Pathophys Exam 3

Card Set Information

Author:
Rx2013
ID:
53605
Filename:
Pathophys Exam 3
Updated:
2010-12-05 22:03:22
Tags:
Renal Pathophysiology
Folders:

Description:
Renal Pathophysiology
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user Rx2013 on FreezingBlue Flashcards. What would you like to do?


  1. What space are the kidney's located in?
    retroperitoneal space
  2. Which kidney is slightly lower?
    right kidney
  3. Two basic functions of the kidneys
    • remove nitrogenous wastes
    • maintaint e-, acid/base and fluid balances in blood
  4. 4 primary components of the kidney
    • renal capsule (membrane)
    • renal cortex (below capsule)
    • Medullary Region (renal medulla)
    • Renal pelvis (connects to ureter)
  5. glomerular filitration
    passive diffusion of water and small mw ions into bowmans capsule
  6. Reabsorption of drugs occurs along the
    distal tuble and collection tubules
  7. Secretion
    • blood to urine
    • carrier mediated
    • active transport process
    • for bulky compounds
  8. The primary underlying factor to decreased renal blood flow with age is
    the decreased renovascular bed
  9. 3 important hormones keneys release
    • erythropoietin
    • renin
    • calcitriol (calcium maintenance)
  10. 2 primary functions of renal system
    • endocrine
    • excretion
  11. Functions of the nephron
    • filtration of water soluble substances
    • reabsorption of nutrients, wastes and e-
    • secretion of wastes
  12. site of fluid filtration from blood to nephron tubule
    Glomerulus
  13. Proximal convoluted tubule
    Reabsorbs water, electrolytes, bicarb, glucose amino acids and vitamins
  14. Descending loop of henle
    reabsorbs water
  15. ascending loop of henle
    reabsorbs Na, K, CL
  16. Distal convoluted tubule
    • reabsorbs Na, CL, water, urea
    • secretes H and K
  17. Collecting tubule
    • reabsorbs water under influence of ADH
    • secretes H and K
  18. inhibits ADH
    alcohol
  19. Reabsorbs 2/3 of water
    proximal convoluted tubule
  20. Fine tunes sodium and water changes
    DCT
  21. utilizes transporters in the apical and basolateral membranes of tubular cells
    transcellular route
  22. allows passive transpot of substances between tubular cells
    paracellular route
  23. Reabsorption of glucose is accomplished by
    proximal tubule cell sodium dependent transporters
  24. reabsorption mechanism for HCO3-
    • conver to CO2 by carbonic anhydrase
    • H+ provided by NaH pumps on apical cell membrane
  25. Secretion of potassium ions
    • Na/K pump
    • basolateral membrane in distal tubule
    • pumps regulated by aldosterone
  26. increase potassium excretion
    Aldosterone
  27. increases permeability of collecting tuble to water, resulting in increased reabsorption and reduced blood osmolality
    ADH
  28. alter blood volume without affecting blood osmolality
    • aldosterone
    • angiotensin II
    • atrial natriuretic peptide
    • urodilatin
  29. Increase sodium and water reabsorption
    • aldosterone
    • angiotensin II
  30. inhibit sodium and water reabsorption
    • atrial natriuretic peptide
    • urodilatin
  31. normal GFR
    125 ml/min
  32. fewer sodium ions delivered to the macula densa results in GFR ____
    increase
  33. mesangial cells respond to
    • glomerular capillary stretch
    • contract to reduce surface area
  34. Afferent constriction with efferent dilation results in
    decreased GFR
  35. Afferent dilation and efferent constriction results in
    increased GFR
  36. Important chemical mediators of arteriolar resistance
    • Angiotensin II
    • prostaglandins
  37. Infants have reduced ability to make concentrated urine due to
    kidney immaturity
  38. Aged individuals have
    • reduced numbers of functioning nephrons
    • reduces renal blood flow & GFR
    • decreased ability to conserve salt and water
  39. Renal blood flow decreased from 1200 ml/minat age 30 to _____ at age 80
    600 ml/min
  40. Manifestations of Vitamin D deficiency
    • soft tissue calcification
    • secondary hyperparathyroidism
    • renal osteodystrophy
    • hypocalcemia
  41. Tests of renal structure and function
    • urinalysis
    • blood tests
    • ultrasound/CT/MRI
    • Renal scans
    • Renal biopsy
  42. Blood tests for kidney function
    • BUN
    • Scr
  43. Ultrasounds/CT/MRI of kidneys
    • size of kidneys
    • renal cysts
    • hydronephrosis
  44. Renal scans
    • renal blood flow
    • urine leaks
    • voiding disorder
  45. detection of protein in the urine?
    not normally
  46. glucose present in urine?
    • diabetes
    • kidney damage or disease
  47. Nitrites in urine?
    UTI
  48. Leukocyte esterase (WBC esterase) in urine?
    • detects wbc in urine
    • UTI
  49. Ketones in urine?
    • diabetic ketoacidosis
    • when fat is broken down for energy
  50. red blood cells in urine?
    • inflammation
    • disease
    • injury to UT
    • strenuous exercise
  51. wbc in urine?
    • infection
    • cancer
    • kidney disease
  52. sulfur urine smell
    asparagus
  53. sweet urine smell
    diabetes
  54. foul urine smell
    infection
  55. normal urine smell
    urea and ammonia
  56. dark yellow urine
    dehydration
  57. green urine
    • asparagus
    • food dye
    • infection
  58. orange urine
    • blackberries
    • beets
    • rhubarb
    • jaundice
  59. pink urine
    • blood
    • food dye
  60. red urine
    • blood
    • foods
  61. brown urine
    nitrofurantoin
  62. serum creatinine
    more reliable than BUN
  63. Serum creatinine and BUN levels increase in conditions of
    reduced GFR
  64. BUN
    blood urea nitrogen
  65. increases serum creatinine
    • meat
    • exercise
    • muscle mass
    • cimetidine
    • trimethoprim
    • age
  66. decreases serum creatinine
    • muscle wasting
    • female gender
    • amputation
    • vegetarian diet
  67. Increases BUN
    • GI hemorrhage
    • corticosteroids
    • TCN
    • catabolic state
  68. decreases BUN
    • malnutrition
    • liver disease
  69. GFR can be estimated by measuring
    the clearance of a filterable substance from the urine
  70. provides more accurate measurement of GFR
    inulin clearance
  71. simple calculated method of estimating GFR using serum creatinine values
    MDRD
  72. tests in order of clinical utility from most to least
    • serum creatinine
    • creatinine clearance
    • nonisotopic contrast
    • radiolabeled inulin
    • inulin
  73. tests of renal function in order of accuracy from least to most
    • serum creatinine
    • creatinine clearance
    • nonisotopic contrast
    • radiolabeled inulin
    • inulin
  74. what is the difference between CrCL and GFR?
    CrCl approximates GFR
  75. CrCl may overestimate GFR due to the fact that
    creatinine is secreted in the proximal tubule
  76. When should a 24 hour urine collection be performed?
    • extremes of age and body size
    • malnutrition/obesity
    • skeletal muscle disease
    • para/quadriplegia
    • vegetarian diet
    • pregnancy
    • prior to kidney toxic drugs
  77. cockcroft gault equation for crcl
    • [(140-age)x wt in kg]
    • 72 x serum cr (mg/dL)

