Duke PA Kidney Disease/ Kidney Function
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| stimulation of the renal sympathetic nerves stimulates the release of ___ thereby increasing angiotensin and alsosterone production | renin
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| normaly ___ raises GFR | pregnancy
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| GFR for men is usually ___mL/min | 120
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| GFR for women is usually ___mL/min | 100
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| the ____ reclaims at least 60% of the filtered load of Na+, Cl-, water, urea, K+ and fully 90% of the filtered HC03- | proximal tubule
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| in the ___ organic acids such as uric acid and drugs such as penicillin are secreted | straight portion of the proximal tubule
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| a significant portion of Ca+ reabsorption occurs within the | loop of Henle
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| increased luminal acids and decreased Cl- concentration increase ___ secretion | K+
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| increased contration of K+ in the plasma increases K+ secretion directly and by provoking ___ secretion | aldosterone
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| Distal K+ secretion is decreased by | metabolic acidosis
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| distal K+ secretion is increased by | metabolic alkalosis
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| When ___ is present water passes across the collecting duct tubule wall readily | ADH
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| ___ impair distal water reabsorption through several mechanisms | prostaglandins
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| ____, by blocking prostaglandins, may impair renal free water excretion | nonsteroidal anti-inflammatory drugs
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| normal daily GFR ___ L | 180
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| essential hypertension may represent a primary defect in ___ excretion by the kidneys | Na+
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| overproduction of ___ causes sever hypertension | renin
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| decreased insulin catabolism by the kidneys in patients with diabetes and renal failure may lead to | hypoglycemic episodes
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| the kidney is a major site of ___ production | erythropoietin
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| ___ production increases in states of decreased tissue oxygen delivery | erythropoietin
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| a potent vasoconstrictor that is a stimulus to aldosterone secretion | angiotensin II
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| promotes the formation of angiotensin II | renin
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| stimulates renal Na+ absorption | aldosterone
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| stimulates renal K+ and H+ excretion | aldosterone
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| during prolonged starvation the kidney can contribute up to __% of plasma glucose | 40
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| certain drugs such as cimetidine, trimethoprim, triamterene, and amiloride may interfere with ___ and cause false elevation in the blood | creatinine secretion
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| is often used in conjunction with the serum creatinine level as a measure of kidney function | BUN (Blood Urea Nitrogen)
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| The major end product of protein metabolism | urea
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| the usual ratio of BUN:creatinine is __:1 | 10
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| a significant amount of ___ is reabsorbed during volume depletion states | urea
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| ___ is less dependant on volume status than urea | serum creatinine concentration
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| may be more reliable than creatinine in determining GFR | cystatin C
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| failure to acidify urine in the presence of systemic acidosis suggests | distal renal tubular acidosis
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| a normal individual excretes less than ___ mg/day of protein | 150
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| persistant proteinuria almost always idicates | renal disease
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| defined as the excretion of 30-300 mg/24 hr of albumin | microalbuminuria
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| for individuals with diabetes mellitus measuring ____ may help early identification of underlying kidney damage | microalbuminuria
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| is associated with the progression of renal disease and with higher cardiovascular morbidity and mortality in patients with diabetes mellitus and hypertension | microalbuminuria
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| blood detected by dipstick that cannot be accounted for by RBC's in the urine sediment is the result of either myoglobin or hemoglobin often associated with | rhabdomyolysis
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| defined as more than 2 RBC's per high powered feild | mircroscopic hematuria
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| prototypical cause of acute nephritic syndrome | acute poststreptococcal glomerulonephritis
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| characterized by increased glomerular permeability in excess of 3.5g/day/1.73m(2)body surface area | nephrotic syndrome
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| characterized by the relatively abrupt onset of kidney dysfunction accompanied by the presence of red blood cell casts and dysmorphic erythrocytes in the urine sediment, as well as varying degrees of proeitnuria | acute nephritic syndrome
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| red blood cell casts associated with | glomerulonephritis
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| red blood cell casts associated with | vasculitis
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| WBC casts associated with | interstitial nephritis
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| WBC casts associated with | pyelonephritis
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| Epithelial cell casts associated with | acute tubular necrosis
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| Epithelial cell casts associated with | interstitial nephritis
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| Epithelial cell casts associated with | glomerulonephritis
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| Granular casts associated with | renal parynchymal disease
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| waxy, broad casts associated with | advanced renal failure
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| hyaline casts associated with | normal findings in concentrated urine
