DM/Renal-Self Learning Module stuff

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DM/Renal-Self Learning Module stuff
2013-09-10 19:45:17
N172 DM Renal

Self Learning Stuff
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  1. The organs of the endocrine system are glands that produce
  2. The endocrine glands secrete their substances directly in to the blood stream where they eventually affect specific
    target tissues
  3. The hormone recognizes target tissues through
    cell receptors
  4. Regulation of hormone secretion is based on
  5. A gland responds to negative feedback by ....
    increasing or decreasing the secretion of a hormone
  6. Insulin secretion is an example of what kind of feedback?  Between?

    glucose and insulin
  7. Elevated blood glucose levels stimulates the secretion of insulin from the
  8. Decreasing blood glucose levels will decrease the stimulus for?
    insulin secretion
  9. What part of the pancreas secretes the hormones?
    Islet of Langerhans
  10. What do Alpha cells make?

    What's it in response to?

    • low blood glucose, protein ingestion
    • and exercise
  11. What do Beta cells secrete? and what is it in response to?

    increased blood glucose levels
  12. How does insulin affect glucose metabolism in the liver?
    It inhibits glucogenesis
  13. What kind of hormone is insulin?
    anabolic/storage hormone
  14. What's anabolism?
    facilitates storage of nutrients after the ingestion of food
  15. How does insulin facilitate catabolism?
    when a person is sleeping or they are NPO the insulin will break down the stored fuels for energy
  16. 4 effects of normal aging on the Endocrine system
    • decreased hormone production and secretion
    • altered hormone metabolism and biologic activity
    • decreased responsiveness of target tissues to hormones
    • alterations in circadian rhythms
  17. 3 primary functions of the kidney
    • remove nitrogenous and toxic waste products
    • regulate fluid, electrolyte and acid base balance
    • hormonal activity
  18. What does the kidney produce?
    • erythropoietin for RBC production
    • vitamin D
    • renin regulation
    • prostaglandin synthesis
  19. What does Renin Regulation do?
    regulates our BP as a response to decreased blod flow volume, pressure or decreased Na

    Also assists in the regulation by stimulating the production of angiotensin II and Aldosterone
  20. What do prostaglandins do?
    regulates glomerular filtration, vascular resistance and renin production
  21. What are the effects of aging on the kidneys?
    • decreased amount of renal tissue
    • decreased number of nephrons and renal blood vessels
    • decreased function of loop of Henle and tubules
  22. BUN (Blood Urea Nitrogen) test measures what?
    • the renal excretion of urea nitrogen
    • Normal is 10-20mg/dL
  23. What would an elevated BUN mean?
    • dehydration
    • renal disease
    • steroid use?
    • high protein diet
  24. What is Creatinine level used to determine?  What is it...and what are the norms?
    • the level of a persons renal function
    • It is the end product of muscle and protein metabolism

    • Normal
    • M .6-1.2mg/dL
    • F .5-1.1mg/dL
  25. What do these Creatinine values tell you?
    • 1.5mg/dL  >50% of Nephron function is lost
    • 4.8mg/dL  >75% of Nephron function is lost
    • 10mg/dL   90% of Nephron function is lost
    • End stage renal Disease (ESRD)
  26. Creatinine Clearance....what is it? and what does it do?

    it is a calculation of a persons GFR and it is the BEST indicator of overall renal function

    24 hr. urine collection and serum creatinine draw
  27. What is the amount of normal creatinine clearance to maintain life without renal replacement?

    What is NORMAL?

    • Men 95-135mL/min
    • Women 85-125 mL/min
  28. Urinalysis provides information about....
    • acidity or alkalinity
    • presence or absence of waste products
    • sediment
    • bacteria
    • concentration or dilution of the urine
  29. Primary function of the kidneys
    • Balance solute and water transport
    • Excrete metabolic waste products
    • conserve nutrients
    • Regulate acid/base balance
    • secrete hormones
    • form urine
  30. What do the ureters do?
    Transports urine from the kidneys to the bladder
  31. Urinary bladder
    stores urine
  32. Urethra
    a tube that channels urine to outside the body
  33. 3 ways nephron makes urine
    • glomerular filtration
    • tubular reabsorption
    • tubular secretion
  34. How many litres of blood derived fluid does the kidney process each day?
    180 litres (47 gallons)
  35. What's glomerular filtration?
    a non selective process in which hydrostatic pressure forces fluids and solutes through a membrane
  36. What's the GFR?
    it is the amount of fluid filtered from blood into the capsule per minute
  37. Normal GFR?
  38. Rnal autoregulation
    If there is an increase in systemic blood pressure, the renal vessels will.....?

    If there is a decline in blood pressure, afferent arterioles will...?

  39. What is the Renin-Angiotensin mechanism?
    When there is a drop in systemic blood pressure renin will be released which acts on antiotensin to release antiotensin I which is converted to antiotensin II causing SYSTEMIC VASOCONSTRICTION and an increase in BP.
  40. Assessment of urinary function
    • urine color, odor, amt
    • difficulty starting stream?
    • frequency/urgency?
    • dysuria (pain)
    • nocturia
    • hematuria
    • oliguria (sm amt)
    • polyuria (lg amt)
    • Discharge?
    • Flank pain?
  41. Pyuria
    cloud, foul smelling urine