Patho Unit 7 Flashcards
muscular tubes that carry urine to the bladder
ureters
external sphincter the controls urine outflow under voluntary control
urethra
functional unit of the excretory kidney
nephron
two types of nephrons
cortical
juxtamedullary
4 processes of the renal system
filtration
reabsorption
excretion
secretion
all substances found in the urine that are not reabsorbed back into the body (left in the filtrate)
excretion
accumulation of potassium, acids, fluid, and waste products that should have been removed in urine
anuria
results in fluid overload, acid-base disturbances, electrolyte abnormalities, and build up of waste products
renal failure (uremia)
in severe hypoglycemia, when the liver and kidneys make glucose from other substances
gluconeogenesis
filtrate flows down the ______ ______ in the cortex and reabsorption takes place here
proximal tubule
movement of fluids from filtrate back into the peritubular capillaries
reabsorption
things that are reabsorbed back into the peritubular capillaries
Na and Cl water amino acids glucose phosphate proteins
movement from peritubular capillaries back into the filtrate
secretion
a measure of renal glomular filtration
creatinine clearance
part of juxtamedullary nephron that creates a very salty environment in the medulla of the kidney
Loop of Henle
part of J nephron that monitors the filtrate to indirectly assess vascular volume
macula densa (dense body)
type of cells that release renin to activate the RAS
juxtaglomular apparatus
part of loop of Henle that prevents the rapid flow and washout of the concentration gradient
hairpin loop
once filtrate can no longer be changed by reabsorption or secretion, the filtrate is now called _____
urine
where is ADH synthesized
hypothalamus neurons
where is ADH stored
posterior pituitary gland
three reasons ADH would be released
elevated osmolarity
peripheral baroreceptor activation with hypotension
angiotensin 2 stimulation via RAS activity
mineralcorticoid hormone made by the adrenal gland that affects mineral homeostasis
aldosterone
disease caused by lowering production of aldosterone. involves Na wasting (hyponatremia) from excess loss of Na into the urine, K accumulation (hyperkalemia), and acidosis
Addison’s disease
disease caused by overproduction of aldosterone, Na and water retention (edema), K wasting (hypokalemia), and alkalosis
Cushing’s disease
two types of natriuretic peptides
brain (BNP) and atrial (ANP)
type of drug that interferes with the body’s sodium excretion resulting in increased sodium and water loading the increases overall blood volume and therefore blood pressure
NSAID’s
what is satisfied when our osmolality returns to normal and mouth dryness is relieved.
thirst response
stimulates salt eating
hyponatremia
metabolic waste product of muscle creatine that is filtered out in the urine
creatinine
amount of creatinine cleared out by filtration is a measure of
glomerular filtration rate
acute or chronic disease that can be caused by many things and deceases the GFR or tubular function
renal failure
two types of acute renal syndromes
acute kidney injury
acute renal failure
3 types of chronic renal syndromes
chronic kidney disease (CKD)
chronic renal failure (CRF)
renal insufficiency
3 labs run to test renal function
BUN
creatinine
cystatin
when there is BUN protein in the blood
uremia (azotemia)
risk of acute renal failure, injury to the kidney,failure of renal function, loss of function, end stage renal failure
RIFLE
caused by use of contrast dyes used in radiology studies - damages the kidneys
contrast induced nephropathy
caused by any condition that reduces perfusional pressure to the glomerulus (hypovolemia, sepsis, cardiogenic shock, low output HF, dehydration, severe hemorrhage, liver failure)
pre-renal AKI (acute kidney injury)
acute renal failure when there is nothing wrong with the kidneys (can occur due to liver failure)
hepatorenal syndrome
any condition that damages STRUCTURES of the kidneys
intra-renal AKI
feeling that you have to urinate very soon
urgency
having to urinate often but only a small amount is expelled
frequency
waking up to urinate more than normal
nocturia
