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Advanced Patho EXAM 3

What do the kidneys filter? sodium and potassium; reabsorb what the body needs
What does the Renin angiotensin aldosterone do? Regulate BP and maintain circulating blood volume
What does the urinary system consist of? kidneys, ureters, urinary bladder and urethra
What do the afferent and efferent arterioles do in regards to circulation? afferent lets blood in, efferent takes blood out
What does the glomerulus do? high pressure capillary filtration unit encased in the bowman's capsule. Blood flows into capillaries from the afferent arteriole and flows out of the capillaries into the efferent arteriole
Describe the job of the basement membrane. prevents plasma proteins, RBCs, WBCs and platelets from passing through
What is a sign of basement membrane dysfunction? proteinuria
What happens if proteinuria is not treated? permanent damage to the basement membrane
What is GFR? glomerular filtration rate; 125mL/min
What are the 2 tests used to measure GFR? serum creatinine level and 24 hour urine collection
What does Bowman's capsule do? drains glomerular filtrate into proximal tubule, there 2/3 of water and electrolytes are reabsorbed
Where does approximately 65% of all re-absorptive and secretory processes occur? proximal convoluted tubule
What is the desired amount of urine produced per hour? 30-60 mLs
What does increased BUN or serum creatinine indicate? renal damage
When s/s are seen with ADPKD (autosomal dominant polycystic kidney disease? presents at 30-50 yrs of age, UTIs, back/flank pain, defects on chromosomes 16 and 4
What is the most common cause of UTIs? e. coli
How is pyelonephritis different than a UTI? it is in the actual kidney itself versus the urinary tract (i.e. urethra, bladder, ureters)
What would a urinalysis show in acute pyelonephritis? WBCs and casts, RBCs, nitrites
What are the s/s of pyelonephritis? fever, chills, flank pain, dysuria, frequency, urgency, CVAT, nausea, vomiting
How would living with one kidney affect you? it is possible, you won't necessarily go into renal failure just renal insufficiency
Where are the afferent and efferent arterioles? glomerulus
How do prostaglandins help the kidneys? may protect the kidneys against the vaso-constricting effects of SNS and angiotensin II
Where is renin released, why and what are the effects? plays a part in short and long term regulation of blood pressure; converts angiotensin I to angiotensin II which is a potent vasoconstrictor
What can cause renal stones? hypercalciuria, calcium stones
What is another name for renal calculus? stones (kidney stones)
What is the term given to dilation of kidney? hydronephrosis
Why are ACEI drugs helpful, especially in patients with diabetes? helps efferent arterioles relax and open
How would renal damage or failure lead to hypertension? HTN is an early manifestation of chronic kidney disease and its cause is multifactorial
What is the cause of pre-renal failure? decreased blood flow ie.shock, CHF, burns, third spacing, MI
What is the cause of intra-renal failure? disorders in the kidneys itself prolonged pre-renal failure; most common cause is acute tubular necrosis (ATN)
What is the cause of post-renal failure? obstruction to urine output most occur bilaterally; ureteral obstruction, bladder outlet obstruction
What happens in post-strep glomerulonephritis? the strep infx is not treated, so the acute glomerulonephritis turns into chronic which can lead to renal failure or renal insufficiency
Describe a Wilm's Tumor. it is the most common type of abdominal tumor in kids occurs around 3-5yrs chromosomal defect 11p13 Tx is to remove kidney and tumor
What s/s would you see in Glomerulonephritis? gross hematuria red cell casts, wbcs, proteinuria with loss of 3 grams of protein/day, edema, ascites, diastolic HTN
What are the s/s of renal failure? hyperkalemia, proteinuria, loss of albumin, decreased creatinine, calcium levels decrease/phosphorus levels increase
What are some pre-existing conditions that increase the risk of renal failure/impairment? atherosclerosis, HTN, DM, HF, chronic liver failure, advanced age
What is the most common cause of chronic renal failure? diabetes mellitus
What are the 3 areas of the kidneys? pelvis, medulla (inner), cortex (outer)
What does the cortex contain? glomeruli, convoluted tubules of nephron and blood vessels
What does the medulla contain? renal pyramids, a lobe of the kidney
Describe the blood flow to the kidneys. each kidney supplied by a single renal artery; nearly all blood flow passes through the cortex; under certain conditions blood flow is redistributed to the medulla (shock, nervous system stimulation)
What is the function unit of the kidney and what is its job? nephron; filtration, reabsorption and excretion
Where is the basement membrane and bowman's capsule found? glomerulus
Describe the kidney. pair of bean shaped organs, right sits lower than left due to liver. composed of 18 lobes each lobe composed of millions of nephrons each nephron has a glomerulus and a system of tubular structures
Describe the outer cortex of the kidney. contains the glomerulus, blood vessels, and convoluted tubules
Describe the inner medulla of the kidney. contains the renal pyramids
True or false, the loop of henle plays an important role in controlling the concentration of urine. true
When there is increased sympathetic nervous activity, what happens to the kidney? constriction of afferent and efferent arterioles, causing a decrease in blood flow
What hormone regulates the ability of the kidneys to concentrate urine? ADH (anti-diuretic hormone)
ADH, aka vasopressin, does what? acts at the level of the collecting tubule to increase water absorption
What 2 conditions can increase renal blood flow and glomerular filtration? an increased amount of protein in the diet and an increase in blood sugar
How do the kidneys regulate body pH? by conserving base bicarbonate and eliminating hydrogen ions (H+)
What are the endocrine functions of the kidney? participate in BP control through the renin-angiotensin aldosterone mechanism, in calcium metabolism by activating vitamin D and in regulating RBC production through the synthesis of erythropoietin
What s/s do you see in acute nephritic syndrome? sudden onset of hematuria, proteinuria, diminished GFR, oliguria and signs of impaired renal function
Created by: lbl317537
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