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urology & nephrology
med emergencies
| Question | Answer |
|---|---|
| functions of urinary system | maintain blood volume, balance of water, electrolytes, and pH; ensures key substances such as glucose remain in bloodstream and other wastes removed (urea and creatinine), BP regulation via release of renin and controls development of RBC's |
| causes of end-stage renal failure | poorly controlled diabetes and uncontrolled hypertension |
| 4 major structures of the urinary system | kidneys, ureters, urinary bladder, urethra |
| functional unit of the kidney | nephron |
| after age 40 about how much % of nephrons are lost every decade? | 10% |
| normal GFR | 180mg/dL/day |
| most glucose/dextrose reabsorbed here; urea and creatinine should not be | proximal convoluted tubule |
| salty reabsorption of water - only permeable to water via osmosis from high concentration of sodium in medulla | descending loop of henle |
| no longer permeable to water; sodium potassium pumps; Pump sodium into the medulla - where furosemide works turning off sodium pumps = more dumping of filtrate and water in urine in the descending loop because the medulla is not as sodium concentrated | ascending loop of Hele |
| what pressor/hormone works on the collecting ducts of the nephron | ADH/vasopressin |
| potassium sparing diuretics work in what part of the nephron | collecting duct |
| Blood urea nitrogen test (BUN) directly measures blood concentration of urea; an indirect indicator of GFR; what are normal levels | 7-20mg/dL |
| Creatinine: larger molecules than urea and is not reabsorbed which is a direct indicator of GFR; what are normal levels | 0.6-1.2mg/dL |
| Sudden (period of day) drop in urine output, reversible if diagnosed and treated early | Acute Renal Failure |
| leading cause of ARF is? most common metabolic cause of death? | hypovolemic shock hyperkalemia |
| 3 types of ARF | most common prerenal, renal, postrenal |
| rhabdomyolysis is common and hypotension, cardiac failure, cardiovascular collapse (shock and sepsis), renal artery stenosis | prerenal dysfunctions causing ARF |
| small vessel/glomerular damage, tubular cell damage, interstitial damage (pyelonephritis, allergic reaction) | renal dysfunctions creating ARF |
| kidney stone, prostate enlargement, obstruction of bladder neck/urethra/ureters | postrenal dysfunctions creating ARF |
| what is AMS in ARF patients usually due to? | high uremia |
| what is a huge sign of renal failure on the ECG? | hyperkalemia |
| Inadequate kidney function due to permanent loss of nephrons (70%). Metabolic instability does not occur until 80% of nephrons destroyed (end-stage renal failure) Must have dialysis or kidney transplant to survive | Chronic Renal Failure (CRF) |
| 3 pathological processes for CRF | microangiopathy, tubular cell injury, inflammation or infection in interstitial tissue |
| jaundice (yellowing of eyes = icterus), skin pale/moist/cool, scratches and ecchymosis common skin changes, uremic frost, AMS, HTN; symptoms of ? | chronic renal failure |
| complication of dialysis that is major cause of AMS | hypotension/hypovolemia |
| most common cause of priapism | sickle cell disease |
| first step in urine formation: glomerular filtration | High blood pressure in the glomerulus forces water, ions, waste products, glucose, and amino acids out of the blood and into the Bowman’s capsule, forming filtrate. Blood cells and large proteins remain in the bloodstream. |
| second step of urine formation: tubular reabsorption | As the filtrate moves through the proximal tubule, Loop of Henle, and distal tubule, the body reabsorbs 99% of the water and necessary nutrients (glucose, ions) back into the peritubular capillaries, returning vital substances to the blood. |
| third step of urine formation: tubular secretion | Waste products (such as urea, creatinine, excess ions, and drugs) are actively transferred from the peritubular capillaries into the renal tubule (specifically the distal tubule and collecting duct) to be added to the urine. |
| final excretion after urine formation | After the three steps, the remaining fluid—now urine—is collected in the renal pelvis, travels down the ureters to the bladder for storage, and is excreted via the urethra. |
| what is considered lower urinary tract infection? | urethritis, cystitis, prostatitis |
| what is considered upper urinary tract infection? | pyelonephritis |
Created by:
Lindsey.George