death of skeletal muscle cells realeases cell contents into circulation - myoglobin, calcium, potassium, proteins, creatine, acid - can be fatal
caused by extreme exertion. febrile, tenderness of large muscles
rhabdomyolysis
any condition that BLOCKS urinary outflow (kidney stone in ureter, bladder tumor)
post-renal AKI
condition/disease that is usually caused by DM and HTN (or analgesic abuse) where pt is anemic, has elevated BUN, PTH, hyperphosphatemia, hyperkalemia, hypocalcemia, hyponatremia, low bicarbonate, and low pH (acidosis)
chronic kidney disease (CKD)
aka chronic renal failure (CRF)
aka end stage renal disease (ESRD)
type of diet has low sodium, restricted protein intake, low acid
diabetic diet
what will patient need if CKD reaches stage 5
Renal Replacement Therapy (RRT)
two types of renal replacement therapy
peritonial/ hemodialysis
kidney transplant
3 types of dialysis
hemodialysis
peritoneal dialysis
hemofiltration
used to remove toxins from the blood, such as: drugs, potassium, calcium, urea, and acidosis that were not filtered out by the kidney
dialysis
type of dialysis that allows rapid access in the critically ill patient via a catheter in a large vein
hemodialysis
longterm access where an artery and a vein are joined either in the arm or hand
arterio venous fistula (AV fistula)
catheter pushes fluid into the peritoneal cavity and the peritoneum serves as the semi-permeable membrane
peritoneal dialysis
test strip with chemical reagents that demonstrate abnormalities in urine
urinalysis (dip stick)
normal range of specific gravity in urinalysis
1.005- 1.025
leukocytes in urine
pyuria
positive in urine infection
nitrite
blood in the urine (gross or microscopic)
hematuria
large amounts of albumin in the urine, losing water along with albumin, presenting with edema, pulmonary edema, pleural effusion, complications of infection
nephrotic syndrome / severe proteinuria
pediatric condition where acidosis presents with HYPOkalemia, and failure to thrive. either impairment in bicarbonate reabsorption or reduced acid secretion
Renal Tubule, Acidosis (RTA)
means excessive urine production
diabetes
deficiency of ADH (pituitary), can be genetic or idiopathic, and acquired from trauma or a tumor in the pituitary. presents with polydipsia, polyuria, nocturia, dehydration with volume contraction if unable to keep up with fluid losses
CENTRAL Diabetes Insipidus
genetic, acquired disorder that is a renal resistance to ADH. presents with thirst, dilute urine, hypernatremia if water not available to unable to drink
NEPHROGENIC Diabetes Insipidus
condition where too much ADH secretion results in over reabsorption of free water resulting in dilutional hyponatremia of the blood. presents with neurological symptoms such as ataxia (abnormal gait) and confusion
syndrome of inappropriate ADH secretion (SIADH)
LOWERED production of aldosterone, Na wasting from excess loss of Na into the urine, K accumulation, and acidosis
Addison’s disease
OVERPRODUCTION of aldosterone, Na and water retention (edema), K wasting, alkalosis
Cushing’s disease
normal bladder voids how many times per day?
4-8 times
adult bladder can hold about ___ ml
600
normal adult bladder gets urge to void at ___ ml
300
painful urination
dysuria
needing to strain or bear down on the external sphincter to urinate
straining
newborn abdominal masses (enlarged kidneys)
hydronephrotic kidneys (hydronephresis)
pediatric diagnosis where the vesicoureteral junction is incontinent and allows urine to pass backward toward the kidneys
vesicoureteral reflux
disorder associated with undescended testicles where there is a severe reduction in abdominal musculature and the gut hangs our because there is nothing to keep it tight
prune belly syndrome (eagle-barrett syndrome)
when the prepuce of the penis cannot be retracted over the glans
phimosis
when the prepuce of the penis is retracted beyond the coronal sulcus and cannot be returned
papaphimosis
septum develops in vagina that can go all the way up through the cervix and uterus
septate vagina
exposure to androgens in fetal life can masculinize the female infant
masculinization
disease presents with painless hematuria, with risk factors being exposure to certain chemicals and smoking
bladder cancer
