Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

A1 > Kidney APEX > Flashcards

Kidney APEX Flashcards

1
Q

Body fluid compartments

A

ECF-14L (vascular 3L, interstitial 11L)
ICF- 24L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What compartments are in the cortex of the kidney?

A

Glomerulus/ bowmans capsule
PCT
DCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What compartments are in the medulla

A

Loop of Henle (ascending and descending)
Collecting duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The kidney produces ___

A

Renin (JG cells)
Calcitrol (active vitamin D3)
EPO stimulates stem cells in the bone marrow
Prostaglandins control blood flow
Glucose from amino acids (gluconeogensis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The kidneys receive _____% of cardiac output, ____ L/min

A

25
1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Renal blood flow formula

A

RBF = (MAP-Renal venous pressure)/ Renal vascular resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Blood flow thru the kidney

A

Renal artery
Afferent arterioles
Glomerular capillary bed
Efferent arterioles
Peritubular capillary bed
Renal segmental vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

At what map mmHg can RBF autoregulate?

A

50-180

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Renal autoregulation is carried out by what processes?

A

Myogenic mechanism- constricts or dilates afferent arterioles
Tubuloglomerular feedback/ JG apparatus-
PGs, ANP, SNS, RAAS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What states can decrease RBF?

A

Sepsis
Surgical stress
Ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

After 50 years old, RBF decreases by _____

A

1% per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What increases renin release?

A

PEEP reduces renal blood flow
Beta 1 stimulation from circulating or exogenous catecholamines
Hemorrhage
CGF
Liver failure w ascites
Sepsis
Diuresis
Decreased sodium and chloride delivery to the DCT (Tubuloglomerular feedback
Hypovolemia
Hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

BP is regulated by what 3 systems?

A

SNS
RAAS
Vasopressin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Beta 1 ____ renin

A

STIMULATES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Plasma osmolarity formula

A

(2Na) + (glu/18) + (BUN/2.8)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the normal plasma osmolarity?

A

280-290

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What pathways promote renal vasodilation?

A

PGs
Natriuretic peptide
Dopamine receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

D1 vs D2

A

D1- vasodilation, increased RBF
D2- decreases norepi release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How can NSAIDs affect RBF?

A

Inhibit PGs- prevent vasodilation- decrease RBF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The plasma is slightly ____ charged

A

positively because it has more cations such as sodium and potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What term refers to the pressure that prevents osmosis?

A

Osmotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

If an isotonic solution is added to ECF, the effect will be ____

A

An increase in ECF only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

A rapid correction in ______ can cause permanent brain damage

A

Hyponatremia from 3% hypertonic saline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Intracellular edema can lead to ____

A

Lack of nutrients to the cells
Depression of metabolic function
Reduced blood flow, oxygen, and nutrients
Inflammation increases cell permeability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What can cause increased capillary pressure?

A

1- increased capillary pressure (Kidney retention of salt and water, high venous pressure, low arteriolar pressure)
2- Decreased plasma proteins (nephrotic syndrome, wounds, liver disease)
3- Increased cap permeability (toxins, immune reactions, infections, burns)
4- Lymph blockage (cancer, surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

In heart failure, blood flow to the kidneys is _____, which stimulates _____, causing _______

A

Decreased
Renin
AT2 & aldosterone which will cause additional salt and water retention by the kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What 3 factors prevent edema?

A

Low interstitial compliance (-3mmHg)
Drainage (lymphatic) (7mmHg)
Wash down of IF proteins as lymph is washed away (7mHg)
Thus, capillary pressure could rise to 17 (double the normal value) before edema would occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Plasma filtration occurs in the ____

A

glomerulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

The kidneys receive ____ % of CO

A

20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the two types of nephrons?

A

Cortical- short loops of henle
Juxtamedullary- Long loops of henle, concentrate urine, higher GFR, larger glomeruli

30
Q

How fast do we lose nephrons?

A

10% every 10 years after 40 (apex says 50)

31
Q

Each nephron contains what?

A

A glomerulus
A renal tubule- where filtered fluid become urine

32
Q

The bowmans capsule and glomerulus form the ___

A

Renal corpuscle- where GFR begins

33
Q

____ % of RBF is filtered by the glomerulus, the remaining ___% is delivered to the _____

A

20%
80% goes to the peritubular capillaries

34
Q

The normal GFR is ____

A

125ml/min

35
Q

Where does most sodium get reabsorbed?

A

PCT- 65%

36
Q

Reabsorption of what requires ATP?

A

Electrolytes
NOT water- water occurs via osmosis

37
Q

What is the primary function of the Loop of Henle?

