Jeff Buttram<br />Bio 120<br />Medical Terminology<br />Common Urinary System Pathologies and Procedures<br />
ARF   Acute Renal Failure<br />
<ul><li>sudden loss of kidney's ability to remove waste and concentrate urine without losing electrolytes.
leads to build up of waste products, fluids, and electrolytes in body.
also called acute kidney injury (AKI). 
was once called uremia or uremic poisoning (contamination of blood with urine).</li></ul> Acute Renal Failure (ARF)<br />
<ul><li>Bruising easily.
Seizures.
Bloody Stools.
Breath odor.
Flank pain (pain between ribs and hips).
Decreased urine output.
Swelling in ankle, foot, hands.
Nausea or vomiting.
Metallic taste in mouth.
Fatigue.</li></ul>Acute Renal Failure (ARF) symptoms<br />
<ul><li> Prerenal -sudden, serious drop in blood flow to the kidney from injury or illness.
 Intrarenal-  damage from medicines, poisons, or infection.
 Postrenal - damage from a form of blockage.</li></ul>Three Main Causes of ARF:<br />
Acute Renal Failure (ARF)<br />
<ul><li>Antibiotics - such as Gentamicin or Streptomycan.
Pain Medications - such as aspirin or ibuprofen.
Blood Pressure Medications - such as ACE inhibitors.
 Also dyes from certain x-ray tests.
Usually only affects individuals with long-term health issues.</li></ul>Medicines that can contribute to ARF<br />
<ul><li>Kidney stones
Tumor
Injury
  Enlarged prostate</li></ul>Common causes of ARF kidney blockage<br />
<ul><li>Older adults.
Those with long-term health issues such as diabetes, high blood pressure, heart failure, or obesity.
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  1. 1. Jeff Buttram<br />Bio 120<br />Medical Terminology<br />Common Urinary System Pathologies and Procedures<br />
  2. 2. ARF   Acute Renal Failure<br />
  3. 3. <ul><li>sudden loss of kidney's ability to remove waste and concentrate urine without losing electrolytes.
  4. 4. leads to build up of waste products, fluids, and electrolytes in body.
  5. 5. also called acute kidney injury (AKI). 
  6. 6. was once called uremia or uremic poisoning (contamination of blood with urine).</li></ul> Acute Renal Failure (ARF)<br />
  7. 7. <ul><li>Bruising easily.
  8. 8. Seizures.
  9. 9. Bloody Stools.
  10. 10. Breath odor.
  11. 11. Flank pain (pain between ribs and hips).
  12. 12. Decreased urine output.
  13. 13. Swelling in ankle, foot, hands.
  14. 14. Nausea or vomiting.
  15. 15. Metallic taste in mouth.
  16. 16. Fatigue.</li></ul>Acute Renal Failure (ARF) symptoms<br />
  17. 17. <ul><li> Prerenal -sudden, serious drop in blood flow to the kidney from injury or illness.
  18. 18.  Intrarenal-  damage from medicines, poisons, or infection.
  19. 19.  Postrenal - damage from a form of blockage.</li></ul>Three Main Causes of ARF:<br />
  20. 20. Acute Renal Failure (ARF)<br />
  21. 21. <ul><li>Antibiotics - such as Gentamicin or Streptomycan.
  22. 22. Pain Medications - such as aspirin or ibuprofen.
  23. 23. Blood Pressure Medications - such as ACE inhibitors.
  24. 24.  Also dyes from certain x-ray tests.
  25. 25. Usually only affects individuals with long-term health issues.</li></ul>Medicines that can contribute to ARF<br />
  26. 26. <ul><li>Kidney stones
  27. 27. Tumor
  28. 28. Injury
  29. 29.   Enlarged prostate</li></ul>Common causes of ARF kidney blockage<br />
  30. 30. <ul><li>Older adults.
  31. 31. Those with long-term health issues such as diabetes, high blood pressure, heart failure, or obesity.
  32. 32.  Those already ill and in hospital - often follows heart/abdominal surgery or a bone marrow transplant.</li></ul>High-risk populations for ARF<br />
  33. 33. BUN    Blood Urea Nitrogen<br />
  34. 34. <ul><li>a diagnostic test to measure kidney function by the level of nitrogenous waste (urea) that is in the blood.
  35. 35. used to evaluate general health as part of a basic metabolic panel (BMP) or a comprehensive metabolic panel (CMP).
  36. 36. used to monitor patients with acute or chronic kidney dysfunction or failure.</li></ul>BUN (Blood Urea Nitrogen)<br />
  37. 37. <ul><li>when kidney problems are suspected.
  38. 38. usually part of CMP/BMP for non-specific complaints.
  39. 39. as part of routine-testing panel.
  40. 40. kidney function check before starting new therapies or medications.
