladder
- Inflammation and immune response
- Bacteria multiply and ascend to kidneys and colonize
- If still untreated: bacteria can spread into circulation via renal veins causing
bacteremia & septic shock
,2|Page
Acute Pyelonephritis- Assessment
- Diagnosing by clinical symptoms alone can be difficult (similar to cystitis- lower
tract).
- S/S: flank pain, abdominal tenderness, fever.
- Severe infection: systemic signs: high fever, chills, tachycardia.
Acute Pyelonephritis- Diagnosis
- Urinalysis: positive urine culture with significant bacteriuria and the presence of
pyuria. WBC casts indicates pyelonephritis, but may not always be present.
- CBC: can show an elevated WBC, indicating infection.
- Imaging studies: renal ultrasound or CT scan, can help identify structural
abnormalities and complications like abscess formation or obstruction.
Acute Pyelonephritis- Treatment
- Antibiotics
- Supportive care: adequate hydration and analgesics (NSAIDs)
- Hospitalization: severe cases, pregnant women, individuals w/underlying
comorbidities, or those unable to tolerate oral intake may require hospitalization
for IV antibiotic therapy and close monitoring.
- Follow-up: crucial to monitor treatment response, complete full course of
antibiotics, and ensure resolution of infection through follow-up visits and repeat
urine cultures.
Renal Calculi (kidney stones)- Pathophysiology
,3|Page
- Supersaturation: urine becomes oversaturated with certain substances like
calcium.
- Nucleation: crystals act as nucleation sites, where further crystal deposition can
occur.
- Crystal retention: urinary stasis or inadequate urine flow allows crystals to remain
in the urinary tract.
- Stone growth and composition: overtime, crystals accumulate and grow into
stones.
Renal Calculi- Assessment
- Medical hx: identify risk.
- Physical exam: flank or abdominal pain, costovertebral angle (CVA) tenderness,
hematuria
- Imaging studies: crucial for assessing the presence, size, location, and
composition of stones: CT scan, renal ultrasound, or X-ray.
- Lab tests: urinalysis (blood, crystals, or infection), blood tests evaluate renal
function and identify metabolic abnormalities.
Renal Calculi- Treatment
- Conservative treatment for stones <5mm that are asymptomatic or causing mild
symptoms.
- Medical management: thiazide diuretics (calcium stones) or allopurinol (uric acid
stones).
- Stone removal (lithotripsy) for larger stones (>5mm) or stones causing severe
symptoms.
, 4|Page
Renal Calculi: Goals of Treatment
- Manage acute pain
- Promote passage of stone
- Reduce the size of stone already formed
- Prevent new stone formation
Chronic Kidney Disease (CKD)
- Progressive, irreversible loss of kidney function.
- Associated with systemic diseases such as hypertension, diabetes mellitus (most
significant risk factor), systemic lupus erythematosus, or intrinsic kidney disease.
- Once stage IV is reached, progression to stage V is inevitable (plus dialysis or
kidney transplant).
CKD- Candidates for Dialysis
- Based on symptoms, kidney function, overall health status, and individual
circumstances.
- Symptomatic uremia.
- Fluid overload and hypertension.
- Hyperkalemia.
- Acid/base imbalances.
- Progressive loss of kidney function.
