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Patho II > exam 1: renal disorders > Flashcards

exam 1: renal disorders Flashcards

1
Q

renal cortex:

A

dense outer section, contains glomeruli, renal columns

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2
Q

renal medulla

A

middle section, contains pyramids

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3
Q

pyramids papillae

A

empty into calyces in sinus (inner section)

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4
Q

where do the renal pyramids unite

A

in renal pelvis then go into ureter

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5
Q

primary functions of kidneys

A
  1. balancing h2o and wastes
  2. excrete waste
  3. conserve nutrients
  4. regulate acid base
  5. secrete renin
  6. synthesis and secrete erythropoietin
  7. secrete D3
  8. formation of urine
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6
Q

renal arteries

A

branch off into smaller afferent arteries wich flow into glomerulus

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7
Q

efferent arterioles

A

peritubular caps surrounding nephron which aid in reabsorption and secretion and bring o2 to kidney cells

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8
Q

how many liters of blood flow per minute does the glomarulus get

A

1-2

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9
Q

glomerular filtration membrane has how many layers

A

3 layers and is selectively permeable

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10
Q

the glomerular filtration rate depends on

A
  1. functioning healthy membrane

2. adequate perfusion pressure (high cap hydrostatic pressure)

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11
Q

what is the GFR

A

120-140 ml/min

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12
Q

how much of the total filtrate is actually excreted

A

1% or 1500ml

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13
Q

what filters through the G

A

all components of blood EXCEPT

RBC’s and plasma proteins

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14
Q

hematuria

A

RBC in urine

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15
Q

proteinuria

A

proteins in urine

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16
Q

what are the 3 main processes of the nephrons

A
  1. filtration
  2. reabsorption
  3. secretion
    (4) . excretion
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17
Q

filtration

A

from blood into the glomerulus via osmosis and diffusion

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18
Q

What are the glomfiltrate

A 
primary water
Na
K
glucose
urea
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19
Q

reabsorption:

A

movement of substances out of the renal tubules back into the bloodstream
(h2o, glucose, Na and other ions)

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20
Q

secretion:

A

movement of substances from the blood stream into the distal and collecting tubules
(H+, K, NH3, drugs)

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21
Q

excretion:

A

out of the body via urine…. peeing

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22
Q

Renal Hormones

A

Vitamin D

erythropoietin

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23
Q

Vitamin D

A

comes from diet and sun but are inactive but are then activated by liver and kidney
need D to absorbe Ca and phosphate

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24
Q

erythropoietin

A

synthed in the kidneys

stimulates bone marrow to produce RBC

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25
hormones acting on kidneys
antidiuretic hormone aldosterone natriuretic peptides
26
antidiuretic hormone
from posterior pituitary gland and acts on kidneys to increase reabsorption of free water
27
aldosterone
rom adrenal cortes, acts on kidneys to increase reabsorption of Na and H2O
28
natriuretic peptides
(ANP and BNP) from myocardium releases in responses to increased blood volume and inhibits the RAA system
29
BUN test
waste product of cell metabolism NL-10-20 must infuse continuously too much time
30
creatinine test
need only one blood sample NL- .7-1.5/100 ml more accurate than BUN 24 hour creatinine clearance test also done
31
increased H+
metabolic acidosis (decreased pH)
32
Azotemia
rapid decline (days-weeks) in GFR causes retention of metabolic waste
33
oliguria
output less than 400ml/day
34
acute kidney injury (acute renal failure)
sudden kidney failure of sudden loss of the kidneys to remove waste products and concentrate urine
35
renal insufficiency
decline in renal function to about 25% of normal (starting to fail) (can be reversed)
36
Etiologies of acute kidney failure
1. prerenal (30-80%) 2. intrarenal (10-40%) 3. postrenal (5-15%)
37
prerenal
befor kidney- renal artery, afferent arteriole (blood pressure or flow problems) Ischemia- renal failure
38
causes of prerenal
loss of blood or water= decreased BF to renal arteries
39
intrarenal
intrinsic (inside kidney)
40
causes of intrarenal
1. tubular disease: necrosis or HTN 2. vascular disease: occlusion 3. glomerular disease: glomerulon ephritis toxins meds trauma
41
post renal
below the kidney obstruction of outflow uti-> back flow-> renal failure
42
causes of post renal
crystals any obstruction paralysis of tubes
43
clinical presentation of ARF
often asymptomatic: 1. increases blood urea nitrogen and serum creatine 2. 1st olgiuria for 10-14 days 3. over 3 l/day
44
clinical mani of ARF
R/T waste buildup: - anorexia - fatigue - mental changes - N/V - pruitis - Seizures if bun is high R/T fluid overload: - SOB - crackles in lungs - peripheral edema R/T encephalopathy - asterixix (flapping tremor) - Myoclonus (muscle jerk)
45
Chronic Kidney Injury(CRF)
kidney is no longer able to maintain the homeostasis of body
46
stage 1 CRF
end stage- chronic/peristent
47
stage 2 CRF
uremic system clinical s/s appear
48
eitologies of CRF
- acute kidney disease that is unresolved - slow and insidious over time 1. diabetic nephropathy 2. glomerulonephritis 3. long term HTN
49
kidney mani in ESRD
kidneys atrophy and scar tissue forms 10% of normal function remains uremia symptoms prevalant
50
uremia symptoms
both seen in acute and chronic RF: increase in urea and creatinine symptoms seen in all areas of body
51
musculoskeletal uremia symptom
(renal osteodystrophy) | bone mineralization deficiency due to hyperphosphate and hypocalcemia
52
cardiovascular uremia symptoms
fluid overload, CHF, HTN
53
hematologic uremia symptoms
anemia (decreased erythropoietin)
54
GI uremia symptoms
urea=irritating=N/V and bleeding
55
dermatologic uremia symptoms
related to increased urea products: | -dryness, itching, yellow gry skin, pale beds, uremic frost
56
reproductive uremia symptoms
infertility, amenorrhea, impotence
57
respiratory uremia symptoms
lung congestion due to edema
58
neurologic uremia symptoms
fatigue | peripheral neuro irritibility
59
psychological uremia symptoms
depression | insomina
60
hyponatremia
due to fluid overload=dilution of na
61
hypocalcemia
due to Vitamin D issues
62
hyperphosphatemia
cannot excrete excess
63
hyperkalemia
cannot excrete excess
64
decreased hemoglobin and hematocrit
due to no erythropoietin

Patho II (23 decks)

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