P22 - Urinary Part 2 Flashcards
ways that acute renal failure can lead to death without supportive therapy
- cardiotoxicity of elevated serum potassium
- metabolic acidosis
- pulmonary edema
T/F: anemia is only seen with acute renal failure
- false is seen with chronic renal failure and is non-regenerative
calcium and phosphorus levels in chronic renal failure
- hyperphosphatemia
- hypocalcemia
renal secondary hyperparathyroidism pathogenesis
- hpyerphosphatemia that results in hypocalcemia -> stimulates PTH secretion -> Ca mobilized by osteoclasts -> reduced bone density (osteopenia)
- may lead to fibrous osteodystrophy (bone replaced by fibrous tissue)
T/F: bilateral parathyroid gland hyperplasia is a common occurrence during renal secondary hyperparathyroidism
- true
acute renal failure parameters:
- PCV
- BUN/Creat
- Serum K
- urine volume
- kidney size
- bone density
- normal or increased (dehydration)
- previously normal with progressive increase
- +/- hyperkalemia
- oliguric initially
- normal or increased
- normal
chronic renal failure parameters:
- PCV
- BUN/Creat
- Serum K
- urine volume
- kidney size
- bone density
- decreased (reduced EPO)
- previously increased with sustained elevation
- usually normal with hyperkalemia only at end stage
- polyuric
- decreased
- may be decreased (renal osteopenia)
kidney portals of entry (4)
- ascending from ureter
- hematogenous
- glomerular filtrate
- direct penetration
ascending bacterial infection results in what type of inflammation
- suppurative pyelonephritis
what is the most important barrier of the renal corpuscle
- glomerular basement membrane
how do glomerular mesangium remove macromolecules
- phagocytosis
- part of monocyte-macrophage system
what part of the tubules prevents ascending bacteria from gaining access to interstitium
- tubular basement membrane
kidney dose have regenerative potential but only if what is intact
- basement membrane
where do you find most inflammatory cells when inflammation in the kidneys occur
- interstitium
injury to one part of the nephron results in what
- progressive damage to other components of the nephron with eventual loss of function
glomerular injury can occur as a result of deposition of (4)
- immune complexes
- thromboemboli
- bacterial emboli or direct infections
- proteins
glomerular injury can occur by hyperfiltraiton (2)
- prolonged systemic hypertension
- increased dietary protein
protein losing nephropathy cause and effects
- glomerular damage -> proteinuria -> hypoproteinemia predominantly due to loss of albumin -> reduced plasma oncotic pressure
- nephrotic syndrome
nephrotic syndrome signs
- swelling of head and limbs
- due to decreased oncotic pressure resulting in ascites, pleural effusion and generalized edema
loss of antithrombin III can result in what kind of state and lead to what
- hypercoagulable -> thromboembolic disease
tubular damages responses (4)
- atrophy
- degeneration
- regeneration
- necrosis
regeneration after tubular injury is only possible if what is left intact
- tubular basement membrane
T/F: toxic tubular injury generally leaves TBM preserved which allows for regeneration
- true
T/F: ischemic tubular injury generally leaves TBM preserved which allows for regeneration
- false
what is the single most important cause of acute renal failure in animals
- acute tubular necrosis
2 general causes of acute tubular necrosis
- ischemia
- nephrotoxicity
3 mechanisms of acute tubular necrosis resulting in oliguria or anuria
- leakage of tubular ultrafiltrate from damages
- intratubular obstruction from sloughed necrotic epithelium (cellular casts)
- loss of blood supply
nephrotoxic injury is caused by
- chemicals and/or toxic metabolites that become concentrated in tubules to toxic levels
T/F: nephrosis is caused by an inflammatory process
- false - typically caused by hypoxic injury combined with nephrotoxic injury
lymphofollicular inflammation is most common response to choric ____ infection
- leptospira
- multi-nodular lymphocytic reaction
progressive fibrosis leads to loss of what
- renal function
kidney vasculature response to injury (4)
- hyperemia and congestion
- hemorrhage and thrombosis
- vasculitis
- infarction
localized area of coagulative necrosis that results form vascular occlusion
- infarction
large emboli resulting in large renal infarct is occlusion of what artery
- arcuate artery
small emboli resulting in small renal infarct is occlusion of what artery
- interlobular artery
