Renal

Question 1

How sodium homeostasis maintained?

Answer 1

Through the RAAS - increases sodium reabsorption and ANP - increases natriuresis.

Question 2

What portion of the nephron is always pereable to water?

Answer 2

Proximal convoluted tubule and descending loop of henele.

Question 3

Which portion of the nephron is permeable to water with ADH present?

Answer 3

the collecting duct.

Question 4

What part of the nephron does the bulk of the reabsorption occur?

Answer 4

The proximal tubule, where most of the filtered glucose, amino acids and other solutes are reabsorbed.

Question 5

What is hyperosmotic solution?

Answer 5

A greater difference between solutes and solutions between a membrane.

Question 6

Where does the active reabsorption of NaCI occur in the nephron?

Answer 6

In the thick ascending limb of the loop of henle.

Question 7

What happens first in response to increase osmolarity, increase in ADH or the thirst mechanism?

Answer 7

The secretion of ADH begins when plasam osmolarity rises about 280mmol/L.
The thirst mechanism begins second when osmolarity reaches and surpasses 290mmol/L.

Question 8

What is the physiological advantage of increase ADH secretion over night?

Answer 8

By increasing ADH, we decrease the rate of urine formation. This prolongs the time needed for the bladder to fill and urination is required, allowing us to sleep with less interruptions.

Question 9

How does an increase in ADH secretion at the start of exercise an advantage?

Answer 9

Decreasing the rate of urine formation, retaining water, helping us to remain hydrated as our body gains heat and sweats.

Question 10

What fluid compartment are ions, calcium and chloride most likely found in?

Answer 10

Interstitial and plasma.

Question 11

Define osmolarity

Answer 11

the total number of dissolved particles in a solution.
high osmolarity = high concentration

Question 12

How would neurons in the hypothalamus respond to an increase in osmolarity?

Answer 12

Release aDH which increases water reabsorption by the kidneys and increasing the sensation of thirst.

Question 13

How does alcohol effect ADH secretion and what would happen physiologically?

Answer 13

ADH secretion would decrease = leading to a decrease in water reabsorption, increased osmolarity.

Question 14

What is the main intracellular and extracellular ions?

Answer 14

Intra = potassium
Extra = sodium

Question 15

How is the relationship between extracellular ions and intracellular ions maintained?

Answer 15

The Na+/K+ pump - for every 3 sodiums out of the cell, it will bring 2 potassium into the cell - it maintains resting membrane potential.

Question 16

how would neurons in the hypothalamus respond to an increase in osmolarity?

Answer 16

Releasing ADH, which increase water reabsorption by the kidneys and increase in sensation of thirst.

Question 17

What treatments are there for end stage kidney disease?

Answer 17

periotoneal dialysis
haemodialysis
kidney transplant.

Question 18

Explain dialysis to your patient?

Answer 18

Dialysis carries out the function the kidney can no longer do. It will remove waste and extra fluid from the blood, through a machine, just like an artifical kidney.

Question 19

What is peritoneal dialysis?

Answer 19

catheter is inserted into peritoneal cavity, dialysis solution is added which will absorb excess wastes and fluids.

Question 20

What are the 3 phases of acute renal failure?

Answer 20

Phase 1 Oliguric / uraemic phase
phase 2 diuretic phase
phase 3 recovery phase

Question 21

what is the oliguric phase of kidney failure?

Answer 21

Lasts 7-14 days
characterised by reduced blood flow
reduced urine output
increase plasma urea + creatine
metabolic acidosis
fluid overload

Question 22

What is the diuretic phase of kidney failure?

Answer 22

7-14 days
increase BP
Increase in GFR
diuresis resulting in electrolyte imbalance.

Question 23

What is the recovery phase of acute kidney failure?

Answer 23

Process of normal renal function returning, normal BUN, creatinine and urine output 1-2L day.

Question 24

What are some clinical manifestations of ARF?

Answer 24

oedema
weight gain
Oliguria
drowsiness / tiredness
SOB
loss of appetite
vomiting
confusion
fever

Question 25

What are the causes of prerenal kidney failure?

Answer 25

decrease blood flow to the kidney - hypotension, blood fluid / loss, pre-clampsia

Question 26

What are the causes of renal / interenal / intrinsic KF?

Answer 26

actual damage in the kidneys

Question 27

What are the causes of post renal kidney failure?

Answer 27

obstructing of urinary tract, bladder / prostate cancer
kidney stones
nerve damage involving bladder

Question 28

What signs would indicate uremia?

Answer 28

Build up of waste products in the blood can cause itching, gout flare ups, ammonia breath and food to taste like metal.

Question 29

What would happen if the kidneys cannot remove adequate fluid from the body?

Answer 29

Fluid would build up in the extremities and sometimes give the face a puffy appearance.

Question 30

What medical management would be initiated for kidney stones?

Answer 30

Analgesia
IV fluids
diuretics
antispasmodics
ABX
lithotripsy - ultra sounds which bust the stone

Question 31

What pH range predisposes kidney to stone formation?

Answer 31

abnormally high or low.

Question 32

What is GFR?

Answer 32

The glomerular filtration rate, which is the rate at which the glomerulus filters the blood mL/min

Question 33

What would you expect to see on a CBC for pyelonephritis?

Answer 33

Increase leukocytes.
Pylonephritis is an upper urinary tract infection of the renal pelvis.