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NR507 CHAMBERLAIN ADVANCED PATHO FINAL EXAM
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NR507 CHAMBERLAIN ADVANCED PATHO FINALEXAM 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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