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| fatty casts associated with | heavy proteinuria
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| calcium phosphate crystals are associated with | alkaline urine
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| calcium oxalate crystals can be associated with | ethylene glycol poisoning
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| squamous epithelial cells are associated with | contamination
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| patients who have had more than 50% loss in kidney function over weeks to months | rapidly progressive renal failure
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| abrupt decline in renal function over several days | acute renal failure
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| decline in renal function over months to years | chronic renal failure
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| decrease in renal blood flow | prerenal azotemia
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| intrinsic parenchymal disease | intrarenal azotemia
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| obstruction to urine flow | postrenal azotemia
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| condition characterized by abnormal levels of nitrogen-containing compounds, such as urea, creatinine, various body waste compounds, and other nitrogen-rich compounds in the blood. It is largely related to insufficient filtering of blood by the kidneys | azotmia
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| in a patient with advanced renal failure, the presence of bilaterally small kidneys typically less than 8cm implies a | chronic irreversible process
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| difference in kidney size by more than 2 cm may suggest | ischemic damage such as renovascular disease
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| disadvantage of IVP is the requirment of ____ which may induce nephrotoxicity | radiocontrast
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| Kidney is key in making | 1,25 vit D
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| the leakage of protein across the glomerular capillary loop | nephrotic syndrome
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| your kidneys process __L of filtrate per hour, most of which is reabsorbed | 6
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| when the kidney is ischemic the ____ cells take the biggest hit b/c of their high oxygen demand | convoluted tubular cells
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| these cells are responsible for reabsorbing water and other necessary ions | convoluted tubular cells
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| increases with steroid treatment | BUN
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| blood urea nitrogen | BUN
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| generated in proportion to muscle mass | Creatinine
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| lab abnormality of elevated BUN or creatinine | azotemia
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| a syndrome of "autointoxication" that occurs with a GFR of 5-10% normal | uremia
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| Produced by all nucleated cells at a constant rate, Filtered but not reabsorbed or secreted, Not affected by muscle mass, age, gender, Blood level proportional to GFR, expensive | cystatin C
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| filtered, not reabsorbed, secreted: may over estimate GFR | creatinine
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| filtered, reabsorbed, not secreted: may underestimate GFR | urea
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| estimating creatinine clearance without a timed urine collection. This formula uses age, plasma creatinine, and weight | Cockroft-Gault formula
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| most urinary excreted protein is | Tamm Horsfall protein
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| normal albumin/creatinine ratio <__mg/gram Cr | 30
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| microalbumiuria albumin/Cr ratio ___ mg/gram Cr | 30-300
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| dipstick positive albumin/Cr ratio >__ mg/gram Cr | 300
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| nephrotic albumin/Cr ratio >__ mg/gram Cr | 3000
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| regulation of blood volume is the same as regulation of | blood pressure
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| if blood is too dilute the brain will | swell and herniate
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| if the blood is too concentrated the brain will | shrink and pull away from the skull
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| high ADH will lead to | concentrated urine
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| low ADH, or the inability to respond to ADH will lead to | dilute urine
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| high ADH will lead to | reabsorption of water from convoluted tubules
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| low ADH, or the inability to respond to ADH will lead to | decreased reabsorption of water from convoluted tubules
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| body water volume __L intracellular | 25
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| body water volume __L intravascular | 6
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| body water volume __L extracellular | 17
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| sensors for tonicity | osmoreceptors
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| sesnors for volume | baroreceptors
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| sense stretch | baroreceptors
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| effectors for tonicity | ADH,thirst
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| effectors for volume | renin/angiotensin, sympathetic NS, natriuretic peptides, ADH
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| management of patients with low GFR and volume overload | loop diuretic, low sodium diet
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| management of patients with low GFR and hyperkalemia | Low potassium diet, Bicarbonate, Kayexalate
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| Management of Patients with Low GFR and hyperparathyroidism | Phosphate binder, Calcium supplement, 1,25-vitamin D replacement
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| makes the patient lose potassium in the stool | kayexalate
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| promotes calcium reabsorption from the gut | 1,25-vitamin D
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| makes the patient lose too much calcium from bone | hyperparathyroidism
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| good bedside methods of determining volume status | turgor, neck veins, orthostatics
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| most common drug allergy | proton pump inhibitors
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| third most common drug allergy | NSAIDs
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| second most common drug allergy | antibiotics
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