Brainscape's Knowledge GenomeTM

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


See full index

WGU Pathophysiology > Lesson 10 Renal System > Flashcards

Lesson 10 Renal System Flashcards

1
Q

what is the basic unit of the kidney? (a sequence of tubes that filters the blood of waste and conserves the fluid and electrolytes that the body needs)

A

nephron

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

What are all of the functions of the kidney?

A

filtration of blood (waste elimination)
control BP
regulate RBC production
breakdown drugs
Metabolize hormones
synthesize Vit D
manage electrolytes
conserve and excreting H2O
balance the pH of bloodstream
glucose homeostatis

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

What hormone acts at the distal tubule of the renal system to reabsorb more sodium and water into the bloodstream and secrete potassium into the tubule fluid?

A

aldosterone

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

How do the kidneys maintain the acid-base balance in the blood?

A

involves excretion or conservation of hydrogen ions [H+] and bicarbonate ions [HCO3−].

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

What are some of the waste products that the kidneys help eliminate?

A

urea, uric acid, creatinine, and drug metabolites.

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

The kidney has several unique secretory functions that are triggered by certain conditions in the body.
Hypoxia stimulates ____1_____secretion
Low blood volume stimulates ___2____secretion

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

The major mechanism whereby the kidneys influence systemic blood pressure and blood volume is by what system?

A

renin–angiotensin–aldosterone system (RAAS)

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

What does renin–angiotensin–aldosterone system (RAAS) contribute to/what does it cause at the kidneys?

A

sodium and water reabsorption into the bloodstream and potassium excretion at the renal tubules. (cells in kidney sense low sodium and, in response, secrete renin. Other triggers for renin secretion include decreased renal perfusion and increased sympathetic nervous system activity. The net effects of the RAAS activity are sodium and water reabsorption, potassium excretion, and arterial vasoconstriction.)

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

How are the kidneys involved with glucose homeostasis

A

renal tubules reabsorb glucose from the glomerular filtrate up to the renal threshold of a blood glucose level of 180 mg/dL. If the blood glucose level is greater than the renal threshold, the excess glucose is excreted in the urine. Additionally, in states of prolonged fasting or starvation, the kidneys can create glucose from amino acids in a process known as gluconeogenesis.

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

General term of kidney disfunction caused by decreased blood flow and perfusion to the kidney. affect GFR, Any condition that directly or indirectly decreases renal perfusion, occurs because of reduced cardiac output or severe hypovolemia (low blood volume)

A

Prerenal dysfunction

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

General term of kidney disfunction develops secondary to actual injuries to the kidney itself. most commonly caused by nephrotoxic medications, renal infections, or systemic illnesses that affect the kidney. Common examples include nephrotoxicity caused by NSAIDs and poststreptococcal glomerulonephritis (PSGN), Autoimmune diseases, untreated hypertension, and uncontrolled diabetes

A

Intrarenal dysfunction

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

General term of kidney disfunction related to obstruction of urine outflow from the kidneys. include kidney stones in the ureter, prostate gland enlargement, and bladder cancer. In postrenal kidney dysfunction, urine backs up within the ureter and into the kidney, which can lead to hydronephrosis, a fluid-filled, swollen kidney. Urine is toxic to the nephron cells, and urine stagnation increases the risk of infection.

A

Postrenal dysfunction

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

Ischemia and hypoxia can damage the renal tubules and result in what?

A

acute tubular necrosis (ATN),

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

What is the most common cause of acute tubular necrosis (ATN),

A

acute kidney injury AKI

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

Long-term DM and HTN often lead to what?

A

renal failure

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

What is a classic sign of a kidney disorder, particularly infection?

A

Costovertebral angle (CVA) tenderness

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

What should the urinary pH level be normally?

A

should be close to a neutral pH of 7, but it does vary from acidic to basic.

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

What does a positive urinalysis lab value of glucose indicate?

A

hyperglycemia, diabetes

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

What does a positive urinalysis lab value of ketones indicate?

