Renal

Question 1

What organs make up the urinary system?

Answer 1

Kidneys, ureters, bladder, urethra (plus prostate in males).

Question 2

Where are the kidneys located?

Answer 2

Posterior abdominal wall, below the diaphragm.

Question 3

Name the main layers/structures of the kidney.

Answer 3

Renal capsule, cortex, medulla (pyramids), pelvis, hilum.

Question 4

What enters/exits through the renal hilum?

Answer 4

Renal artery, renal vein, ureter.

Question 5

List the main functions of the kidneys.

Answer 5

Regulate BP (RAAS)

Maintain ion balance & pH

Control water & osmolarity (ADH)

Produce hormones (EPO, calcitriol)

Excrete wastes (urea, uric acid, drugs)

Regulate blood glucose (via gluconeogenesis)

Question 6

What are the main nephron processes?

Answer 6

Filtration, reabsorption, secretion.

Question 7

What is the pathway of filtrate through the nephron?

Answer 7

Glomerulus → PCT → Loop of Henle → DCT → Collecting duct.

Question 8

Which hormones regulate nephron function?

Answer 8

ADH → ↑ water reabsorption (collecting duct)

Aldosterone → ↑ Na⁺ reabsorption, ↑ K⁺ secretion (DCT)

Question 9

What is normal glomerular filtration rate (GFR)?

Answer 9

≈ 125 mL/min.

Question 10

How is GFR measured?

Answer 10

Serum creatinine or estimated GFR (eGFR).

Question 11

Name factors that can decrease GFR.

Answer 11

Age, dehydration, low BP, kidney disease, urinary obstruction.

Question 12

What are key renal assessment methods?

Answer 12

Inspection (skin turgor, oedema), auscultation (renal bruits), urinalysis, serum tests (urea, creatinine, eGFR).

Question 13

Normal urinalysis results: color, pH, protein, blood, glucose, ketones, nitrates?

Answer 13

Pale yellow; pH 4.6–8; protein negative; blood negative; glucose negative; ketones negative; nitrates negative.

Question 14

What does abnormal urinalysis indicate?

Answer 14

Color: dehydration/infection

pH: infection/metabolic issues

Protein: kidney damage

Blood: trauma/infection

Glucose: diabetes

Ketones: starvation/diabetes

Nitrates: infection (E. coli)

Question 15

What are normal serum renal values?

Answer 15

Urea 3–8 mmol/L, creatinine 53–115 µmol/L, eGFR >90 mL/min.

Question 16

What causes urinary tract infections (UTIs)?

Answer 16

Bacterial infection (usually E. coli) ascending urethra → bladder/kidneys.

Question 17

Name risk factors for UTIs.

Answer 17

Female anatomy, poor hygiene, catheters, diabetes, dehydration.

Question 18

Types of UTIs?

Answer 18

Cystitis (bladder), pyelonephritis (kidney), urethritis (urethra).

Question 19

Common UTI symptoms?

Answer 19

Dysuria, frequency, urgency, suprapubic pain, cloudy/foul urine, fever.

Question 20

UTI complications?

Answer 20

Urosepsis, renal scarring.

Question 21

How are UTIs treated?

Answer 21

Antibiotics (trimethoprim, nitrofurantoin, cephalexin), hydration, avoid unnecessary catheterisation.

Question 22

Nursing care for UTI?

Answer 22

Pain relief, monitor vitals, encourage fluids, educate on hygiene, follow-up urinalysis.

Question 23

Define acute kidney injury (AKI).

Answer 23

Sudden decrease in kidney function over hours–days → accumulation of wastes.

Question 24

Types of AKI?

Answer 24

Prerenal: ↓ blood flow (dehydration, shock)

Intrarenal: kidney damage (nephrotoxins, inflammation)

Postrenal: obstruction (stones, BPH, tumor)

Question 25

Phases of AKI?

Answer 25

Oliguric (↓ urine, fluid overload, ↑ K⁺/urea/creatinine), diuretic (↑ urine, dehydration risk), recovery (GFR normalises).

Question 26

AKI symptoms?

Answer 26

Oliguria, oedema, acidosis, hyperkalaemia, fatigue, confusion.

