Worksheets1. Clinical manifestations of renal diseases
Total questions: 41
Worksheet time: 21mins
Flank pain, fever and chills may be indicative of:
Ureteral colic
Urethral pain
Bladder pain
Pyelonephritis
Kidney pain is characterized by:
Intense
dull
aching
steady felted
It causes violent hyperperistalsis with paroxysmal spasms. It is a very intense pain, accompanied by sweating, prostration and occasionally shock, The patients can also present nausea and/or vomiting. Usually, ureteral colic is more strongly and suddenly than renal one.
Ureteral colic
Low back pain
Bladder pain
Urethral pain
It is usually duller, less radiated, and more
Ureteral colic
Low back pain
Bladder pain
Urethral pain
It is an intense pain in the suprapubic region and urethra.
Ureteral colic
Low back pain
Bladder pain
Urethral pain
Pain accompanied by burning, dysuria and tenesmus. It radiates to the perineum and urethral meatus.
Urethral pain
Bladder pain
Low back pain
Ureteral colic
The presence of more than 5 red blood cells per microscopic field is called:
Hematuria
Pyuria
Dysuria
Anuria
The precipitation of phosphates in alkaline urine causes:
Hematuria
Pyuria
Dysuria
Anuria
Can be caused by allergic reactions, urethral irritants, and genitourinary trauma causing painful urination.
Anuria
Dysuria
pyuria
Hematuria
It may be due to:
1. Lack of emission (secretory): Kidney failure
2. Lack of excretion: (excretory): Blockage of upper urinary tract
Anuria
Dysuria
Pyuria
Hematuria
Foam urine ->
albuminuria
chyluria
<500 ml urine volume indicates:
oliguria
polyuria
>1,500 ml urine volume indicates:
polyuria
oliguria
Normal urine density fluctuates between:
1.025
1.035
1.045
1.015
< 150 mg of protein in 24 hr.
Normal
proteinuria
Casts: Precipitated protein
Hyalines
Granular
Leukocyte
Hematic
Casts: by degeneration of epithelial cells, leukocytes or erythrocytes, albumin and fat
Hyalines
Granular
Leukocyte
Waxy
Casts: made up of leukocytes agglutinated by a protein matrix
Leukocyte
Purulent
Hematic
Waxy
Casts: degenerated erythrocytes; and always indicate renal disease and are characteristic of nephritic syndromes.
Hematic
Waxy
Granular
Purulent
Casts: suggest tubular flow is very slow, indicating chronic kidney disease.
Waxy
Hematic
Leukocyte
Granular
It is characterized by different types of acute or chronic low back pain, accompanied by alterations in urination and modifications in the urine appearance.
Local
renal
syndrome
Nephritic
syndrome
Nephrotic
syndrome
AKI
The main origin of this syndrome comes from the presence of local
masses.
Local
renal
syndrome
Nephritic
syndrome
Nephrotic
syndrome
AKI
Glomerular inflammation defined by hematuria, oliguria, blood high pressure, and edema.
Nephritic
syndrome
Nephrotic
syndrome
AKI
CKI
Immunological disorders are the most common causes, but it
can be origin from local or systemic infectious or inflammatory processes.
Nephritic
syndrome
Nephrotic
syndrom
Acute
kidney
injury
Chronic
kidney
injury
Defined by intense proteinuria (> 3.5 g/day), edema, hypoalbuminemia (<3.0 g/dl), alpha 2 globulin increased levels, hyperlipidemia, urinary fatty casts and hyper coagulation.
Nephrotic
syndrome
Nephritic
syndrome
Acute
kidney
injury
Chronic
kidney
injury
Caused by severe lesions of the glomerular capillary walls that results in massive filtering of proteins that exceed reabsorption tubular capacity.
Nephrotic
syndrome
Nephritic
syndrome
Acute
kidney
injury
Chronic
kidney
injury
Defined by rapid decline in glomerular filtration rate (GFR, within hours to days) until oliguric ranges (< 20 ml/h or <400 ml/day), dysregulation of fluid and electrolyte balance, and retention of metabolic waste products.
Acute
kidney
injury
Nephrotic
syndrome
Uremic
syndrome
Chronic
kidney
injury
Symptoms of AKI depends on the level of catabolites, therefore, these symptoms are from: acute uremia, neurologic (stupor), GI (uremic breath, nausea, vomiting, digestive tracts hemorrhages), hematologic symptoms (anemia, purpura).
Nitrogen
Electrolytes
Blood pH
Symptoms of AKI depends on the level of catabolites, therefore, these symptoms are from: hyperreflexia, muscle spasms, electrocardiographic
changes (T-spike waves, widening of the QRS complex, PR interval elongation, among others) that can lead in cardiac arrest
Nitrogen
Electrolytes
Blood pH
Symptoms of AKI depends on the level of catabolites, therefore, these symptoms are from:Blood pH: metabolic acidosis, Kussmaul’s breathing
Nitrogen
Electrolytes
Blood pH
Defined by the presence of a diminished GFR that is persistently < 60 mL/minute/1.73 m2 for at least 3 months, from any cause, and/or persistent albuminuria.
Chronic
kidney
injury
Uremic
syndrome
Acute
kidney
injury
Nephrotic
syndrome
CKI can be present polyuria (range of 2 to 3 L/day), hypostenuria and gradual increasing of blood creatinine levels. It is characteristic the urine rhythm inversion (nicturia). These stages are often called compensated chronic renal failure.
[STAGE]
initial
later
In CKI we can notice hyperazoemia and diuresis decrease until normal (pseudonormaluria) or oliguric ranges (< 400 ml/day) creatinine blood levels increasing, electrolyte imbalance, anemia (normocytic, normochromic)
[STAGE]
initial
later
In CKI, the progression toward uremia or uremic syndrome.
[STAGE]
Final
later
initial
Defined by dramatic and irreversible hyperazoemia (>100 mg/dl) which is constantly increasing until it culminates in the death of the patient.
Uremic
syndrome
Chronic
kidney
injury
Acute
kidney
injury
Nephritic
syndrome
Stage 1: normal or high GFR
>90
89> - >60
59> - >40
44> - >40
Stage2: mild decreased GFR
>90
89 - 60
59-40
29- 15
Stage 3A: mild to moderate decreased GFR
>90
89-60
59-40
44-30
Stage 3B: mild to moderate decreased GFR
>90
59-40
44-30
29-15
Stage 4: severely decreased GFR
44-30
29-15
<15
59-40
Stage 5: Kidney failure
<15
<20
<25
<30
