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Pathophysiology > Patho Quiz 7 (Renal) > Flashcards

Patho Quiz 7 (Renal) Flashcards

1
Q

Tenderness from the kidneys would be felt in what area on the back?

A

Costovertebral angle

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2
Q

Compounds that are not reabsorbed back in the vasculature are excreted how?

A

In the urine

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3
Q

What is a normal GFR?

A

125 mL/min

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4
Q

Which substances filtrate easily across the podocytes to Bowman’s Capsule?

A

Electrolytes and water.

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5
Q

How much production is necessary for adequate function?

A

5%

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6
Q

What determines the GFR?

A

Filtration pressure in the glomeruli, and the permeability of the golerular membrane.

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7
Q

What is the most important physiologic regulator of Glomerular Filtration?

A

Blood volume

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8
Q

Why can too much Sodium in the blood cause spillage of Glucose into the urine?

A

The level of sugar exceeds the absorption rate and the sugar is expelled in the urine.

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9
Q

Which BP medication increases the osmolality of the blood?

A

Mannitol.

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10
Q

What BP medications are K+ sparing?

A

ACEI, Aldosterone inhibitors

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11
Q

What hormone is secreted by the kidneys and what condition may result from decreased secretion of this hormone?

A

Erythropoietin; Anemia

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12
Q

How do we know the kidneys are failing?

A

Urinalysis.

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13
Q

What is normal urine output?

A

30 mL/hr
OR
0.5 mL/kg/hr

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14
Q

What would you expect on a UA in an infection?

A

Nitrates

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15
Q

What lab values should not be found (negative) in the urine?

A

Protein, Nitrates, Blood, Bilirubin, Glucose

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16
Q

Which kidney lab is most indicative of kidney function?

A

Creatinine.

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17
Q

Which clinical manifestation likely indicates kidney disease?

A

Pain the the costovertebral angle (late in the disease process).

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18
Q

What is the difference in development in recessive v. dominant Cystic Kidney Disease?

A

Recessive is evident from childhood.

Dominant is later in life.

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19
Q

What is a growth that is found in children of 2 years old and younger on the kidneys?

A

Wilm’s tumor.

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20
Q

What is the first sign of a tumor on the kidneys?

A

Blood in the urine.

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21
Q

What is pyelonephritis and how does it typically start?

A

Inflammation of the kidneys brought on by UTI (and also systemic bacterial infection from blood stream, less common)

22
Q

A UTI is considered what type of infection (direction of bacteria)?

A

Ascending–starts in the meatus and moves upward.

23
Q

What are glomerulopathies and what is the hallmark manifestation?

A

Results from alterations in glomerular capillary structure and function; Proteinuria.

24
Q

What is Glomerulonephritis?

A

An assortment of immune-mediated conditions that produce inflammation glomeruli and other areas of the kidneys.

25
Q

What are three things that happen to the kidneys in chronic glomerulonephritis?

A
  • Proliferative lesions with sclerotic injury
  • Nephrons atrophy
  • Kidneys become scarred, small, and non functional
26
Q

When does Nephrotic Syndrome occur and what does happens during this process?

A

Occurs due to increased glomerular permeability to proteins. Causes albumin to leak into Bowman’s Capsule and causes blood in the urine.

27
Q

Increase in liver activity, from nephrotic syndrome, can cause?

A

Hyperlipidemia, hypercoagulation

28
Q

Urinalysis provides a foundation for the differential diagnosis of renal dysfunction. Which of the following UA values is an indication of normal renal function?

A

<1-2 WBCs

29
Q

Pyelonephritis is an infection of the renal pelvis and parenchyma. Which of the following is true of this problem?

A

It may result in a chronic disease process.

30
Q

Obstructive processes result in urine stasis which predisposes to infection and structural damage. Identify the correct statement in relation to the disease?

A

Stones are a result of solute supersaturation and can cause complete obstruction.

31
Q

How do Glomerulopathies manifest?

A

Decreased capillary flow and increased glomerular membrane permeability.

32
Q

What hormones regulate distal convoluted tube retention of water and Sodium? Which hormones affect water and which affect Sodium?

A

ADH affects water. convoluted tubules/ collecting ducts
Aldosterone affects Sodium and water. Collecting ducts main effect.
both act of the distal tubules. this is where the convo/ collecting ducts

33
Q

Glomerulopathies glomerulus are penetrable to what?

A

Protein.

34
Q

Define Chronic Kidney Disease

A

A potentially REVERSIBLE syndrome characterized by the abrupt deterioration of renal function, occurring over hours to weeks that results in the retention of nitrogenous waste.

35
Q

How much urine output is present in oliguria?

A

<400 mL in 24 hours

36
Q

How much urine output is present in anuria?

A

<100 mL in 24 hours

37
Q

What criteria is present in Acute Kidney Injury?

A

R-risk: 1st stage of AKI=Creatinine ↑ x 1.5 or GFR↓ 25%
I-injury: 2nd stage = ↑ Creatinine x 2 or GFR ↓ 50%
F-failure: 3rd stage = ↑ Creatinine x 3 or GFR ↓ 75% or Creatinine >4 mg/dL
L-loss: 4th stage = persistent acute kidney failure; loss of function >4 week
E-end stage kidney disease = complete loss of kidney function >3 months

38
Q

Prerenal injury is characterized by what? (4)

A
  • Low sodium
  • Oliguria
  • High specific gravity and osmolality
  • Low GFR
39
Q

Postrenal injury is caused by what?

A

Obstruction of normal outflow of urine from kidneys.

40
Q

What is the most common cause of Intrarenal kidney injury?

A

Acute tubular necrosis.

41
Q

What is the most common toxic substance to the kidneys?

A 
Ibuprofen  (in the home).
Contrast media (in the hospital).
42
Q

What causes vascular acute tubular necrosis?

A

Embolus.

43
Q

What are the stages of Acute Tubular Necrosis (ATN)?

A
  • Prodromal phase: injury has occurred, normal or low urine output,elevated BUN and CR
  • Oliguric phase: oliguria/anuria, volume overload, hyperkalemia, azotemia/uremia, metabolic acidosis
  • Postoliguric phase: fluid volume deficit, labs begin to normalize
44
Q

When do Creatinine levels start to increase in ATN?

A

12-48 hrs

45
Q

Chronic Kidney Disease is usually related to which chronic conditions?

A
  • Diabetes Mellitus
  • Hypertension
  • Recurrent pyelonephritis, glomerulonephritis, and polycystic kidney disease
46
Q

What is CKD characterized by?

A

Glomerulosclerosis and tubulointerstitial inflammation and fibrosis.

47
Q

How the progression of CKD slowed?

A
  • BG control in DM
  • ACE inhibitors (kidney protective qualities)
  • Management of HTN, CVD, Hyperlipidemia and anemia
  • Nutritional support
48
Q

Acute kidney injury is an abrupt reduction in renal function which always results in?

A

Accumulation of waste materials in the blood.

49
Q

Intrarenal kidney injury is a result of dysfunction of the nephrons. Which of the following is specific for this type of kidney injury?

A

Frequently is caused by nephrotoxic substances.

50
Q

Acute Tubular Necrosis…

A

Will show resolution within return of BUN and Creatinine to normal levels.

51
Q

Chronic kidney disease is characterized by a gradual irreversible loss of functional nephrons. The stages of chronic kidney disease may be determined by the:

A

Number of nephrons that are damaged.

Pathophysiology (4 decks)

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