Kidneys and Accessories Flashcards
functional unit of kidney
nephron
where is plasma filtered in the kidney
nephron
two parts of a nephron
vascular part
tubular part
only part of the nephron that dips down into the medulla
loop of henle
normal adult GFR
100ml/min
most reabsorption occurs where
in the proximal tubule (some in distal too)
what is the cause of Acute Tubular Necrosis (ATN)
burn of hemorrhagic injury leading to fluid loss
trauma of some sort
what happens in ATN
lots of fluid is being lost so the renal tubules constrict to conserve fluid which can cause the renal tubules to become ischemic
What is Rhabdomyolysis
the release of myoglobin with muscle injury. if this gets into the small vessels of the kidneys it can clog the kidneys and cause necrosis
what two things cause an increase in blood pressure with decreased renal blood flow
increase in peripheral vasoconstriction
increase in plasma volume
inflammation of the renal pelvis
Pyelonephritis
Cystitis is what
urinary bladder infection
Is cystitis seen more in males or females
females
flank pain is common with what
pyelonephritis
inflammation of the glomeruli
glomerulopnephrits
what can lead to glomerulonephritis
Strep throat
what type of immune reactions is acute glomerulonephritis
3
what happens in acute glomerulonephritis
antigen-antibody complex accumulates in the subpeipthelial space, so not good at filtering
does acute glomeruloneprhtis occur mostly in kids or adults
kids
what are glomerular crescents
proliferating cells in Bowman’s capsule that are filling Bowman’s space during rapdily progressigng glomerulonephritis
what does hyaline contain
fibrin
what type of glomerulonephritis does hyalinaization occur in
chronic
sx of acute glomerulonephritis
HTN Proteinuriia (protein in urine Hypoproteinmia (protein in blood is low) Edema Electrolyte imbalance (headaches, nausea, vomiting, muscle spasms, heart issues like dysrhythmias)
What is Tam-Horsfall Protein
24 hour trace protein. this is a normal finding
what accumulates around the glomeruli in bowman’s space with rapidly progressive glomerulonephritis
fibrin (this is fatal in 2 years due to lack of filtration)
What is Goodpasture’s syndrome
Immune reaction to Goodpastures antigen. This causes diffuse glomerular loss due to subepithelial immune complexes
what two things does Goodpasture’s syndrome affect
kidneys and lungs (can lead to filtration issues as well as repiratory distress)
true or false: Goodpasture’s Syndrome is a Rapidly Progressive Glomerulonephritis
true
uremic syndrome is the same thing as _____
Renal failure
is diffuse diabetic or nodular diabetic diabetic neuropahthy most common
diffuse
what type of respirations are seen with ESRD
Kussmauls to comepensate for the acidosis
when electrolytes pass from renal interstitial fluid to the tubules
secretion
when electrolytes pass from kidneys via the urine
excretion
where does filtration occur
Glomerular-Bowman’s Capsule Interface
where does Reabsorption occur
the tubules
is there high levels of Na or K with ESRD
K (low Na)
renal osteodystrophy is due to what
decreased vit d
why do bones break easier in people with kidney dz
bc the kidneys activate vit d which makes bones strong by absorbing Ca from the GI tract
retention of nitrogenous metabolic waste =
Azotemia
high BUN suggests what
renal failure
high urea, creatine, and uric acid may suggest what
renal failure
renal induced anemia results from what
lack of EPO (which is made by the kidneys and helps increase the rate of prodcution of mature RBCs)
what is uremic frost
caused by metabolic byproducts diffusing out into the skin
Options for prserving life in ESRD
Hemoialysis (in clinic)
Peritoneal Dialysis (at home)
Renal transplant
Is acute renal failure reversible
yes (recovery in 6-8 weeks)
causes of ARF
kidney stones
acute prostatic hypertrophy
Urinary bladder tumor
Nephrotoxin consumption (exposure to lead or mercury
Acute interstitial nephritis (allergic reaction to meds
ATN
Pigment release (myoglobin or hemoglobin release)
causes of CRF
chronic glomerulonephtris chronic hypertensive vascular dz collagen vascular dz (lupus) chronic pyelonephtritis polycystic kidney dz (heridiatry) renal tubule acidosis (RTA-- inability of renal tubules to process acid)...involves accumulation of acid in the body due to a failure of the kidneys to appropriately acidify the urine elevated blood uric acid hyperthyroidsism (calcium deposits in the kidneys) ....leads to kidney stones amyloidosis nephrotoxins Chronic obstuction (BPH or prostate cancer) neurogenic bladder renal cell carcionoma DM
Hydronephrosis is what
back pressure from the UB to the kidney
where does a renal cell carcionoma arise
proximal convoluted tubule
normal range for BUN
6-20 mg%
normal range for blood creanine
less than 1.5%mg
normal range for 24 hour urine blood volume
1200-1500ml
what looks like a cobra head
urterocele/pyelocele
what type of tumors are the UB are most common
transitional cell tumors
risk factor for UB cancer
smoking and airborne carcinogens
risk factors for uretral cancer
hx of bladder cancer
chronic urethral inflammation
being over 60
female
what is hypospadias
when the penile urethra does not close completely –young male babies
