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Abdomen - Coggle Diagram

- - - - Inflammatory conditions
        
        Acute pyelonephritis
        
        Glomerulonephritis
        
        Interstitial nephritis, caused by antibiotics and nsaids
        
        Sarcoidosis
      - tubular
        
        Nephrotoxic
        
        analgesics, antibiotics, heavy metals, contrast, nsaids
        
        Exotoxic, Hb or Mb deposition
        
        In case of Mb/rhabdomyolysis, vigorous alkaline diuresis needs to be done in order to prevent myoglobin precipitation in tubules
      - vascular
        
        Polyarteritis nodosa
        
        Eclampsia
        
        Malignant hypertension
        
        vasculitis
    - - Causes
        
        Hypovolemia
        
        Burns
        
        Dehydration
        
        Hemorrhage
        
        Movement of fluid to third spaces
        
        Overuse of diuretics
        
        Hypotension
        
        Sepsis
        
        Cirrhosis
        
        Antihypertensive drugs
        
        Reduced cardiac output
        
        arrhythmias
        
        Cardiac myopathies
        
        Massive pulmonary embolism
        
        Obstruction of great vessels
        
        Renal artery stenosis
        
        Renal artery atherosclerosis and thrombosis of artery or vein
        
        Vasculitis
      - Can be predecessed by prerenal cause
        
        Leads to ischemic tubular necrosis
    - - file:///C:/Users/vvare/Downloads/Screenshot%202023-06-06%20183307.png
    - - Oliguric phase
        
        Necrosis of tubules
        
        Intrarenal release of AT II
        
        Azotemia, oliguria and electrolyte imbalance
      - Diuretic phase
        
        Excretion of dilute urine leading to electrolyte imbalances
        
        Hypokalemia, - natremia and -calcemia
      - Other symptoms
        
        Hyper K and PO4
    - - Anorexia nausea and vomiting due to toxins effect on CNS
      - Diarrhea or constipation
      - Bleeding
      - Hematemesis
      - Dry mucus membranes
      - Uremic breath test
  - - - Bilateral small kidneys
      - Uremia
        
        Retained products normally excreted
        
        Normal products such as hormones present in increased amounts
        
        Loss of normal products of kidneys
      - Metabolic acidosis
      - file:///C:/Users/vvare/Downloads/Screenshot%202023-06-07%20144251.png
      - Pericarditis due to uremic toxins
      - Normochromic and normocytic anemia
      - Myoclonus, sleep disorders, peripheral neuropathy, stupor, seizure, coma, RLS
      - Uremia can lead to low estrogen levels, and low testosterone in men
      - Decreased insulin degradation leading to decreased need for insulin and other hypoglycemic medications
      - Gray discoloration from hemochromatosis, ecchymoses, pallor and anemia, pruritis
      - GI, peptic ulcer disease, uremic gastroenteritis, hiccups
    - - Chronic injury leads to irreversible loss of nephrons
        
        Less nephrons bore greater burden
        
        Leads to higher glomerular filtration pressure and hyperfiltration
        
        Leads to fibrosis and scarring
        
        Can lead to uremia
  - - - Hematuria and proteinuria with decreased GFR, water and renal salt retention
      - RPGN
        
        Crescents in bowmans space
        
        In response to severe damage to glomerular capillaries
      - In setting of infectious diseases
      - Nephrotic syndrome
        
        RPGN or CGN with massive proteinuria
        
        Mechanism
        
        Proteinuria
        
        Loss of proteins, hypoalbuminemia
        
        Systemic edema
        
        Hyperlipidemia and lipiduria
        
        Podocyte usually the target
      - IGA nephropathy, immune complex disease with diffuse mesangial IGA deposition
      - Goodpasture syndrome
        
        Circulating antibodies develop against antigens intrinsic to the GBM
      - ANCA or pauci-immune GN
        
        Few or no immune deposits
    - - Manifests in hematuria and edema and HTN
    - - Hematuria + proteinuria
      - Complement levels usually low
      - Hypercoagulability
      - Thyroid problems (reduced thyroxine-binding globulin, vitamin D deficiency (loss of vitamin D-binding proteins and increased susceptibility to infections
  - - - Normally fluids, citrate and magnesium protect
      - Distal renal tubular acidosis
      - Dehydration, Lesch-Nyhan and malignant tumours can lead to uric acid stones
      - Struvite can be caused by increased urine pH and proteus or klebsiella
- - - - Toxic megacolon, bowel obstruction and paralysis
      - Peri-rectal abscess and infection in ulcerated area
  - - - Fistula formation, ulceration through all layers and adjacent structures
      - Severe malabsorption of nutrients and electrolytes