NR507- Advanced Pathophysiology Final Exam
1. Acute renal failure: Reversible
Determining prognosis- kidneys respond to diuretic with good output; this indicates that kidneys are functioning well
2. Acute Pyelonephritis: Diagnosing by clinical symptoms alone can be difficult; can be similar to cystitis
Diagnosis established by: -Urine culture
-Urinalysis (WBC casts indicates pyelonephritis, but may not always be present) -Signs/Symptoms
-Complicated pyelonephritis requires blood cultures and urinary tract imaging 3. Renal Calculi (Renal Stones): Goals of
Treatment:
Manage acute pain
Promote passage of stone
Reduce size of stone
Prevent new stone formation
4. Chronic Renal Failure: Chronic Kidney Disease (CKD) is a progressive loss of renal function associated with systemic
disease such as hypertension, diabetes mellitus (most significant risk factor), systemic lupus erythematosus or intrinsic
kidney disease
CKD stage is determined by estimates of GFR and albuminuria
5. Who is a candidate for dialysis?: End-stage renal disease (ESRD) is the final stage of CKD with the number one cause
being diabetes mellitus combined with hypertension. At this point, the patient is completely dependent on dialysis to
survive. CKD is classified into five stages and is based on the patient's GFR rather than symptoms.
Patients will need dialysis when the following symptoms are present:
--Metabolic acidosis.
--Hyperkalemia: Hyperkalemia in the presence of EKG changes (peaked T-waves) is an indication for dialysis. --Hyperkalemia by
itself is not an indication for dialysis. --Drug toxicity: Drug toxicity due to the following drugs is an indication for dialysis and
include salicylates, Lithium, Isopropanol, Methanol and Ethylene glycol).
--Fluid volume overload that is not responsive to diuretics.
--Uremic symptoms due to nitrogenous wastes in the blood stream.
6. Stage I CKD: There is kidney damage with normal or elevated GFR
90-120
7. Stage II CKD: There is kidney damage with mild decrease in GFR 60-89
8. Stage III CKD: There is a moderate decrease in GFR
30-59
9. Stage IV CKD: There is a severe decrease in GFR
15-29
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, NR507- Advanced Pathophysiology Final Exam
10. Stage V CKD: Kidney failure- End-stage renal disease
<15 (dialysis) Once Stage IV is reached, progression to Stage V is inevitable as well as dialysis or kidney transplant
11. Complications of Decreased GFR: Anemia
Hypertension
Decreased calcium absorption
Hyperlipidemia
Heart failure
Left ventricular hypertrophy
Fluid volume overload
Hyperkalemia
Hyperparathyroidism
Hyperphosphatemia
Metabolic acidosis
Malnutrition (late complication)
12. GERD: Warning signs include: Symptoms over age of 50:
-Dysphagia (difficulty swallowing)
-Odynophagia (pain on swallowing)
-Nausea and vomiting
-Weight loss
-Melena
-Early satiety (feeling full after eating very little food
13. Hiatal Hernia: Often asymptomatic
Generally, a wide variety of symptoms develop later in life and are associated with other GI disorders, primarily GERD
--Sliding hiatal hernia: treatment usually conservative. Individuals can diminish reflux by eating small, frequent meals and avoiding
the recumbent position after eating. Abdominal supports and tight clothing are avoided and weight control recommended for
obese individuals.
14. Duodenal Ulcer: Characteristic manifestation = chronic intermittent pain in epigastric area
Pain begins 30 minutes to 2 hours after eating when stomach is empty
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1. Acute renal failure: Reversible
Determining prognosis- kidneys respond to diuretic with good output; this indicates that kidneys are functioning well
2. Acute Pyelonephritis: Diagnosing by clinical symptoms alone can be difficult; can be similar to cystitis
Diagnosis established by: -Urine culture
-Urinalysis (WBC casts indicates pyelonephritis, but may not always be present) -Signs/Symptoms
-Complicated pyelonephritis requires blood cultures and urinary tract imaging 3. Renal Calculi (Renal Stones): Goals of
Treatment:
Manage acute pain
Promote passage of stone
Reduce size of stone
Prevent new stone formation
4. Chronic Renal Failure: Chronic Kidney Disease (CKD) is a progressive loss of renal function associated with systemic
disease such as hypertension, diabetes mellitus (most significant risk factor), systemic lupus erythematosus or intrinsic
kidney disease
CKD stage is determined by estimates of GFR and albuminuria
5. Who is a candidate for dialysis?: End-stage renal disease (ESRD) is the final stage of CKD with the number one cause
being diabetes mellitus combined with hypertension. At this point, the patient is completely dependent on dialysis to
survive. CKD is classified into five stages and is based on the patient's GFR rather than symptoms.
Patients will need dialysis when the following symptoms are present:
--Metabolic acidosis.
--Hyperkalemia: Hyperkalemia in the presence of EKG changes (peaked T-waves) is an indication for dialysis. --Hyperkalemia by
itself is not an indication for dialysis. --Drug toxicity: Drug toxicity due to the following drugs is an indication for dialysis and
include salicylates, Lithium, Isopropanol, Methanol and Ethylene glycol).
--Fluid volume overload that is not responsive to diuretics.
--Uremic symptoms due to nitrogenous wastes in the blood stream.
6. Stage I CKD: There is kidney damage with normal or elevated GFR
90-120
7. Stage II CKD: There is kidney damage with mild decrease in GFR 60-89
8. Stage III CKD: There is a moderate decrease in GFR
30-59
9. Stage IV CKD: There is a severe decrease in GFR
15-29
1/8
, NR507- Advanced Pathophysiology Final Exam
10. Stage V CKD: Kidney failure- End-stage renal disease
<15 (dialysis) Once Stage IV is reached, progression to Stage V is inevitable as well as dialysis or kidney transplant
11. Complications of Decreased GFR: Anemia
Hypertension
Decreased calcium absorption
Hyperlipidemia
Heart failure
Left ventricular hypertrophy
Fluid volume overload
Hyperkalemia
Hyperparathyroidism
Hyperphosphatemia
Metabolic acidosis
Malnutrition (late complication)
12. GERD: Warning signs include: Symptoms over age of 50:
-Dysphagia (difficulty swallowing)
-Odynophagia (pain on swallowing)
-Nausea and vomiting
-Weight loss
-Melena
-Early satiety (feeling full after eating very little food
13. Hiatal Hernia: Often asymptomatic
Generally, a wide variety of symptoms develop later in life and are associated with other GI disorders, primarily GERD
--Sliding hiatal hernia: treatment usually conservative. Individuals can diminish reflux by eating small, frequent meals and avoiding
the recumbent position after eating. Abdominal supports and tight clothing are avoided and weight control recommended for
obese individuals.
14. Duodenal Ulcer: Characteristic manifestation = chronic intermittent pain in epigastric area
Pain begins 30 minutes to 2 hours after eating when stomach is empty
2/8
