Advanced Patho EXAM 3
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| What do the kidneys filter? | sodium and potassium; reabsorb what the body needs
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| What does the Renin angiotensin aldosterone do? | Regulate BP and maintain circulating blood volume
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| What does the urinary system consist of? | kidneys, ureters, urinary bladder and urethra
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| What do the afferent and efferent arterioles do in regards to circulation? | afferent lets blood in, efferent takes blood out
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| 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
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| Describe the job of the basement membrane. | prevents plasma proteins, RBCs, WBCs and platelets from passing through
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| What is a sign of basement membrane dysfunction? | proteinuria
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| What happens if proteinuria is not treated? | permanent damage to the basement membrane
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| What is GFR? | glomerular filtration rate; 125mL/min
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| What are the 2 tests used to measure GFR? | serum creatinine level and 24 hour urine collection
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| What does Bowman's capsule do? | drains glomerular filtrate into proximal tubule, there 2/3 of water and electrolytes are reabsorbed
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| Where does approximately 65% of all re-absorptive and secretory processes occur? | proximal convoluted tubule
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| What is the desired amount of urine produced per hour? | 30-60 mLs
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| What does increased BUN or serum creatinine indicate? | renal damage
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| 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
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| What is the most common cause of UTIs? | e. coli
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| How is pyelonephritis different than a UTI? | it is in the actual kidney itself versus the urinary tract (i.e. urethra, bladder, ureters)
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| What would a urinalysis show in acute pyelonephritis? | WBCs and casts, RBCs, nitrites
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| What are the s/s of pyelonephritis? | fever, chills, flank pain, dysuria, frequency, urgency, CVAT, nausea, vomiting
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| How would living with one kidney affect you? | it is possible, you won't necessarily go into renal failure just renal insufficiency
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| Where are the afferent and efferent arterioles? | glomerulus
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| How do prostaglandins help the kidneys? | may protect the kidneys against the vaso-constricting effects of SNS and angiotensin II
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| 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
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| What can cause renal stones? | hypercalciuria, calcium stones
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| What is another name for renal calculus? | stones (kidney stones)
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| What is the term given to dilation of kidney? | hydronephrosis
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| Why are ACEI drugs helpful, especially in patients with diabetes? | helps efferent arterioles relax and open
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| How would renal damage or failure lead to hypertension? | HTN is an early manifestation of chronic kidney disease and its cause is multifactorial
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| What is the cause of pre-renal failure? | decreased blood flow
ie.shock, CHF, burns, third spacing, MI
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| 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)
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| What is the cause of post-renal failure? | obstruction to urine output
most occur bilaterally; ureteral obstruction, bladder outlet obstruction
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| 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
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| 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
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| 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
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| What are the s/s of renal failure? | hyperkalemia, proteinuria, loss of albumin, decreased creatinine, calcium levels decrease/phosphorus levels increase
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| What are some pre-existing conditions that increase the risk of renal failure/impairment? | atherosclerosis, HTN, DM, HF, chronic liver failure, advanced age
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| What is the most common cause of chronic renal failure? | diabetes mellitus
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| What are the 3 areas of the kidneys? | pelvis, medulla (inner), cortex (outer)
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| What does the cortex contain? | glomeruli, convoluted tubules of nephron and blood vessels
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| What does the medulla contain? | renal pyramids, a lobe of the kidney
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| 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)
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| What is the function unit of the kidney and what is its job? | nephron; filtration, reabsorption and excretion
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| Where is the basement membrane and bowman's capsule found? | glomerulus
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| 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
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| Describe the outer cortex of the kidney. | contains the glomerulus, blood vessels, and convoluted tubules
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| Describe the inner medulla of the kidney. | contains the renal pyramids
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| True or false, the loop of henle plays an important role in controlling the concentration of urine. | true
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| When there is increased sympathetic nervous activity, what happens to the kidney? | constriction of afferent and efferent arterioles, causing a decrease in blood flow
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| What hormone regulates the ability of the kidneys to concentrate urine? | ADH (anti-diuretic hormone)
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| ADH, aka vasopressin, does what? | acts at the level of the collecting tubule to increase water absorption
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| 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
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| How do the kidneys regulate body pH? | by conserving base bicarbonate and eliminating hydrogen ions (H+)
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| 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
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| What s/s do you see in acute nephritic syndrome? | sudden onset of hematuria, proteinuria, diminished GFR, oliguria and signs of impaired renal function
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