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Clin Path > P30 - Urinary System > Flashcards

P30 - Urinary System Flashcards

1
Q

3 major processes of the nephron

A
  • glomerular filtration (passive
  • tubular resorption (passive and active)
  • tubular secretion (passive and active)
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2
Q

what passes through glomerular filtration

A
  • water

- solutes (small proteins - smaller than albumin)

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3
Q

what does not pass through glomerular filtration and stays in the blood

A
  • cells

- most plasma proteins

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4
Q

decrease glomerular filtration rate effects (2)

A
  • substances cleared slower -> stay in plasma longer

- substances stay longer -> concentrations usually increase

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5
Q

what part of blood does the glomerulus filter

A
  • plasma
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6
Q

factors that affect GFR

A
  • cardiac output
  • number of functional glomeruli
  • constriction/dilation of afferent/efferent arterioles
  • capsular hydrostatic pressure
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7
Q

most H2O in glomerular ultrafiltrate is resorbed by what

A
  • tubules
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8
Q

in a healthy person how much H2O enters tubules each day and how much is excreted each day

A
  • 180 L

- 1-2 L

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9
Q

concentrating ability of cats

A
  • can really concentrate their urine
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10
Q

proximal CT effect on concentrating urine

A
  • removes volume
  • no change in concentration
  • osmolality of tubular fluid is same as plasma
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11
Q

descending loop of Henle effect on concentrating urine

A
  • removes H2O
  • increases solute concentration
  • urine becomes more concentrated
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12
Q

ascending loop of Henle effect on concentrating urine

A
  • removes solutes

- dilutes (decreases concentration)

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13
Q

distal nephron effect on concentrating urine if removes H2O

A
  • increases concentration
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14
Q

distal nephron effect on concentrating urine if does not remove H2O

A
  • stays dilute
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15
Q

azotemia

A
  • increase nonprotein nitrogen compounds

- increase [urea] &/or increase [creatinine] in serum/plasma

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16
Q

if azotemic 3 areas to try and define the problem

A
  • prerenal
  • renal
  • postrenal
17
Q

uremia is a clinical sign indicating what

A
  • renal failure
18
Q

major criteria for CRF diagnosis

A
  • decrease GFR -> azotemia

- decrease concentrating ability -> USG (1.007-1.013)

19
Q

progressive renal disease urine production

A
  • polyuria -> oliguria -> anuria
20
Q

acute renal insufficiency/failure (3)

A
  • reversible or irreversible
  • frequently oliguria or anuria
  • acid-base problems
21
Q

where is urea produced

A
  • in hepatocytes from ammonia
22
Q

urea excreted into intestine is important in what animals

A
  • large animals
23
Q

what is a better measurement of renal failure in large animals

A
  • creatinine
24
Q

where is creatinine produced

A
  • from degradation of creatine or creatine-PO4 from muscle
25
Q

T/F: creatinine is reabsorbed by tubules

A
  • false
26
Q

T/F: urea is reabsorbed by tubules

A
  • true
27
Q

what can cause prerenal azotemia

A
  • decrease renal blood flow (dehydration, shock)

- increase urea production

28
Q

pathophysiology of prerenal azotemia due to dehydration (decrease blood volume) (3 main things)

A
  • release renin -> increase angiotensin II -> constrict glom. arterioles -> decrease blood flow -> decrease urea & Crt clearance
  • decrease amount of fluid into proximal tubules -> decrease flow rate -> increase time for urea resorption
  • increase increase release of ADH -> increase resorption of urea in distal nephron
29
Q

pathophysiology of prerenal azotemia due to protein degradation

A
  • increase formation of NH4 -> increase formation of urea -> increase [UN] (if production > clearance)
  • no decrease in GFR
30
Q

pathophysiology of renal azotemia due to glomerular &/or tubular disease

A
  • loss of functional nephrons -> decrease renal blood flow -> decrease GFR -> decrease clearance of urea and creatinine from plasma -> increase [UN] and [Crt]
31
Q

pathophysiology of post renal azotemia due to partial or complete urinary tract obstruction

A
  • release of vasoactive substances -> constriction of glomerular arterioles -> decrease renal blood flow -> decrease GFR -> decrease clearance of urea and creatinine from plasma -> increase [UN] & [Crt]
32
Q

pathophysiology of post renal azotemia due to urine leakage

A
  • fluid with increase [urea] and [creatinine] in extravascular fluid -> urea and creatinine diffuse into plasma -> increase [UN] and [Crt]
33
Q

decreased [UN] in serum or plasma can be due to (3)

A
  • disorders that cause decreased urea synthesis (hepatic insufficiency)
  • disorders that cause increased renal excretion of urea
  • disorders that cause impaired proximal tubular resorption of urea
34
Q

is decreased [UN] or [Crt] considered not clinically relevant

A
  • [Crt]
35
Q

what is a better indicator of decrease GFR in horses

A
  • [Crt]
36
Q

how does central diabetes insipidus create decreased [UN] in the serum or plasma

A
  • decrease ADH release -> increase excretion
37
Q

how does renal diabetes insipidus create decreased [UN] in the serum or plasma

A
  • decrease tubular response to ADH

Clin Path (43 decks)

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