B4-042 Renal Failure due to Hypertension

Question 1

in young patients, HTN is usually due to

Answer 1

high cardiac output

Question 2

in adult patients, HTN is usually due to

Answer 2

increased TPR

Question 3

• no obvious underlying cause
• diagnosis of exclusion
• 90-95% of hypertension

Answer 3

primary HTN

Question 4

damage of the kidney due to chronic renal HTN

Answer 4

hypertensive kidney disease

Question 5

GFR <60 mL/min/m2

Answer 5

chronic kidney disease

Question 6

two main causes of CKD

Answer 6

• diabetes
• HTN

Question 7

signs of CKD

6

Answer 7

• HTN
• peripheral edema
• SOB
• chest pain
• decreased GFR
• increased creatinine/BUN

Question 8

dictate filtration in capillary beds

Answer 8

starling forces

Question 9

hydrostatic pressure > oncotic pressure

Answer 9

filtration

Question 10

in the beginning, HTN causes […] filtration

Answer 10

increased

tapers over time due to damage

Question 11

in the beginning of HTN, the increased intraglomerular pressure will result in […] GFR

Answer 11

increased or maintained

Question 12

over time of HTN, vessel damage will lead to […] GFR

Answer 12

decreased

Question 13

decreased perfusion results in

2

Answer 13

1. glomerular damage (podocyte effacement, detachment)
2. microalbuminuria/proteinuria

Question 14

damage of […] allows passage of proteins into urine

Answer 14

glomerular membrane

Question 15

damage to the glomerulus causes proliferation of mesangial cells. proliferation of mesangial cells causes

2

Answer 15

1. decreased filtration (due to capillary compresion)
2. increased renin production

Question 16

angiotensin 2 causes

2

Answer 16

• vasoconstriction
• Na+ retention

Question 17

low perfusion of the kidney causes increased sympathetic nerve activity resulting in

Answer 17

vasoconstriction

Question 18

as GFR decreases, the amount of plasma creatinine

Answer 18

increases

Question 19

BUN/Cr> 15 indicates

Answer 19

glomeruli more affected than tubules

urea retained

Question 20

BUN/Cr<15 indicates

Answer 20

tubules more affected

decreased urea reabsorption

Question 21

decreased GFR causes […] retention, leading to volume overload

Answer 21

sodium

edema, HTN

Question 22

treatment of CKD

Answer 22

• treat HTN
• sodium restriction
• diuretics

Question 23

first manifestation of renal hypertensive disease

Answer 23

microalbuminuria

Question 24

ACE inhibitors block the conversion of

Answer 24

angiotensin 1 to angiotensin 2

Question 25

which would you expect to be reduced in the plasma of a patient on an ACE?

Answer 25

angiotensin 2

Question 26

water retention and tissue edema is caused by

Answer 26

sodium retention

Question 27

provides best assessment of kidney function

Answer 27

creatinine in plasma

Question 28

renal insufficiency is commonly accompanied by

Answer 28

anemia

Question 29

the kidney produces […], important for RBC production

Answer 29

EPO

Question 30

renal insufficiency causes the rention of […] in plasma

2

Answer 30

urea
creatinine

Question 31

plasma potassium […] in renal insufficiency

Answer 31

increases

Question 32

renal insufficiency causes anemia due to

Answer 32

decreased EPO production

Question 33

the kidney participates in the activation of vitamin D to

Answer 33

calcitriol

Question 34

calcitriol is vital for maintaining

Answer 34

bone density

Question 35

continuous high pressure results in the […] of the renal arteriole wall

Answer 35

hyalinization