Pathophys Test 3

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Author:
cgordon05
ID:
14384
Filename:
Pathophys Test 3
Updated:
2010-04-13 22:49:21
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Renal 1 6
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Description:
Renal 1-6
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  1. Anatomy of the nephron (p.1-2)
    • Each kidney contains approximately 1 million nephrons
    • Each nephron contains:
    • o Glomerulus – coiled within Bowman’s capsule
    • o Proximal convoluted tubule
    • o Loop of Henle
    • o Distal convoluted tubule
  2. Specific functions of the nephron:
    • Filtration- glomerular capillaries
    • Reabsorption - tubules and peritubular capillaries
    • Secretion - tubules and peritubular capillaries
    • Excretion - collecting duct
  3. Primary functions of kidney:
    • o Removal of waste products
    • o Maintenance of fluid and electrolyte balance
    • o Acid-base balance
    • o Secretion of hormones and autocoids
    • o Regulation of BP
  4. Blood flow to kidneys accounts for what percent of cardiac output? (p.5)
    • 25% of cardiac output
    • (4-6 L/min)
  5. What is the normal GFR/minute or per day? (p.2-3)
    • GFR/minute = 90-130 mL/min (average = 110 mL/min)
    • GFR/hr = average 6600 mL/hr
    • GRF/24 hours = 158 L/day
  6. What is the blood threshold for appearance of glucose in urine? (p.5)
    225 mg/min
  7. Renal: Urine pH
    • Normal = 4.5 - 8.0
    • Increased = Alkalosis
    • Decreased = Acidosis, intrarenal ARF
    • Notes: Should be on acidotic side to discourage bacterial overgrowth
  8. Renal: Specific gravity of urine
    • Normal = 1.003 - 1.030
    • Increased = volume deficit, glycosuria, proteinuria, prerenal ARF (>1.020)
    • Decreased = volume overload
    • Notes: measure of concentration of urine. Closer to 1 = more dilute
  9. Renal: Osmolality of urine
    • Normal = 300 - 1200 mOsm/kg
    • Increased = volume deficit, prerenal ARF (urine osmol > serum osmol)
    • Decreased = volume excess, intrarenal ARF (urine osmol < serum osmol)
  10. Renal: Protein in urine
    • Normal = 30 - 150 mg/day
    • Increased = trauma, infection, intrarenal ARF, transient with exercise, glomerulonephritis

    • Notes:
    • Does not belong in urine. If seen, think problem with glomerulus. Does not filter due to electrical charge and large size.
  11. Renal: Sodium in urine
    • Normal = 27 - 287 mEq/day
    • Increased = High sodium diet, intrarenal ARF
    • Decreased = prerenal ARF
    • Notes: Help differentiate between injury and failure
  12. Renal: Creatinine in urine
    Normal = 1 - 2 g/day

    • Decreased = intrarenal ARF, CRF
    • Notes: Less creatinine in urine is problem in tubular system
  13. Renal: Urea in urine
    • Normal = 6 - 17 g/day
    • Decreased = Intrarenal ARF, CRF
  14. Renal: Myoglobin in urine
    • Normal = Absent
    • Increased = crush injury, rhabdomyolysis
    • Notes: from muscle cells, nephrotoxic, and giant clogging tubules; seen with trauma
  15. Renal: RBCs in urine
    • Normal = 0 - 5
    • Increased = trauma, intrarenal ARF, strenuous exercise, renal artery thrombus
  16. Renal: WBCs in urine
    • Normal = 0 - 5
    • Increased = infection
    • Notes: look for leukocyte esterase (more sensitive than WBC)
  17. Renal: Bacteria in urine
    • Normal = none - few
    • Increased = Infection
  18. Renal: Casts in urine
    • Normal = none - few
    • Increased:
    • RBC = glomerular disease
    • WBC = pyelonephritis, glomerular disease, nephrotic syndrome
    • Epithelial = glomerular disease
    • Broad waxy casts = longstanding kidney dysfunction (very negative)
  19. Review the renin-angiotensin-aldosterone mechanism (p.4)

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