Patho exam 3-Intrarenal disorders Last updated 28 April 2021 0 1483 Can cystic kidney disease be genetically transmitted? yes Autosomal recessive cystic kidney disease (ARPKD) symptoms are evident at birth Autosomal dominant cystic kidney disease (ADPKD) symptoms occur later in life cystic kidney disease is more common in men ARPKD etiology Identified in neonatal period, kidneys retain shape but are enlarged, collecting ducts dilated, and abnormal portal ducts Clinical manifestations of ARPKD respiratory distress, palpable kidneys, and systemic hypertension How is ARPKD diagnosed? By recessive pattern of inheritance in the family, liver biopsy, and CT,MRI, ultrasound will be similar to ADPKD What is the most common type of polycystic kidney disease? autosomal dominant Clinical manifestations of ADPKD inability to concentrate urine, hypertension, proteinuria, hematuria, pain, kidney stones, urinary tract infections, and cyst infections. What is the treatment for ADPKD? management of other conditions, dialysis, and kidney transplant is Renal cell carcinoma (RCC) genetic? No, but youre at a higher risk for getting it if a family member has it What are the primary risk factors for renal cell carcinoma (RCC)? smoking, obesity and hypertension What are the clinical manifestations of RCC? Costovertebral angle tenderness, hematuria, palpable abdominal mass, bone pain, shortness of breath, and chest pain from metastatic disease (cooties have palpable bony short chest hair - Liz's deliriousness) How do you treat RCC? surgical removal (nephrectomy) What are the normal host defenses quite effective at preventing infection? acidic pH & urea in urine, prostatic secretions in men, urethral secretions in women, micturition (unidirectional flow) and the epithelial cells trap bacteria and provide additional protective barrier What are the risk factors for infection? increasing age, vesicoureteral reflux of urine, congenital abnormalities, female gender, pregnancy, neurogenic bladder, urinary obstruction, obesity, diabetes, uncircumcised male children, and catheters What is the causative organism for acute pyelonephritis? E. coli Acute pyelonephritis is usually an __________ infection ascending ___________ is a major risk factor for acute pyelonephritis due to alterations in urinary tract pregnancy Clinical manifestations of acute pyelonephritis sudden onset, fever/chills, nausea/vomiting/anorexia, CVA tenderness, dysuria, urgency, frequency and other complications such as septic shock, ARDS, and chronic kidney disease due to scarring How do you treat acute pyelonephritis? antibiotic therapy for 7-10 days usually as outpatient. In more severe cases you would give IV antibiotics and IV fluids What is chronic pyelonepthritis characterized by? small atrophied kidneys with diffuse scarring What are the risk factors for chronic pyelonephritis? vesicoureteral reflux, urinary obstruction, and neurogenic bladder Share this post
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