    x 0.85 for women
  78. congenital and inherited disorders of renal function
    • cycstic kidney
    • cysts
  79. Renal unilateral agenesis
    • failure of an organ to develope
    • 1/1000
    • boys > girls
  80. renal hypoplasia
    kidney doesn't develope to normal size
  81. dysplasia
    • abnormality in structure
    • aplastic or cystic kidneys
  82. most common type of dysplasia
    multicystic renal dysplasia
  83. Autosomal dominant polycystic kidney disease
    • cysts
    • slow progression
    • may have hepatic cysts
  84. autosomal recessive PCKD
    • infants with renal, liver, lung impairment
    • portal hypertension
  85. neprhonopthisis
    • medulary cystic disease complex
    • onset in childhood
    • cysts and shrunken kidneys
  86. Presentation of nephronophtisis
    • polyuria
    • polydipsia
    • bed wetting
    • progressive renal failure in 5-10 years
  87. typical renal cysts
    • 1 cm in diameter
    • asymptomatic
    • usually >50 y/o
    • surgical removal
  88. Partial obsruction
    frequent urination
  89. complete obstruction
    no urnination
  90. antegrade nephrostomy
    obstruction to the ureters
  91. Hydroephrosis
    • dilation of renal pelvis and ureters
    • obstruction of urine flow
  92. causes of hydroephrosis
    • stone
    • stricture
    • blood clot
    • tumor
  93. symptoms of hydroephrosis
    • pain
    • elevated scr
    • urinary retention
  94. diagnosis of hydronephrosis
    • ultrasound
    • CT
  95. Treatment of hydronephrosis
    • remove obstruction
    • nephrostomy
    • stent
    • catheter
  96. Renal calculi
    • most common obstruction
    • can form anywhere in the urinary tract
  97. four types of stones
    • calcium (most common)
    • magnesium ammonium phosphate (uti)
    • uric acid
    • cystine (cystinuria)
  98. Drugs that cause kidney stones
    • diuretics
    • calcium based antacid
    • calcium based phosphorus binders
  99. foods that may cause kidney stones
    high oxalate foods
  100. pyelonephritis
    kidney infection
  101. urethritis
    uretheral infection
  102. cystitis
    bladder infection
  103. inflammatory process that involves flomerular strucures
    glomerulonephritis
  104. Proliferative cellular changes
    increase in glomerular or inflammatory cell number
  105. symptoms of cellular changes
    • elevated scr
    • proteinuria
  106. treatment of cellular changes
    immunosuppressive agent
  107. acute tubulointerstial disorders
    • interstitial edema
    • pylonephritis
    • hypersensitivity to drugs
  108. chronic tubulointerstitial disorders
    interstitial fibrosis, atrophy and monnuclear infiltrates
  109. polyuria tubulointerstitial disorders
    • change in pH
    • metabolic acidosis
    • deminished reabsorption of sodium and other
  110. proximal renal tubular acidosis
    impared HCO3 reabsorption
  111. distal renal tubular acidosis
    impared secretion of fixed metabolic acid
  112. aldosterone deficiency
    • imparied reabsorption of sodium
    • decreased elimination of hydrogen and potassium
  113. Wilms tumor
    • nephroblastoma
    • 3-5 y/o with HTN
    • gene WT1 on chromosome 11
  114. Renal cell carcinoma
    • 90-95% of all kidney tumors
    • ages 55-84

What would you like to do?

Home > Flashcards > Print Preview