A

starvation or diabetic ketoacidosis

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

What does a positive urinalysis lab value of proteins indicate?

A

Minimal: exercise or infection
Moderate: polycystic kidney disease (PKD), infection, heart failure, diabetic kidney disease
Marked: PKD, glomerulonephritis, diabetic kidney disease, nephrosis, lupus nephritis

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

What does a positive urinalysis lab value of blood indicate?

A

infection, kidney stone, or bladder cancer

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

What does a positive urinalysis lab value of bilirubin indicate?

A

hemolysis or liver disease

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

What does a positive urinalysis lab value of urobilinogen indicate?

A

if high; liver disease

24
Q

What does a positive urinalysis lab value of nitrite indicate?

A

UTI

25
Q

What does a positive urinalysis lab value of leukocyte esterase indicate?

A

UTI

26
Q

Why should the clinician not rely on blood urea nitrogen (BUN) alone as an indicator of renal disfunction?

A

Because of the possible elevation of BUN with nonrenal conditions such as dehydration

27
Q

This is muscle breakdown product that is filtered almost completely at the glomerulus. The normal range of it is approximately 0.5 to 1.5 mg/dL. After being filtered out of the bloodstream, it is not reabsorbed by the nephron tubules.

A

Creatinine

28
Q

Why is serum creatinine a reliable indicator of kidney function?

A

Accumulation of serum creatinine indicates decreased filtering of creatinine at the glomerulus.

29
Q

Why should IV contrast-enhanced imaging studies be avoided in patients with renal impairment?

A

radiopaque dye can cause renal failure. Dehydration markedly increases this risk.

30
Q

This has classic presentation of sudden edema, hematuria, proteinuria, and HTN. The onset of clinical manifestations occurs approximately 7 to 21 days following a streptococcal infection. This is consistent with the time frame needed for antibody formation.

A

Acute glomerulonephritis

31
Q

This is the formation of stones, also called calculi, in the kidney.

A

Nephrolithiasis: kidney stones

32
Q

What increases susceptibility to kidney stone formation? (For this reason, people living in the south and southwest United States have higher incidences)

A

dehydration

33
Q

What are the metabolic risk factors of kidney stones?

A

hypercalcemia, hyperoxaluria, hyperuricemia, hyperparathyroidism, or gout.

34
Q

Struvite stones commonly cause _________ which can fill the entire renal pelvis

A

Staghorn calculi

35
Q

What are the treatment options for someone with kidney stones?

A

Drink 3 L of fluid and strain urine
lithotripsy
cystoscopic surgery and laser

36
Q

What kind of diet is recommended to someone prone to kidney stones?

A

Calcium phosphate, calcium carbonate, and magnesium phosphate stones develop in alkaline urine; when this occurs, the urine is kept acidic. (meat and cranberry juice)
Uric acid, cystine, and calcium oxalate stones precipitate in acidic urine; in this situation, the urine should be kept alkaline or less acidic than normal. (citrus fruits, legumes, and vegetables)

37
Q

This is an infection of the renal pelvis and interstitium. It can be either acute or chronic and is most often caused by bacteria that ascend from the lower urinary tract. (whenever there is obstructed outflow of urine, the stagnant urine acts as a medium for bacterial growth, which can ascend into the kidney)

A

Pyelonephritis

38
Q

How is acute pyelonephritis is usually treated?

A

antibiotic therapy; antibiotic selection depends on the specific microorganism identified by urine culture. Antipyretic medications and analgesics may be necessary. The patient is advised to drink large amounts of water (e.g., 3 L per day).

39
Q

This is a slower process where the patient’s blood is drawn out of the body and passed through a device to normalize solutes in blood. It is used for patients who are hemodynamically unstable and fluid overloaded. This continuous process takes smaller volumes of blood from the patient and filters it through a dialyzer over 24 hours.

