Patho 3

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Author:
cgordon05
ID:
16741
Filename:
Patho 3
Updated:
2010-04-29 19:11:05
Tags:
renal part
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Description:
renal part 2
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  1. Review the renin-angiotensin-aldosterone mechanism.
    (p.4)
    • JG apparatus --> [renin] --> [angiotensin I] --> lungs --> [angiotensin II] --> adrenals --> [aldosterone] --> tubules --> increase Na+ --> increase H2O (ADH) --> increase BP
  2. What are systemic and local effects of angiotensin II? (p.20)
    • powerful vasoconstrictor
    • stimulates adrenals to release aldosterone
    • increases Na+ reabsorption
    • increases H2O reabsorption
    • increases vascular volume
    • increases BP
  3. What is effect of ADH in collecting ducts?
    Increased H2O reabsorption
  4. Disorder of glomerular and renal function.
    (p.8-10)
    • Glomerulonephritis - autoimmune disease
    • capillary wall injured = increased membrane permeability
    • may result in permanent kidney damage
    • inflammatory condition
    • classic form develops in child 1-4 weeks after Group A Streptococcus infection
    • kidney can be primary or secondary organ
  5. Know significance of blood creatinine level (creatinine clearance) as marker for renal function.
    (p.2-3)
    • Average creatinine clearance = 120 mL/min
    • Approximates GFR = 90-130 mL/min
    • Good marker for evaluating renal function
    • If GFR falls, creatinine clearance overestimates
    • Gold standard - creatinine clearance = 24-hour urine
  6. Review sequence of events in the inflammatory process that lead to glomerular injury.
    (p.10)
    • endothelial and epithelial cell damage
    • increased glomerular permeability to proteins
    • accumulation of proteins in surrounding matrix with fibrin deposit
    • proliferation of mesangial cells
    • sclerosis
  7. Goodpasture's Syndrome
    (p.10)
    • Autoantibodies react with basement membrane of glomerulus and alveoli
    • Lesions develop simultaneously in kidney and lung
  8. Nephrotic syndrome - clinical findings
    (p.11)
    • massive proteinuria
    • generalized edema
    • hypoalbuminemia
    • hyperlipidemia and lipiduria
  9. Causes of nephrotoxic syndrome
    • Age dependent:
    • children <15 years - primary lesion in kidney
    • adults - secondary to systemic disease -- diabetes, lupus erythmatosus
  10. Nephritic Syndrome - clinical findings
    • hematuria - cola-colored urine
    • oliguria and azotemia - to some degree
    • hypertension
    • *less likely to have generalized edema
  11. Causes of nephritic syndrome
    • primary lesion of glomerulus
    • secondary to systemic disease
    • common occurrence from post-Streptococcal glomerulonephritis developing in children after Streptococcal infection

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