Patho

Question 1

What is the functional unit of the kidney?

Answer 1

The nephron

Question 2

How many nephrons per kidney?

Answer 2

1 million

Question 3

What is the anatomy of the nephron?

Answer 3

Bowman Capsule and Tubular System (PCT, DCT, LOOP OF HENLE)

Question 4

Fenestration are what?

Answer 4

Hole in lining that allows particles to pass through (filtrate)

Question 5

T or F :Albumin is small but does not pass through the glomerulus due to the negative charge of the basement membrane.

Answer 5

TRUE

Question 6

T OR F: Inflammation of glomerulus will positively affect filtration.

Answer 6

False. NEGATIVE FILTRATION.

Question 7

What 3 forces control Glomerular filtration?

Answer 7

Hydrostatic pressure (BP) Colloid Osmotic Pressure (Albumin pull) Capsular Hydrostatic Pressure

Question 8

What collects glomerular filtrate and funnels it into the tubule?

Answer 8

Bowmans Capsule

Question 9

What has a reabsortion of 80% of electrolytes (Na, K, Cl, Ca, etc.) 100% Glycose & 70% water

Answer 9

PCT

Question 10

What concentrates the filtrate?

Answer 10

LH

Question 11

What has some water and electrolyte reabsorption, including bicarbonate, potassium and hydrogen secretion?

Answer 11

DCT

Question 12

__________ Mantain a constant blood flow and blood pressure therefore– constant GFR

Answer 12

Kidneys

Question 13

Response to TOO MUCH blood or pressure:

Answer 13

LOW GFR by constricting AFFERENT arteriole and dilating EFFERENT arteriole

Question 14

Response to TOO LITTLE blood or pressure:

Answer 14

HIGH GFR by dilating AFFERENT arteriole and constricting EFFERENT arteriole.

Question 15

Limitation of the system:

Answer 15

This ability to auto-regulate fails when the systolic BP drops below 65-70 mmHg

Question 16

Whats the primary Major Kidney Function?

Answer 16

Regulation

Question 17

Whats the secondary function of Kidneys?

Answer 17

Hormones

Question 18

How do the kidneys produce and secrete Renin?

Answer 18

Renin Angiotensin Aldosterone pathway ( AKA: RAAS) work to increase BP and Blood flow when LOW

Question 19

How does the kidney produce Erythropoietin?

Answer 19

Hormone is realeased in response to HYPOXIA- stimulates production of RBC’S

Question 20

How do the kidneys aid in activation of Vitamin D?

Answer 20

Vit D is obtained through diet and must be activated. Vit D is needed for the absorption of ingested calcium.

Question 21

Where are the kidneys located?

Answer 21

Retro-peritoneal Below the costovertebral angle 12th rib

Question 22

Describe the RAAS system:

Answer 22

Liver- release angiotensinogen
Kidney- release renin in response to decreased BP and perfusion
Renin: Converts angiotensinogen activating angiotensin
Lungs- release angiotensin-converting enzyme activate angiotensin 1 to angiotensin 11

Angiotensin 11 and aldosterone cause increase sodium and water retention to increase BP

Question 23

What is needed for Normal Kidney Function?

Answer 23

1. Adequate glomerular perfusion
2. Functional Nephrons

Question 24

What are the consequences of Abnormal Kidney Function?

Answer 24

Renal dysfunction will alter the kidneys ability to filter the blood and this will be reflected in abnormal blood work.

Question 25

Abnormal Kidney Function Abnormal Blood Work:

Answer 25

High Blood urea nitrogen (BUN) High Serum Creatinine Failure to maintain Na & K Water rention Acid-base imbalance

Question 26

Azotemia:

Answer 26

an accumulation of metabolic waste products in the blood (ex. Urea, Creatinine).

Question 27

Uremia:

Answer 27

A group of signs and symptoms that occur due to inadequate renal function.

Question 28

Oliguria:

Answer 28

Urine output that is less than normal (lower than 400 ml/day)

Question 29

Anuria:

Answer 29

The absence of urine production (lower than 40 ml/day).

Question 30

Characteristic of CHRONIC KIDNEY DISEASE (CKD)

Answer 30

-Gradual Onset (Years) -Most common cause is diabetic nepthropathy -Progressive & Irreversible -Cause of death : CVD (Cardio Vascular Disease)

Question 31

Charactertistics of ACUTE KIDNEY INJURY (AKI)

Answer 31

-Sudden onset (hours to days) -Most common cause if acute tubular necrosis (ATN) -Potentially reversible -Cause of death: Sepsis

Question 32

Cause of death of AKI

Answer 32

Sepsis

Question 34

Cause of death CKD

Answer 34

CVD (cardio vascular disease)

Question 35

Cause of Chronic Kidney Disease:

Answer 35

-Progressive, irreversible loss of kidney function through loss of nephrons -Diabetic Nephropathy -Hypertension -Other causes: Glomerulonephritis, pyelonephritis, polycystic disease, acute kidney injury

Question 36

CKD: What happens to the kidney?

Answer 36

-Remaining nephrons work harder (HYPERFILTRATION) -Over time hyperfiltration causes FIBROSIS and SCARING (Glomerulosclerosis) -Symptoms start to occur once 50% of nephrons are lost -Can LOSE up to 90% before RRT (renal replacement therapy) is required

Question 37

Stage 1 of CKD

Answer 37

AT RISK: Normal kidney function. Urine findings indicate renal disease, GFR>90, likely ASYMPTOMATIC

Question 38

Stage 2 of CKD

Answer 38

Slightly REDUCED kidney function, GFR: 60-89, maybe Asymptomatic, DECREASED ability to concentrate nine. ALBUMINURIA.

Question 39

Stage 3 of CKD

Answer 39

A MODERATE reduction in renal function, GFR:30-59, ALBUMINURIA (LIKELY), may develop: Electrolyte and fluid imbalances, anemia, oliguria, azotemia

Question 40

Stage 4 of CKD

Answer 40

SEVERE REDUCTION in renal function, GFR: 15-29, Azotemia, Anemia, Fluid & electrolyte imbalance (MAYBE), Acid and base imbalance (MAYBE)

Question 41

Stage 5 CKD

Answer 41

ESRD (end stage renal disease), GFR:<15, Uremia (renal replacement therapy started)

Question 42

Fluid retention, electrolyte imbalance, waste product accumulation, hormone insufficiency, increase in blood lipoproteins (HIGH CVD), changes in bone metabolism

Answer 42

What does CKD look like in a patient?

Question 43

CKD signs and symptoms:

Answer 43

Anxiety, Depression, Hypertension, HF, CAD, Pericaditis, PAD, Anorexia