Module 11: Fluid/Renal Disorders

Module Authors

Nancy Nielsen-Brown PA-C
Assistant Professor
Department of Physician Assistant Education
Western University of Health Sciences, Pomona, CA
Physician Assistant, Department of Neurology
Rancho Los Amigos Medical Center, Downey, CA

Tina M. Meyer, PA-C
Clinical Consultant and Adjunct Professor
Western University of Health Sciences, Pomona, CA

Review Concepts

By the end of this Review Concept you should be able to:

• Describe the health consequences of renal insufficiency and failure
• Outline tests and procedures for the diagnostic workup of renal insufficiency and failure
• Define the following clinical signs and syndromes:
  • Hematuria
  • Proteinuria
  • Nephrotic syndrome
• Describe the etiology, clinical presentation, diagnostic workup and clinical management of:
  • Hematuria
  • Proteinuria
  • Nephrotic syndrome

By the end of this Review Concept you should be able to:

• Describe the etiology and clinical presentation of acute renal failure
• List diagnostic indicators of acute renal failure
• Outline goals and procedures for the clinical management of acute renal failure
• Describe therapeutic options for the treatment of acute renal failure Describe the prognosis for patients with acute renal failure

By the end of this Review Concept you should be able to:

• Define chronic renal failure (CRF)
• Outline the progression of CRF from renal insufficiency to end-stage renal disease
• List etiologic factors responsible for CRF
• Differentiate early and progressive signs and symptoms of CRF
• Identify laboratory results that support a diagnosis of CRF
• Outline recommendations for the clinical management of CRF
• Describe interventions for the management of CRF complications, including:
  • Nutritional deficiencies
  • Anemia
  • Cardiovascular disease
  • Acid-base imbalances
• Explain how the pathophysiological changes associated with CRF affect pharmacological treatment of CRF and other diseases
• Describe the clinical management and treatment of end-stage renal disease

By the end of this Review Concept you should be able to:

• Describe the epidemiology of urolithiasis
• Compare and contrast different types of stones in terms of characteristic pathology
• Explain how stones are formed and the pathophysiological changes that result from stone formation
• Describe signs and symptoms, as well as patient management protocols, associated with:
  • Kidney stones
  • Ureteral stones
  • Bladder stones
• List factors that influence the clinical management of urolithiasis
• Discuss types of interventions appropriate for treating different kinds of stones
• Describe indications, contraindications, and expected outcomes of the following therapies for urolithiasis:
  • Percutaneous Nephrostomy
  • Percutaneous Ultrasonic Lithotripsy
  • Extracorporeal Shock Wave Lithotripsy (ESWL)
  • Chemolysis
  • Surgical interventions

By the end of this Review Concept you should be able to:

• Define urinary incontinence (UI)
• Describe the epidemiology and clinical presentation of UI
• List risk factors for UI
• Discuss the causes of each type of UI including medications that contribute to each condition
• Outline procedures and routine findings for the diagnostic workup of UI
• Outline procedures for the clinical management of UI
• List common pharmacological agents used in the treatment of UI and their side effects

By the end of this Review Concept you should be able to:

• Define benign prostatic hyperplasia (BPH) and its incidence in the male population
• Discuss the primary etiology and pathophysiology of BPH
• Describe the clinical presentation of BPH and its impact on patients and their families
• Outline procedures and common findings for a diagnostic workup of the patient with BPH
• Outline common interventions, including pharmacotherapeutic agents, for the clinical management of the patient with BPH

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