GU Patho Renal & Cardiac

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Author:
MeganM
ID:
311371
Filename:
GU Patho Renal & Cardiac
Updated:
2015-11-15 17:49:21
Tags:
GU McCance Patho Renal
Folders:
GU,Patho,Exam 3
Description:
Renal & Cardiac
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  1. Why would someone with kidney disease be anemic?
    IN RF, kidneys won't be producing EPO to stimulate RBC production in BM
  2. Why would a person with kidney disease be hypocalcemic?
    • B/c the kidney is responsible for activating vit D w/ stimulus of PTH & if kidney not working, vit D will not be converted to active form & will not stimulate absorption of Ca++ in GI tract
    • even with high Ca++ diet, it will not be absorbed and person can get osteoporosis.
  3. Why is a midstream catch for UA so important for females?
    • b/c the first part of urine comes from distal urethra and can contain bacteria.  
    • Midstream will be good indicator of what is in urinary or GI tract
  4. How do macula densa cells affect GFR & BV?
    • They sense concentration of Na+ & Cl-. If concentration is high, that means GRF and BV are high, so they inhibit renin secretion. 
    • Vice versa
  5. Function of principal cells.
    • Drive the Na+K+ pump
    • reabsorb Na+ and H2O
    • secrete K+
    • stimulated by aldosterone
  6. Function of Intercalated cells.
    • regulate pH
    •  secrete H+ and reabsorb HCO3- OR 
    • secrete HCO3- and reabsorb K+
  7. What controls the secretion of K+?
    aldosterone
  8. Tubular reabsorption is movement of fluids & solutes from where to where?
    tubular lumen (nephron) back to peritubular capillary plasma (blood)
  9. Tubular secretion is movement of substances from where to where?
    peritubular capillary plasma (blood) to tubular lumen (nephron)
  10. What happens to arteriole smooth muscle when arterial pressure increases? What is the mechanism called that is resposible for this?
    • it contracts, decreasing glomerular perfusion
    • myogenic mechanism
  11. Increased NaCl in the distal nephron _____ renin release.
    • inhibits
    • (macula densa cells)
  12. Decreased NaCl in the distal nephron _____ renin release.
    • stimulates
    • (macula densa cells)
  13. Increased pressure in the Afferent arteriole _____ renin release.
    • inhibits
    • (baroreceptor)
  14. Decreased pressure in the Afferent arteriole _____ renin release.
    • stimulates
    • (baroreceptor)
  15. What are juxtaglomerular cells?
    • baroreceptors that can sense pressure in afferent arteriole,
    • stim by sympathetic nerves
  16. What does GFR tell you about renal function?
    ability of kidneys to filter & fxn properly
  17. What does plasma creatinine concentration tell you about renal function?
    • if it is high, GFR is decreased
    • Cr and GFR are inversely related
    • (Cr is not secreted or reabsorbed)
  18. What does BUN tell you about renal function?
    • BUN and GFR are inversely related
    • Increased BUN = dehydration
    • Urea is reabsorbed so it is not a good measure
  19. What does the presence of epithelial casts tell you about renal function?
    • degeneration of tubular lumen OR
    • necrosis of renal tubules
  20. What does the presence of epithelial casts tell you about renal function?
    • degeneration of tubular lumen OR
    • necrosis of renal tubules
  21. The most common causes of acute tubular necrosis (ATN) are?
    hypotension and nephrotoxins
  22. What part of the heart does the parasympathetic NS innervate? Sympathetic?
    • Parasymp = nodal ONLY (only affects heart rate)
    • Sympathetic = nodal AND myocardium (affects HR and contractility)
  23. What is Ohm's law? Why is it significant?
    • Resistance = change in pressure/rate of flow
    • a small change in resistance means a big change in flow
  24. What is Poiseuille's Law?
    • Resistance is directly r/t length & viscosity;
    • indirectly r/t radius to 4th power
    • ↑ length = increased ↑ resistance = ↓ BF

     ↑ radius to 4th power = ↓ resistance =  ↑ BF
  25. How does EDV affect CO?
    ↑ EDV means  ↑ preload =  ↑ vent contraction = ↑SV & ↑C.O.
  26. What is Laplace's Law?
    • wall tension is
    • directly r/t  intraventricular pressure * radius;
    • inversely r/t wall thickness (m)
    • T=(p*r)/m
    • *rubber band analogy
  27. What happens to the wall cells of the ventricle if it is dilated?
    they increase tension to produce given pressure
  28. How does a dilated ventricle affect blood ejection?
    wall cells must ↑ tension, which ↓ rate of fiber shortening (muscle contraction) and  ↑ ability to eject blood

    (more energy is needed)
  29. BF is _____ r/t pressure; ____ r/t resistance.
    • directly
    • inversely
  30. Autoregulation (myogenic regulation) of BF keeps a constant flow by what?
    altering the resistance in the arterioles with smooth muscle contraction or relaxation
  31. What happens to the LV in aortic stenosis and why?
    LV hypertrophy b/c it has to generate higher pressure to get the blood through
  32. How does aortic stenosis lead to ischemia?
    • LV is enlarged b/c it has to generate more pressure to get blood through;
    • b/c heart muscle is larger, it cannot properly relax to fill
  33. Why would someone with mitral stenosis be on anticoagulant therapy?
    b/c it causes LA to enlarge due to blood backing up; stasis of blood in LA can lead to thrombi
  34. Severe mitral stenosis can lead to what?
    CHF
  35. Two things that can cause chronic aortic regurgitation.
    • rheumatic fever
    • persistent systemic HTN
  36. What does a decreased EF mean?
    • systolic dysfunction;
    • blood cannot get out (or in to) of heart
  37. How can atherosclerosis lead to ischemia & infarction?
    plaques can rupture, cause thrombus & sudden occlusion of BV

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