patho test hint hint hints.txt
Card Set Information
patho test hint hint hints.txt
Mountain State University Physician Assistant class of 2014
what is the peritubular capillary?
originates from the efferent arteriole
low pressure vessels
adapted for reabsorption rather than filtration
rejoin venous channels to take blood away from the kidneys
what are struvate stones?
staghorn stones shaped like calaces
contains proteus bacteria
what is the juxtaglomerular apparatus?
juxtaglomerular cells contain renin and constrict afferent
macula densa in DCT triggers renin release, sense Na osmolality
extraglomerular mesengial cells - anchor and constrict
peripolar cells -
what is the loop of Henle?
thin decending - highly permeable to water, moderate to urea,Na,other ions
osmolality of filtrate reaches highest point at elbow of loop
thin ascending - impermable to water, absorbs solutes, diluting segment
thick ascending -
always absorbs more NaCl than water
what decreases GFR?
decreased kidney perfusion or pressure from afferent constriction, efferent dialation, hypotension, hypovolumia,
what increases GFR?
increased kidney perfusion or pressure due to afferent dialaiton, efferent constriction, hypertension, hypervolumia,
what are the treatable causes of incontenance in elderly?
Atrophied urethitis, vaginitis
Psyciatric - depression
Excessive urine output - hyperglycemia
what is the effect of the liver on the renin angiotensin mechanism?
angiotensinogen is released from the liver, this is then converted to angiotensin I by renin
How does aldosterone work?
released from adrenal cortex in the glomerulosa by high concentrations of angiotensin II or descreased stretch of baroreceptors
causes increased reabsorbtion of Na and thus fluid in the DCT,
increases secretion of K
what counteracts aldosterone?
osmolality of ECF, low potassium, high sodium
spirolactone is an antihypertensive that antagonizes aldosterone
what does sypmathetic tone do to the kidneys?
contricts afferent, everything decreases, urine output can drop to zero
How does lasix work?
inhibits symport of NaCl,K in thick ascending loop, Mg also leaves can cause hypomagnesia
what is the difference between nephrotic and nephritic?
nephrotic - proteinuria >= 3.5mg a day
nephritic - < 3.5
what is the innervation of the urinary system?
sympatetic from T11-L2 to hypogastric nerve, promotes bladder relaxation of detrusor, contraction of internal sphint
parasympathetic from S1-S3 promotes bladder empyting contraction of detrusor, relaxation of internal sphinct
somatic (voluntary) from S2-S4 somatic pudendal nerve
what are the stages of renal failure?
1 - damage with gfr > 90
2 - damage with gfr 60-89
3- gfr 30-59
4- gfr 15-29
5 - FAIL gfr < 15
what are aquaporins?
special transmembrane protein channels where water crosses the cell membrane thru osmosis
what do you give for hyperkalemia?
give insulin, forces K back into the cells
what goes in and out of PCT?
Reabsorbs - NaCl, bicarb,K,water,glucose,amino acids
Secrets-H+, organic acids and bases
in and out of loop of henle
thin decending - reabsorb water
thick acending - reabsorbs NaCl,bicarb,K,Ca,Mg secrets H+
in and out of DCT
early distal - reabsorbs NaCl, Ca, Mg
last distal and CT - reabsorb NaCl, secretes K+, ADH mediated H2O reabsorbtion
Intercalculated cells reabsorbs bicarb and K secrets H+