A

Continuous renal replacement therapy (CRRT)

40
Q

This is a treatment during which the patient’s blood is drawn out of the body at a rate of 200 to 400 mL/minute and passed through a device called a dialyzer. Commonly, a patient has an arteriovenous fistula created in the arm that can facilitate this process. Blood is pumped into a dialyzer, which removes excess solutes and fluid from the blood.

A

Hemodialysis

41
Q

This is related to an abrupt insult to the kidney that causes a rapid decrease in renal filtration function. Because of this decline in function, nitrogenous waste products accumulate in the body. With appropriate interventions, normal renal function can return, usually within 2 weeks to 3 months of the initial precipitating event.

A

Acute Kidney Injury AKI

42
Q

Regardless of the cause of the acute kidney injury, what will AKI cause?

A

oliguria (low urine output) and fluid overload

43
Q

What happens within the body as a consequence of acute kidney injury?

A

Nitrogenous waste builds up in the blood, and signs and symptoms of uremia, such as encephalopathy, anemia, hyperkalemia, metabolic acidosis, thrombocytopenia, and neuromuscular irritability, occur. As urine output decreases, signs of fluid overload, such as edema of the face and extremities, occur. Pulmonary edema can develop, causing respiratory distress.

44
Q

This is an irreversible, progressive disease process. Gradual in onset, the disease may develop over months to years, with 90% to 95% of the nephrons affected. it usually progresses to end stage renal disease.

A

Chronic Renal Failure

45
Q

What are the two most common causes of chronic renal failure?

A

Diabetes and hypertension

46
Q

What are the system wide symptoms of Chronic Kidney failure?

A

Accum of Nitrogen=encephalopathy = confusion, disorientation, or stupor and coma
=platelets and RBCs lyse = thrombocytopenia, anemia = bruising, spontaneous bleeding, fatigue, weakness, dyspnea
Hyperkalemia= cardiac dysrhythmias, muscle weakness
No vit D synthesis= decreased Ca++ absorption = hypocalcemia = neuromuscular irritability, tetany, seizures
HypoCa++ = stim PTH = bone breakdown = renal osteodystrophy = inc fractures

47
Q

How is chronic kidney failure treated?

A

Fluid and electrolyte management is critical
Blood pressure management and erythropoietin-stimulating medications are usually administered.
dietary phosphate binders and dietary phosphate restriction
calcium supplements that contain vitD
diuretics
bicarbonate administration
once the GFR is lower than 10 to 20 mL/min (normal 90 to 120 mL/min), dialysis is initiated, and the patient will be evaluated for a kidney transplant.

48
Q

This is a reflex involving the spinal cord and cortex of the brain, controls voiding.

A

micturition reflex

49
Q

If a patient complains of hesitancy, interrupted flow of a urinary stream, what is the likely cause?

A

BPH, Benign prostatic hyperplasia

50
Q

This is the most common type of urological cancer. It is three times more common in males than in females.

A

Bladder cancer, specifically transitional cell carcinoma (TCC)

51
Q

What is the major risk factor for bladder cancer?

A

smoking

52
Q

What happens if the most common type of bladder cancer, TCC is left untreated?

A

eventually penetrates the basement membrane and then continues into the bladder muscle, where it can metastasize.

53
Q

What is the cardinal feature of bladder cancer?

A

painless, intermittent, gross hematuria. (Other symptoms include frequency, pain, and burning on urination, as well as the sensation of incomplete bladder emptying.)

54
Q

What is a common cause of delayed diagnosis of bladder cancer, especially in women?

A

Assumption of UTI

55
Q

What is the gold standard for evaluating unexplained hematuria?

A

cystoscopy (best diagnostic procedure for detecting bladder lesions and is definitive when combined with transurethral biopsy.)

56
Q

What is the treatment for bladder cancer?

A

Surgical treatment involves a transurethral resection of the tumor. Chemotherapy, immunotherapy, and radiation therapy are also used to eradicate the tumor or reduce tumor size. Radical cystectomy with urinary diversion may be necessary for very large invasive tumors.

57
Q
A

WGU Pathophysiology (7 decks)

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