Immune complexes initiate inflammation and glomerular

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immune complexes initiate inflammation and glomerular injury and increasing membrane permeability Develops 10-14 days after strep infection Signs & Symptoms Oliguria (decreased urination), dark cloudy urine Periorbital edema, hypertension Elevated blood pressure, flank or back pain General signs of inflammation Glomerulonephritis Diagnosis BUN & creatine test, also streptococcal antibodies (ASO) test Hematuria, proteinuria (less than 3g over 24 hours) Metabolic acidosis, low bicarbonate Treatment Sodium restriction: Protein and fluid restrictions if needed Drug treatments: Anti-inflammatory, glucocorticoids, and anti-hypertensives Nephrotic Syndrome Abnormality in glomerular capillaries, increased permeability, large amounts of plasma proteins lost into filtrate, decreased osmotic pressure, hypoalbuminemia, and proteinuria higher than 3 g within 24 hours Blood pressure varies depending on angiotension II Increased aldosterone and abnormal lipid studies May be idiopathic (2 -6 years) or secondary Signs & Symptoms: Casts, massive edema (anasarca), ascites, and pleural effusion Urolithiasis (Calculi or Kidney Stones) Common and frequently reoccur along GU tract Stones may be small or large and anywhere Tends to form with excessive insoluble salts in filtrate Stones manifest only with obstruction of urine flow Calculi forms from calcium salts, uric acid, struvite and cystine (excess amounts of these in filtrate) Signs & Symptoms Stones in kidney or bladder often asymptomatic: sometimes infection and flank pain is noted “Renal colic” caused by obstruction of the ureter Diagnosis: physical symptoms, flank pain, nausea and vomiting, hematuria, radiology exams (IVP (best to use) or KUB) Prevention: treatment of underlying condition and adjustment of urine pH through dietary modifications, and consistent increased fluid intake
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Treatment: Observation, lithotripsy, and drugs to dissolve stones or surgery Hyperonephrosis Secondary problem due to Complications of calculi Tumors, scar tissues in kidney or ureter Untreated prostatic enlargement Congenital abnormalities restricting urine flow Frequently asymptomatic in the early stages Can be diagnosed with ultrasonography, radionucleotide imagine, CT scan or renal scar If cause is not removed there will be chronic renal failure Tumors: Renal Cell Carcinoma Pathophysiology: Primary tumor from the tubule epithelium Symptomatic in the early stages Often has metastasized by diagnosis Manifestations: Painless hematuria initially, flank pain with palpable mass, and anemia Treatment: Removal of the kidney, immunotherapy may be used in some cases Tumor is radioresistant and chemotherapy is not used in most cases Tumor: Bladder Cancer Bladder tumors are malignant because of the transitional epithelium Often develops as multiple tumors Diagnosis: urine cytology and biopsy Signs & Symptoms: Early signs are hematuria, dysuria, and infection- there will be a invasive
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