  41. 41. as part of ER/Hospital admission and/or stay.</li></ul>Reasons for BUN test<br />
  42. 42. * Example of BUN result as part of CMP panel. Normal range is 5-26 mg/DL.<br /><ul><li>high levels suggest impaired kidney function.
  43. 43. low levels are uncommon but are rarely cause for concern.
  44. 44. both increased and decreased levels are part of a normal pregnancy.
  45. 45. can appear normal in person with one functional kidney despite significant dysfunction in other.</li></ul>BUN test results<br />
  46. 46. ESWLExtracorporeal Shock Wave Lithotripsy<br />
  47. 47. <ul><li>non-invasive, out-patient  procedure using ultrasound "shock" waves to break up kidney stones into "passable" pieces.
  48. 48. externally applied, focused, high-intensity, acoustic pulse.
  49. 49. generated by a lithotripter machine.
  50. 50. can be performed with intravenous sedation or general anesthesia.
  51. 51. takes 1 - 2 hours.</li></ul>Extracorporeal Shock Wave Lithotripsy<br />
  52. 52. * Patient and lithotripter (ESWL) apparatus.<br />
  53. 53. <ul><li>can be used on any type of stone.
  54. 54. work best on softer stones (uric acid) and stones 1-2 centimeters in diameter.
  55. 55. less success on harder stones (oxalate monohydrate or cystine).
  56. 56. large stones may require multiple treatments.</li></ul>Extracorporeal Shock Wave Lithotripsy<br />
  57. 57. * Kidney stones before and after ESWL procedure.<br />
  58. 58. <ul><li>with bleeding tendencies.
  59. 59. who are pregnant.
  60. 60. have an active urinary tract infection (UTI).
  61. 61. who are morbidly obese.
  62. 62. have an anatomical abnormality of the urinary tract.</li></ul>ESWL should be avoided in patients (contraindications):<br />
  63. 63. cysto Cystoscopy<br />
  64. 64. <ul><li>thin , lighted tube (catheter) is inserted into bladder via urethra.
  65. 65. allows for views of bladder that do not show up well on  an x-ray.
  66. 66. biopsies and urine samples can be taken.
  67. 67. sometimes bladder stones can be removed.</li></ul>Cystoscopy<br />
  68. 68. * Physician using a cystoscope.<br />
  69. 69. <ul><li>find cause of : blood in urine, painful urination, incontinence, urinary frequency and urgency, and inability to pass urine.
  70. 70. look for blockages.
  71. 71. place urethral stents to help with urine flow.
  72. 72. to take biopsies or blood samples.
  73. 73. for Retrograde Pyelography ( * next slide section ).</li></ul>Reasons for Cystoscopy<br />
  74. 74. * Cystoscope instruments<br />
  75. 75. <ul><li>temporary swelling of the urethra.
  76. 76. urinary tract infections.
  77. 77. pink tinge to urine for a few days following.
  78. 78. punctures in urinary tract wall (extremely rare).</li></ul>Cystoscopy complications<br />
  79. 79. Normal<br />Abnormal<br /><ul><li>swelling or narrowing of the urethra.
  80. 80. bladder tumors or inflammation.
  81. 81. congenital (from birth) structural abnormalites.
  82. 82. pelvic organ prolapse (women).
  83. 83. urethra, bladder, and ureters appear healthy and intact.
  84. 84. no polyps or abnormal tissue, swelling, bleeding, or strictures (narrow areas) in the urinary tract.</li></ul>Cystoscopy results<br />
  85. 85. RPRetrograde Pyelogram<br />
  86. 86. <ul><li>urologic diagnostic x-ray in which dye is inserted through urethra to visualize the bladder, ureters, and renal pelvis.
  87. 87. retrograde refers to the direction in which the dye moves (which is the opposite of urine). </li></ul>Retrograde Pyelogram (RP)<br />
  88. 88. <ul><li>used to see if a stone or something else is blocking urinary tract.
  89. 89. thin, lighted tube called cystoscope inserted into urethra.
  90. 90. dye is injected into tube (catheter) and x-rays are taken.
  91. 91. done under local or regional anesthetic.
  92. 92. often done when Intravenous Pyelogram (IVP) is inconclusive.</li></ul>Retrograde Pyelogram Procedure<br />
  93. 93. <ul><li>abnormal - flow of the dye is blocked, either by a kidney stone or another urinary problem.
  94. 94. normal - blockage is not seen and the kidney, ureters, etc. appear healthy.</li></ul>Retrograde Pyelogram (RP) results<br />
  95. 95. *  Retrograde Pyelogram in an immunocompromised patient with Aspergillosis (a fungal infection). Clumps of fungus balls and debris are discovered in the collecting duct system of the kidney.<br />

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