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Pathophysiology > Renal > Flashcards

Renal Flashcards

1
Q

A factor that increases the glomerular filtration rate is

A

Fluid volume excess

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2
Q

3 main functions of renal?

A

Fluid balance
Electrolyte balance
Acid-base balance

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3
Q

The main driving force for glomerular filtration is?

A

Hydrostatic pressure in glomerular capillaries

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4
Q

What does Glomerulus do?

A

Filter
Water and solutes from blood (glucose, amino acids, ions, creatinine, urea)

-No protein(albumin) and RBCs

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5
Q

What does the Proximal convolutes tubule do?

A

Reabsorption (to the blood)

  • Na+(majority)
  • Water, glucose, K+, amino acids, bicarb, urea
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6
Q

What does Descending loop of Henle do?

A

Reabsorption

-ONLY water

Because the medulla is very salty, water always follows Na+

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7
Q

What does Ascending loop of Henle do?

A

Reabsorption

-ONLY ions, Na, Cl, and K+

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8
Q

What does a distal convoluted tube do?

A

Secretion and Reabsorption

  • Selective secretion ( K+, H+, some drugs)
  • Reabsorption (water, Na+)
  • Maintain blood pH
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9
Q

What does the Collecting duct do?

A

Reabsorption for final water

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10
Q

a) ADH?
b) Where to secret?

c) The function of urine production

A

a) Promote water retention in the kidney
b) posterior pituitary

c) Control concentration of final urine
Acts at distal tubule collecting ducts

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11
Q

ADH increases a_______ by the kidney

By increasing water permeability of the b______ and C________

A

a) water reabsorption
b) distal tubules
c) collecting ducts

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12
Q

The drop in blood pressure detected by each nephron’s juxtaglomerular apparatus

responds by secreting????

A

Renin

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13
Q

Renin triggers the formation of a________?

Which stimulates the release of from the b_______ adrenal cortex??

A

a) angiotensin II
b) aldosterone

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14
Q

Aldosterone?

A

Promote reabsorption of salt

Increase K and hydrogen ion excretion 排泄

Acts at distal tubule (Principal cells)

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15
Q
A
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16
Q

Aldosterone then slowly boosts a______ by the kidneys

by increasing reabsorption of b________

A

a) water reabsorption
b) Na+

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17
Q

Factors affect GFR? 3

A

Obstruction-kideny stone

Losing too many fluid- Vomiting diarrhea

Low plasma proteins-decrease plasma oncotic pressure

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18
Q

What substance are filtered at the glomerulus?

A

Water, electrolytes, glucose, and organic molecules

NO RBCs!

NO Protein!!

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19
Q

Lab test

Blood Uria Nitrogen

A

A waste product formed after the body uses the protein it needs

Urea is metabolism 7-24
( I like BUNs 7/24)

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20
Q

Elevated BUN can also be due to?

A

Dehydration
Urinary tract obstruction
Congestive heart failure
Gastrointestinal bleeding
Shock
Severe burns

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21
Q

lab test

Serum Creatinine

A

The waste product from muscle breakdown/To see how well GFR

Creatine Should NOT reabsorb or secret
High levels of creatinine
=kidney not working properly

Men-1.4
Women-1.2

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22
Q

Kidney stone formation

  1. a_________ of one or more salts in the urine
  2. b________ of the salts from a liquid to a solid state
  3. Growth through c_________ and the presence or absence of stone inhibitors
A

a) supersaturation
b) precipitation 沈澱
c) crystallization

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23
Q

Stone

Supersaturation

A

Period of extremely high mineral concentration in the urine

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24
Q

Stone

Precipitation 沈澱

A

Fine little particles that settle at the bottom, can aggregate and form a kidney stone