Question 27

AKI management?

Answer 27

Treat underlying cause, maintain fluid/electrolyte balance, avoid nephrotoxic drugs, supportive care and monitoring.

Question 28

What are age-related renal changes?

Answer 28

↓ nephron number & GFR, ↓ renal blood flow, ↓ bladder elasticity → urgency/nocturia, weaker sphincters → incontinence, slower drug excretion → toxicity risk.

Question 29

Causes of AKI by type?

Answer 29

Prerenal: low blood flow (hypotension, shock, dehydration) Intrarenal: direct kidney injury (toxins, sepsis) Postrenal: obstruction (stones, tumors)

Question 30

Common causes of CKD?

Answer 30

Diabetes, hypertension, polycystic kidney disease, glomerulonephritis, nephrotoxic drugs.

Question 31

What are the risk factors for CKD & AKI?

Answer 31

Medical: diabetes, hypertension, CVD, repeated UTIs Demographic: older age, Indigenous status, low income/education Lifestyle: smoking, alcohol, obesity Environmental/Exposure: nephrotoxic drugs, toxins

Question 32

Describe CKD pathophysiology.

Answer 32

Progressive nephron loss → fibrosis → ↓ GFR → impaired filtration, fluid & electrolyte regulation.

Question 33

Describe AKI pathophysiology.

Answer 33

Sudden loss of kidney function → accumulation of urea, creatinine, electrolytes; hormonal disturbances (↓ erythropoietin → anemia, altered calcium-phosphate metabolism → bone disease).

Question 34

Name neurological symptoms of CKD.

Answer 34

Fatigue, sleep disturbance, neuropathy, restless legs.

Question 35

Name cardiovascular symptoms of CKD.

Answer 35

Hypertension, heart failure, pericarditis.

Question 36

Name pulmonary symptoms of CKD.

Answer 36

Pulmonary edema, uremic pleuritis.

Question 37

Name gastrointestinal symptoms of CKD.

Answer 37

Nausea, vomiting, anorexia, GI bleeding.

Question 38

Name endocrine/metabolic symptoms of CKD.

Answer 38

Hyperparathyroidism, insulin resistance, hyperlipidemia.

Question 39

Name hematological symptoms of CKD.

Answer 39

Anemia, bleeding, increased infection risk.

Question 40

Name musculoskeletal symptoms of CKD.

Answer 40

Osteomalacia, fractures.

Question 41

Name integumentary symptoms of CKD.

Answer 41

Pruritus, ecchymosis.

Question 42

Name psychological symptoms of CKD.

Answer 42

Anxiety, depression.

Question 43

How is CKD diagnosed?

Answer 43

↓ GFR, urinalysis (proteinuria, hematuria), blood tests (creatinine, urea, electrolytes, hemoglobin), imaging (ultrasound, CT, renal scan), physical exam (fluid overload, edema, hypertension).

Question 44

What are the stages of CKD?

Answer 44

Stage 1–2: GFR >60, may have albuminuria, structural abnormalities Stage 3–4: GFR 15–59, symptoms like fatigue, edema, anemia Stage 5: GFR <15, kidney failure → dialysis or transplant required

Question 45

Lifestyle management strategies for CKD?

Answer 45

Low sodium diet, limit protein, exercise, quit smoking, reduce alcohol.

Question 46

Medications used in CKD management?

Answer 46

ACE inhibitors/ARBs → protect kidneys, reduce BP, proteinuria Diuretics → reduce fluid overload Erythropoietin & iron → treat anemia Statins → reduce CVD risk SGLT2 inhibitors & anti-hyperglycemics → glycemic control

Question 47

What are renal replacement therapy options?

Answer 47

Haemodialysis, peritoneal dialysis, kidney transplant.

Question 48

Key patient education points in CKD?

Answer 48

Monitor urine, weight, BP; attend follow-up care; adhere to lifestyle modifications.

Question 49

Common complications of CKD?

Answer 49

Hypertension, anemia, electrolyte imbalance, bone disease/osteoporosis/fractures, cardiovascular disease, fluid overload/pulmonary edema, increased infection risk.