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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
Q

hormones acting on kidneys

A

antidiuretic hormone
aldosterone
natriuretic peptides

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26
Q

antidiuretic hormone

A

from posterior pituitary gland and acts on kidneys to increase reabsorption of free water

27
Q

aldosterone

A

rom adrenal cortes, acts on kidneys to increase reabsorption of Na and H2O

28
Q

natriuretic peptides

A

(ANP and BNP)
from myocardium
releases in responses to increased blood volume and inhibits the RAA system

29
Q

BUN test

A

waste product of cell metabolism
NL-10-20
must infuse continuously too much time

30
Q

creatinine test

A

need only one blood sample
NL- .7-1.5/100 ml
more accurate than BUN
24 hour creatinine clearance test also done

31
Q

increased H+

A

metabolic acidosis (decreased pH)

32
Q

Azotemia

A

rapid decline (days-weeks) in GFR causes retention of metabolic waste

33
Q

oliguria

A

output less than 400ml/day

34
Q

acute kidney injury (acute renal failure)

A

sudden kidney failure of sudden loss of the kidneys to remove waste products and concentrate urine

35
Q

renal insufficiency

A

decline in renal function to about 25% of normal
(starting to fail)
(can be reversed)

36
Q

Etiologies of acute kidney failure

A
  1. prerenal (30-80%)
  2. intrarenal (10-40%)
  3. postrenal (5-15%)
37
Q

prerenal

A

befor kidney- renal artery, afferent arteriole (blood pressure or flow problems)

Ischemia- renal failure

38
Q

causes of prerenal

A

loss of blood or water= decreased BF to renal arteries

39
Q

intrarenal

A

intrinsic (inside kidney)

40
Q

causes of intrarenal

A
  1. tubular disease: necrosis or HTN
  2. vascular disease: occlusion
  3. glomerular disease: glomerulon ephritis
    toxins
    meds
    trauma
41
Q

post renal

A

below the kidney
obstruction of outflow
uti-> back flow-> renal failure

42
Q

causes of post renal

A

crystals
any obstruction
paralysis of tubes

43
Q

clinical presentation of ARF

A

often asymptomatic:

  1. increases blood urea nitrogen and serum creatine
  2. 1st olgiuria for 10-14 days
  3. over 3 l/day
44
Q

clinical mani of ARF

A

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
Q

Chronic Kidney Injury(CRF)

A

kidney is no longer able to maintain the homeostasis of body

46
Q

stage 1 CRF

A

end stage- chronic/peristent

47
Q

stage 2 CRF

A

uremic system clinical s/s appear

48
Q

eitologies of CRF

A
  • acute kidney disease that is unresolved
  • slow and insidious over time
    1. diabetic nephropathy
    2. glomerulonephritis
    3. long term HTN
49
Q

kidney mani in ESRD

A

kidneys atrophy and scar tissue forms
10% of normal function remains
uremia symptoms prevalant

50
Q

uremia symptoms

A

both seen in acute and chronic RF:
increase in urea and creatinine
symptoms seen in all areas of body

51
Q

musculoskeletal uremia symptom

A

(renal osteodystrophy)

bone mineralization deficiency due to hyperphosphate and hypocalcemia

52
Q

cardiovascular uremia symptoms

A

fluid overload, CHF, HTN

53
Q

hematologic uremia symptoms

A

anemia (decreased erythropoietin)

54
Q

GI uremia symptoms

A

urea=irritating=N/V and bleeding

55
Q

dermatologic uremia symptoms

A

related to increased urea products:

-dryness, itching, yellow gry skin, pale beds, uremic frost

56
Q

reproductive uremia symptoms

A

infertility, amenorrhea, impotence

57
Q

respiratory uremia symptoms

A

lung congestion due to edema

58
Q

neurologic uremia symptoms

A

fatigue

peripheral neuro irritibility

59
Q

psychological uremia symptoms

A

depression

insomina

60
Q

hyponatremia

A

due to fluid overload=dilution of na

61
Q

hypocalcemia

A

due to Vitamin D issues

62
Q

hyperphosphatemia

A

cannot excrete excess

63
Q

hyperkalemia

A

cannot excrete excess

64
Q

decreased hemoglobin and hematocrit

A

due to no erythropoietin

Patho II (23 decks)

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