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25
kidney stone underlying causes?
Drinking too little water Exercise (too much or too little) Obesity High protein food High salt food
26
BUN low means?
Chronic liver disease
27
Acute renal failure **Intrarenal**
* *Damage to nephron** * *Reduce GFR rate** Acute Glomerulonephritis (10%) Acute Tubular Necrosis (90%) Ischemic (All prerenal causes) Nephrotoxins
28
Acute renal failure 4 Prerenal
**Decrease blood flow to the kidney** **Decrease cardiac output** (MI) **Decrease volume** Hemorrhage vomiting/diarrhea **Obstruction** thrombus | (decrease perfusion)
29
Acute renal failure ## Footnote **Prerenal/clinical indicate**
If not corrected quickly (\<90 minutes)݈ Leads to IntraRenal Injury Maybe an irreversible injury
30
Acute renal failure **Intrarenal/clinical indicate**
31
1. ______________ is solely filtered from the bloodstream via the glomerulus and is NOT reabsorbed back into the bloodstream but is excreted through the urine. A. Urea B. Creatinine C. Potassium D. Magnesium
B. Creatinine
32
A patient with acute renal injury has a GFR (glomerular filtration rate) of 40 mL/min. Which signs and symptoms below may this patient present with? Select all that apply: A. Hypervolemia B. Hypokalemia C. Increased BUN level D. Decreased Creatinine level
A and C ## Footnote A GFR of 40 mL/min indicates that the kidney's ability to filter the blood is decreased. Therefore, the kidneys will be unable to remove waste and excessive water from the blood.
33
A 55-year-old male patient is admitted with a massive GI bleed. The patient is at risk for what type of acute kidney injury? A. Post-renal B. Intra-renal C. Pre-renal D. Intrinsic renal
C. Pre-renal
34
Acute renal failure Postrenal
**Urine flow obstructive** Renal Stones Blood clot Edema Tumors Pregnancy (hormones) Spinal Cord Injury (Neurogenic bladder)
35
36
37
Cystitis?
**Also called: UTI, bladder infection** Lower abd pain UA- bacteria Dark yellow, brown ish(hematuria)
38
Pyelonephritis?
Infection of the renal pelvis Upper kidney Flank pain Same SS as cystitis Can lead to PKD and renal failure
39
Glomerulonephritis?
Inflammation of the glomerulus Autoimmune Increase BUN Hyperkalemia Hypernatremia Other electorates imbalance
40
Acute tubular necrosis
Tissue death Ischemic= purfusion issue Diabetics HTN Chronic arteriole disease Cardiovascular disease
41
Acute kidney failure a) Urinary changes? b) Fluid volume? c) Sodium balance? Potassium?
a) Oliguria/Low urine output b) volume overload leading to pulmonary edema c) Both excess
42
Acute Kidney Injury Clinical Manifestations Maintenance/Oliguric phase (1- 14 days) a) BUN, Cr rate? b) other data?
a) increase b) Metabolic acidosis Neurologic disorders
43
If GFR decreases??
Decrease urine output =increase water in body HTN, edema
44
Aldosterone What is the goal?
Increased blood volume Increased blood pressure
45
RAAS System a) What is the goal b) what is the trigger?
Increased blood volume Increased blood pressure
46
Kidney releases a\_\_\_\_\_\_ then acts in adrenal cortex to release b\_\_\_\_\_\_\_?
a) renin Angiotensin I Lungs release ACE Angiotensin II Vasoconstriction b)aldosterone
47
48
ANP and BNP?
Inhibit renin secretion Inhibits and inducesterone secretion Inhibits sodium and water reabsorption Acts on Macula densa cells
49
Receive how much blood per minute from the heart?
1-1.2/L M
50
Renal blood distribution To glomerulus for filtration? To peritubular capillaries?
20% 80%
51
Kidneys able to do what? ## Footnote High BP afferent arteriole doing what? Low BP afferent arteriole trigger what?
Autoregulate but only range 80-180 Constricts RASS
52
Efferent arteiole vasoconstriction ## Footnote glomerular hydrostatic pressure what? GFR?
Both increase
53
Afferent arterioles hydrostatic pressure high or low? Efferent arterioles hydrostatic pressure high or low?
High Low
54
Loos of autoregulation BP at how #?
BP\> 180
55
Loos of autoregulation leads what problem?
Increase glomerular capillary hydrostatic pressure = Pushes more fiuid
56
Low plasma protein(albumin) leads what problem of CFR?
Decrease glomerular capillary oncotic pressure Fluid stay in bowman's space =Damage to the glomerular filtration membrane
57
BP \<80, then what cause of autoregulation?
Decrease glomerular hydrostatic pressure Pushes less fluid Increase glomerular oncotic pressure Fluid stay in capillary= vomiting, diarrhea
58
Principal cells?
Aldosterone effect Reabsorbed Na Secrete K
59
Macula Densa Cells reased/decreased amounts of filtered a\_\_\_\_\_\_\_\_ Increased b\_\_\_\_\_\_\_\_ afferent arteriole vasoconstriction= (decreases c\_\_\_\_\_\_\_\_\_)
a) Na b) GFR & sodium c) GFR
60
Juxtaglomerular Cells Sense increase or decrease BP in where? Decreased a\_\_\_\_\_ in Distal Tubule Initiates b\_\_\_\_\_\_ response
decreased BP in afferent arteriole a) Na b) RAAS
61
Oliguria?
Urine output below normal Less than 400ml/24hr
62
Anuria?
lack of urine production less than 50ml/24hr
63
Uremia
High levels of waste products in the blood (increase BUN and Cr) severe azotemia
64
Uremia
Can lead to kidney failure when left untreated Seizures Loss of consciousness Heart attacks
65
azotemia
Elevated levels of urea and other nitrogen compounds in the blood
66
Glomerulonephritis What organism?
Poststreptococcal Occurs after throat or skin infection with group A alpha-hemolytic
67
Nephr**O**tic Syndrome?
p**O**docyte damage leading to protein exertion Loses 3.5g/day More common in child Reversible
68
Nephrotic findings?
Hypoalbuminemia Edema Vitamin D deficiency
69
NephrItic?
Blood loss through the inflammation of the basement membrane BP high Cola colored urine
70
Chronic kidney causes 3
Type 2 diabetes 42% HTN 28% Type 1 diabetes 4%
71
Chronic kidney stage 1
No symptoms but there are Diabetes HTN Obesity
72
Chronic kidney stage 3
30-60% of kidneys still function dialysis
73
Renal failure Symptoms
Decreased urine output Fluid retention, causing edema Shortness of breath. Fatigue Confusion Nausea Weakness Irregular heartbeat

Pathophysiology (11 decks)

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