Guided Lecture Notes,Chapter 25, Disorders of Renal Function
Learning Objective 1.Differentiate disorders of kidney development.
- Differentiate renal agenesis, renal hypoplasia, and renal dysplasia. (Refer to PowerPoint side 2.)
- Describe abnormalities in location of form of the kidneys, including horseshoe kidney. (Refer to Figure 25-1.)
Learning Objective 2.Describe the genetic basis for renal cystic disease, the pathology of the disorder, and its signs and symptoms.
- Describe renal cystic disease.
- Differentiate autosomal dominant polycystic kidney disease, autosomal recessive polycystic kidney disease, nephronophthisis, and medullary cystic diseases with regard to cause, pathology, and clinical manifestations. (Refer to PowerPoint slide 3 and Figures 25-2 and 25-3.)
- Differentiate simple cysts and acquired renal cystic disease. (Refer to PowerPoint slide 3.)
Learning Objective 3.Differentiate mechanism involved in glomerular injury.
- Review the anatomy and physiology of the glomerulus. (Refer to PowerPoint slide 4and Figure 25-4A.)
- Differentiate the two immune mechanisms implicated in the development of glomerular injury. (Refer to PowerPoint slide 5and Figure 25-5.)
- Differentiate the terms proliferative, membranous, sclerotic, diffuse, focal, segmental,and mesangial to explain changes in glomerular structure that occur with glomerulonephritis.(Refer to PowerPoint slide 6andFigure 25-4B.)
- Differentiate nephritic syndrome and nephrotic syndrome. (Refer to PowerPoint slides 7 and 8.)
Learning Objective 4.Differentiate glomerular diseases.
- Relate the proteinuria, hematuria, pyuria, oliguria, edema, hypertension, and azotemia that occur with glomerular diseases to changes in glomerular structure.
- Differentiate acute nephritic syndrome, acute postinfectious glomerulonephritis, rapidly progressive glomerulonephritis, Goodpasture syndrome, nephrotic syndrome, minimal-change disease/lipoid nephritis, membranous glomerulonephritis, focal segmental glomerulosclerosis, IgA nephropathy, hereditary nephritis/Alport syndrome, and chronic glomerulonephritis with regard to cause, pathology, and clinical manifestations. (Refer to PowerPoint slides9 to 12 and Figures 25-6, 25-7, 25-8, 25-9, and 25-10.)
- Differentiate how diseases such as systemic lupus erythematosus, diabetes mellitus, and hypertension result in glomerular disease. (Refer to PowerPoint slides 13 to 15.)
Learning Objective 5. Differentiate tubular and interstitial kidney disorders.
- Define tubulointerstitial kidney disease, and identify the tissue affected in tubulointerstitial disorders.
- Differentiate acute acute tubular necrosis, tubulointerstitial nephritis, acute pyelonephritis, chronic pyelonephritis, reflux nephropathy, and nephropathy induced by drugs and toxins with regard to cause, pathology, and clinical manifestations. (Refer to PowerPoint slides16 and 17 and Figures 25-11and25-12.)
- Explain why the kidneys’ high blood flow and filtration pressure and metabolic function predispose them to injury due to drugs and toxins.
- Describe how drugs and toxins damage the kidneys.
- Differentiate between acute drug-related hypersensitivity reactions and chronic analgesic nephritis with regard to cause, clinical manifestations, and treatment.
Learning Objective 6. Differentiate obstructive kidney disorders.
- Describe the effects of urinary tract obstruction on renal structure and function.
- Identify common causes and locations of urinary tract obstruction. (Refer to Figure 25-13and Table 25-1.)
- Classify obstructive disorders a sudden or insidious, partial or complete, unilateral or bilateral.
- Describe effects of urine stasis and progressive dilation of collecting ducts and tubular structures and the causes, pathology, clinical manifestations, and treatment associated with hydronephrosis. (Refer to PowerPoint slides 18 to 21andFigure 25-14.)
Learning Objective 7. Differentiate kidney stones.
- Discuss the merits of the saturation, matrix, and inhibitor theories as they relate to the formation of calculi. (Refer to PowerPoint slide 22.)
- Differentiate the anatomy and pathology of the four types of kidney stones/calculi. (Refer to PowerPoint slides23and 24 and Figure 25-15 and Table 25-2.)
- Explain the common clinical manifestations and the mechanisms of pain and infection that occur with kidney stones.
- Describe the methods used in the diagnosis and treatment of kidney stones.
Learning Objective 8. Differentiate two major groups of malignant kidney tumors. (Refer to PowerPoint slide 25.)
- Characterize Wilms tumor in terms of age of onset, possible oncogenic origin, manifestations, and treatment.
- Describe the etiology, pathology, clinical manifestations, diagnosis, and treatment of the embryonic kidney cancer (Wilms tumor or nephroblastoma). (Refer to PowerPoint slide 26 and Figure25-16.)
- Identify risk factors for adult kidney cancer, and discuss its incidence, pathology, clinical manifestations, diagnosis, and treatment. (Refer to PowerPoint slide 27 and Figure 25-17.)