Kidney Flashcards
1
Q
1-4. What hormones does kidney make
PREH(eim)
A
- prostaglandins
- Renin
- Epo
- hydroxylation of vit D
2
Q
(Pre-renal azotemia)
- caused by anything that does what?
A
- reduces blood flow to kidneys
(decreased perfusion pressure)
3
Q
(Pores)
- albumin is smaller than pore - why doesn’t it go through normally?
- What is the hallmark of pore damage?
A
- cause of negative charge of pore
- proteinuria
4
Q
(Tubule)
- What is the hallmark of tubule dysfunction?
A
- azotemia, electrolyte disturbance, glucosuria, proteinuria (to a much lesser extent), can’t conc urine
5
Q
- When you have an abnormal glomerular barrier, albumin leaks - but if the tubules are normal will have normal USG and no azotemia
- Proteinuria (albumin) - is an indicator of what?
A
- glomerular damage **IF NOT OTHER **sources of portein in urinary tract (LUT dz - more common)
6
Q
- GFR depends on renal plasma flow - affected by what?
- total GFR may decrease with what (if kidney completely normal)?
A
- blood vol, CO, #fx glomeruli, constriction/dilation of afferent/efferrent arterioles
- hypovolemia, cardiac dz, vasc disturbance
7
Q
(tubular function)
- ion exchange, water balance, mineral balance, glucose/protein reabsorption
- if failure will lose regulation of all this –> isothenuric, glucosuria (if less than <200), proteinuria (usually from glomerular dmg)
A
8
Q
memorize this chart
- how does Ca interfere?
- example of endocrine interference?
- What is medullay washout?
- With what condition does osmotic diuresis commonly occur?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/093/471/401/q_image_thumb.jpg?1659474287)
A
- closes aquaporin doors –> PU/PD
- corticosteroids –> PU/PD
- when you take urea and salt away –> no gradient –> water will stay where it is
- DM
9
Q
1-3. What are the three reasons Urine can’t be concentrated in renal failure? (KNOW THIS)
A
- dmg cells - less responsive to ADH
- medullary hypertonicity lost (tissue dmg/abnormal blood flow)
- high solute loads to remaining nephrons are overwhelming (can’t reabsorb all the solutes you need to reabsorb - usually solute)
10
Q
(Causes of poorly conc urine)
1-10. What are they?
quadruple H, Dirty Projectors, Matt Preheim, Ray Liotta
A
- hyperadrenocorticism: corticosteroid interfere with ADH action
- hypoadrenocorticism: loss of mineralcorticoid fx (aldosterone -> kidney retains sodium)
- hypercalcemia (malignancy): interefre w/ ADH
- hypokalemia (dec tubular responsiveness to ADH)
- diabetes (insipidus and mellitus): solute diuresis (gluc/keto)
- pyometra: bac interfere w/ ADH
- medullary washout (loss of conc gradient)
- post-obstructive
- renal failure
- liver failure (dec urea prod, ^H20 consumption)
11
Q
- What are the routing renal system tests?
A
- UA, serum biochem, urine protein/creatinine ratio, CBC
12
Q
(urine color)
- yellow/amber = ?
- red/brown = ?
- yellow-orange/green-brwon =
A
- normal
- RBC, hemoglobin, myoglobin
- bilirubin
13
Q
(Turbidity)
- normal is ?
- cloudiness due to what?
- why is horse urine normally turbid?
- cow urine normally turbid on standing from what?
A
- clear (can be a little cloudy)
- cells, bacteria, casts, mucus, lipid
- from mucus and CaCO3
- crystal formation
14
Q
(USG)
- measured how?
- effect of protein and glucose?
- don’t memo chart - just know that cat is the highest
- how do you confirm persistent isosthenuria?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/093/478/425/q_image_thumb.jpg?1659474292)
A
- refractometer
- minimally increase
- test throughout the day
15
Q
(do memo this)
- maximally conc - hardly ever see this
- adequately conc - implies what?
- innappropriate - for who?
- hypothenuria = ?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/093/478/641/q_image_thumb.jpg?1659474293)
A
- suff kindey fx
- azotemic/dehydrated patients
- below isosthenuria