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CPR Exam 3 > Anatomy, Clinical Manifestations of Renal Disease, Laboratory Tests > Flashcards

Anatomy, Clinical Manifestations of Renal Disease, Laboratory Tests Flashcards

1
Q

What is a part of the juxtaglomerular apparatus?

A
  • Macula densa region of the thick ascending limb
  • Extraglomerular mesangial cells
  • Renin/angiotensin II-producing granular cells of the afferent arterioles
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2
Q

What is a part of the filtration barrier?

A
  • Capillary endothelium
  • Basement membrane
  • Foot processes of podocytes
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3
Q

What affects the filtration barrier?

A
  • Size and charge
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4
Q

What is the endothelium permeable to?

A
  • Water
  • Small solutes
  • Smal proteins
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5
Q

What is not permeable to the endothelium?

A
  • Large proteins
  • RBCs
  • WBCs
  • Platelets
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6
Q

What do the endothelial cells do?

A
  • Negatively express glycoproteins which minimize filtration of negatively charged proteins like albumin
  • Synthesize vasoactive substances that are important in controlling renal plasma flow
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7
Q

Where are glomeruli seen?

A
  • Renal cortex (seen on biopsy)
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8
Q

What kind of waste products does the kidney get rid of?

A
  • Body’s concentration of water
  • Salt
  • Calcium
  • Phosphorus
  • Other anions and cations
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9
Q

How does the kidney act as an endocrine organ?

A
  • Secreting hormones like erythropoietin, renin, and prostaglandins, and regulating vitamin D metabolism
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10
Q

What are some warning signs of kidney disease?

A
  1. Creatinine and BUN blood test outside the normal range
  2. Glomerular filtration rate less than 60
  3. Blood and/or protein in the urine
  4. High blood pressure
  5. More frequent urination, particularly at night; difficult or painful urinartion
  6. Puffiness around eyes, swelling of hands and feet
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11
Q

How are the fluids and electrolytes affected in acute or chronic kidney dysfunction?

A
  • Dehydration
  • Edema
  • Hyperkalemia
  • Metabolic acidosis
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12
Q

How is the calcium phosphate and bone affected in acute or chronic kidney dysfunction?

A
  • Hyperphosphatemia
  • Hypocalcemia
  • Secondary hyperparathyroidism
  • Renal osteodystrophy
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13
Q

What hematological signs are seen in acute/chronic kidney dysfunction?

A
  • Anemia

- Bleeding diathesis

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14
Q

What cardiopulmonary signs are seen in acute/chronic kidney dysfunction?

A
  • HTN
  • CHF
  • Cardiomyopathy
  • Pulmonary edema
  • Uremic pericarditis
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15
Q

What GI signs are seen in acute/chronic kidney dysfunction?

A
  • N/V
  • Bleeding
  • Esophagitis/gastritis/colitis
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16
Q

What neuromuscular signs are seen in acute/chronic kidney dysfunction?

A
  • Myopathy
  • Peripheral neuropathy
  • Encephalopathy
17
Q

What dermatologic signs are seen in acute/chronic kidney dysfunction?

A
  • Sallow color
  • Pruritus
  • Dermatitis
18
Q

What is azotemia?

A
  • Biochemical abnormality that refers to an elevation of BUN and creatinine levels
  • Related largely to a decreased GFR
19
Q

What causes uremia?

A
  • When azotemia leads to clinical signs and symptoms associated with biochemical abnormalities
20
Q

What are the signs of uremia?

A
  • Cognitive dysfunction
  • Fatigue
  • SOB
  • Loss of appetite
  • Muscle cramps
  • N/V
  • Itching
  • Unexplained weight loss
  • Metallic taste
21
Q

What is the characteristic sign of uremia?

A
  • Uremic frost –> striking white cutaneous finding
22
Q

What is the ideal ratio of BUN to creatinine?

A
  • Between 10/1 and 20/1
23
Q

What are the renal causes of azotemia?

A
  1. Glomerulonephritis
  2. Pyelonephritis
  3. Diabetes mellitus
  4. Nephrotoxic drugs
  5. Renal failure
  6. Anabolic steroid use
24
Q

What are the postrenal causes of azotemia?

A
  • Urinary tract obstruction
    1. Stones/neoplasm
    2. Bladder/urethral abnormality
    3. Bladder outlet obstruction
25
Q

What is GFR?

A
  • Test used to check how well the kidneys are working

- Estimates how much blood passes through the glomeruli each minute

26
Q

What is GFR estimated from?

A
  • From serum creatinine level and some or all of the following:
    1. Gender
    2. Age
    3. Weight
    4. Race
27
Q

What is a normal GFR?

A
  • 90mL/min
28
Q

What is nephritis sydrome?

A
  • Acute onset of either grossly visible hematuria (red blood cells in urine) OR
  • Microscopic hematuria with dysmorphic red cells and red cell casts on UA, diminished GFR, mild to moderate proteinuria, and HTN
29
Q

What is nephrotic syndrome?

A
  • Heavy proteinuria (more than 3.5g/day)
  • Hypoalbuminemia
  • Severe edema
  • Hyperlipidemia
  • Lipiduria
30
Q

What is acute kidney injury characterized by?

A
  • Rapid decline in GFR with concurrent dysfunction of fluid and electrolyte balance
  • Retention of metabolic waste products normally excreted by the kidney
  • Manifested by oliguria or anuria
31
Q

What is chronic kidney disease defined as?

A
  • Presence of a diminished GFR that is persistently less than 60 mL/min for at least 3 months, from any cause, and/or persistent albuminuria

CPR Exam 3 (16 decks)

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