A

Forming dilute or concentrated urine- separating the handling of sodium and water

38
Q

What are the vasa recta?

A

Peritubular capillaries that run parallel to the Loop of Henle

39
Q

Which part of the Loop of Henle is permeabile to water?

A

Descending IS permeable
Ascending is NOT permeable

40
Q

Target location of Loops, osmotics, CA inhibitors, and Thiazides, K sparing

A

Loop diuretics- loop of henle
CA Inhibitors- PCT
Osmotics- PCT
Thiazides- DCT
K sparing- Collecting ducts

41
Q

Spironalactone MOA

A

Aldosterone antagonist
Blocks K secretion and Na reabsorption

42
Q

Side effects of K sparing diuretics

A

Hyperkalemia (especially if taking with nsaids, BBs, ACEis)
Gyno

43
Q

Side effects of loop diuretics

A

Hypokalemic hypochloremic met alkalosis
Hypokalemia can increase risk of digoxin, and potentiate NMBs
Ototoxicity

44
Q

Side effects of Osmotics

A

If BBB is disrupted, mannitol will enter brain and cause edema

45
Q

Side effects of CA inhibitors

A

Met acidosis (reabsoprtion of H ions while excretion of CA and HCO3)
May exacerbate COPD depression from hypercarbia because of the loss of bicarb buffer

46
Q

What is the best test of tubular function?

A

Urine osmolality
Fractional excretion of sodium

47
Q

What are to best tests of GFR?

A

BUN (although this is a better indicator of uremic symptoms from the metabolism of protein)
Creatinine clearance

48
Q

Normal urine sodium

A

130-260mEq/day

49
Q

Urine specific gravity

A

1.003-1.030

50
Q

What could be some causes of low BUN (<8)

A

Overhydration
Decrease urea production (malnutrition, liver disease)

51
Q

What could cause high BUN (>20)

A

Dehydration
Increased protein input (high protein diet, GI bleed, hematoma breakdown)
Catabolism (trauma, sepsis)
Decreased GFR

52
Q

Creatinine is produced by ___, and is directly proportional to ___

A

skeletal muscle, it is a breakdown of creatine
muscle mass (lower in women and elderly)

53
Q

A 100% increase in creatinine indicates a ___ reduction in GFR, why so?

A

50% reduction
Creatinine only undergoes renal filtration, no reabsorption (half the process)

54
Q

BUN undergoes ____, Creatinine undergoes ___

A

filtration and reabsoprtion
filtration only

55
Q

The normal BUN: Cr ratio is ___, and is useful for evaluating ___

A

10:1
Hydration status

56
Q

____ is the4 most useful tool for GFR

A

creatinine clearance

57
Q

GFR formula

A

[(140-age) x BW] / (72 x serum Cr)
x .85 for women to account for smaller muscle mass

58
Q

Failing kidney __ sodium

A

waste

59
Q

Pre renal vs ATN urinary sodium

A

Pre renal- urinary sodium <20,
ATN- urinary sodium >20,

60
Q

What are intrinsic causes of ATN?

A

Ischemia
Nephrotoxic drugs- nsaids, abx, contrast dye

61
Q

____ maintain GFR and UOP better than levo or phenyl

A

Vaso!
d/t constriction of the EFFERENT arterole

62
Q

What is the most important pump of the ascending LOH?

A

Na K 2 Cl
Site of acrtion for Loop Diuretics

63
Q

ADH and aldosterone are counteracted by ____

A

ANP in the collecting ducts

64
Q

What are the stages of CKD

A

Measured by GFR
1- normal >90ml/min
2- 60-89
3- 30-59
4- 15-29
5- Kidney failure, requires dialysis <15

65
Q

Most common cause CKD is ___, and the second most common cause is ___

A

Diabetes mellitus
Hypertension

66
Q

What are the symptoms of uremic syndrome?

A

Anemia
Fatigue
N/V
Anorexia
Coagulopathy

67
Q

Decreased EPO leads to ____ ____ anemia

A

Normochromic normocytic

68
Q

Acidosis shifts the oxyhemoglobin dissociation curve to the ___

A

right

69
Q

Dialysis is indicated when K exceeds ___

A

6 mEq/L

70
Q

Treatments to reduce serum K are ____

A

Glucose 50g + insulin 10 units
Hyperventilation- for every 10mmHg decrease in paco2, K will decrese by 0.5
HCO3 100mEq
Calcium chloride 1g

71
Q

Most common cause of death in dialysis/ chronic renal failure patients

A

CAD
Then Infection d/t impaired WBC, low protein diet

72
Q

What is the most accurate predictor of bleeding risk in kidney patients?

A

Bleeding time

73
Q
A

A1 (124 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions