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Pathology > Renal > Flashcards

Renal Flashcards

1
Q

Where are the kidneys located?

A

Posterior abdominal wall

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2
Q

What is the function of the kidneys?

A

Filters the blood and excrete excess water and waste products in the form of urine

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3
Q

What is reabsorbed in selective reabsorption?

A

Sodium, amino acids and glucose are reabsorbed from the filtrate into the blood.

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4
Q

How many nephrons does a healthy adult have in each kidney?

A

0.8 to 1.5 million

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5
Q

What do the kidneys eliminate?

A

Drugs, water and H+ ions

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6
Q

What do the kidneys retain?

A

Plasma proteins and blood cells

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7
Q

What do the kidneys secrete?

A

Distal convoluted tubules
H+ and Ammonia

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8
Q

What is reabsorbed by the kidneys?

A

Distal convoluted tubules
Sodium
Chloride
Water
biocarbonate (HCO3)
glucose
organic substrate

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9
Q

Name all the renal function tests.

A

Blood urea
Creatinine
Proteinuria
Albumin creatinine ratio
Serum electrolyte
Blood in the urine
Glomerular filtration rate (GFR)

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10
Q

Renal function tests - blood urea

A

normal blood level = 7-21 mg/dl

raised in renal failure

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11
Q

Renal function tests - creatinine

A

normal blood level = 0.6 to 1.2 mg/dl

Levels are increased when there is reduced glomerular filtration

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12
Q

Renal function tests - Proteinuria

A

Normally protein is not found in urine when a routine dipstick test is performed.
Albumin presence is a sign of renal failure

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13
Q

Renal function tests - albumin creatinine ratio

A

200mg/g of creatinine

Greater the ratio, more albumin in the urine

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14
Q

Renal function tests - serum electrolyte

A

Abnormal levels may be due to kidney problems

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15
Q

What is blood in the urine a sign of?

A

Renal disease

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16
Q

Renal function tests - GFR

A

The GFR test measures how well your kidneys are filtering the blood.

Normal range - 90-120 mL/min/1.74 m2

Older people will have lower than normal GFR levels - GFR decreases with age
Levels below 60 for 3 or more months are a sign of chronic kidney disease

A GFR lower than 15 is a sign of kidney failure

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17
Q

What is the Normal Urinary Output for an Adult?

A

400 to 2,000 mL of urine daily.

18
Q

What are the types of acute renal failure?

A

Prerenal
Intrarenal
postrenal

19
Q

Prerenal failure

A

A sudden and severe drop in blood pressure or interruption of blood flow to the kidneys from severe injury/illness

20
Q

Intrarenal failure

A

Direct damage to the kidneys by inflammation, toxins, drugs infection or reduced blood supply

21
Q

Postrenal failure

A

sudden obstruction of urine flow due to enlarged prostate, kidney stones, bladder tumor or injury

22
Q

Oliguria

A

Excretion of less than 300 ml of urine/day

23
Q

Uremia

A

Urea, creatinine, and other waste products are retained in the blood, along with symptoms such as loss of appetite, nausea, vomiting , pericarditis. Symptoms like lethargy, confusion, coma indicate a progression to the final stages of uremia

24
Q

Dysuria

A

Pain, burning, difficulty, or discomfort related to urination. Causes include stone and/or infection in the urinary tract

25
Q

Renal colic

A

Severe pain that can present suddenly and without warning.
It is usually caused by stones in the kidney, renal pelvis or ureter. The pain is caused by dilatation, stretching and spasm of the ureter

26
Q

Oedema

A

It is an abnormal accumulation of fluid beneath the skin or in one or more cavities of the body.

27
Q

What are the factors contributing to oedema?

A

increased hydrostatic pressure of blood

reduced oncotic pressure of blood

increased blood vessel wall permeability as in inflammation.

obstruction of fluid clearance via the lymphatics

28
Q

Azotemia

A

abnormally high levels of nitrogen-containing compounds, such as urea and creatinine.

29
Q

Prerenal azotemia

A

caused by a decrease in cardiac output, resulting in inadequate blood supply to the kidneys.

30
Q

Renal azotemia (acute renal failure)

A

It is intrinsic disease of the kidney, generally the result of renal parenchymal damage.

31
Q

Postrenal azotemia

A

Blockage of urine flow in an area below the kidneys results in postrenal azotemia.

32
Q

Polyuria

A

Persistent large increase in urine output. It may be due to excess intake of water, or increased excretion of solute, as in hyperglycemia and glycosuria or defective renal concentration ability.

33
Q

Proteinuria

A

It is the most common sign of renal disease. Most reagent strips can detect 20mg/dl or more in urine. These tests primarily detect albumin and are insensitive to globulin.

34
Q

Haematuria

A

It is the presence of red blood cells (erythrocytes) in the urine.
it can be a sign that there is a kidney stone or a tumor in the urinary tract.

35
Q

Pathology of glomerular diseases

A
  1. Cellular proliferation of:
    - visceral epithelial
    - endothelium
    - parietal epithelium
    - mesangial cells
  2. Deposition of immune complexes:
    - subepithelial
    - subendothelium
    - mesangial
36
Q

What are the diseases of the glomerulus?

A

Nephrotic syndrome
Acute nephritic syndrome
Mixed

37
Q

Nephritic syndrome
- manifestations and pathology

A

Manifestations:
Hematuria
Variable proteinuria
Impaired renal function
Hypertension
Edema

Pathology: Endothelial damage and inflammation of glomerulus

38
Q

Nephrotic syndrome

A

Insidious onset

Manifestations:
1) Massive proteinuria
2) Hypoalbuminemia
3) Generalized edema
4) Hyperlipidemia

Pathology:
1) Shortening and fusion of foot processes of podocytes
2) damage to basement membrane due to accumulation of membrane like material, as in diabetes mellitus

39
Q

Nephrotic syndrome

A

Insidious onset

Manifestations:
1) Massive proteinuria
2) Hypoalbuminemia
3) Generalized edema
4) Hyperlipidemia

Pathology:
1) Shortening and fusion of foot processes of podocytes
2) damage to basement membrane due to accumulation of membrane like material, as in diabetes mellitus

40
Q

Focal Segmental Glomerulosclerosis

A

Focal—only some of the glomeruli are involved

segmental—only part of an entire glomerulus is involved

glomerulosclerosis—refers to scarring of the glomerulus

41
Q

What is minimum change disease?

A

Pathology (11 decks)

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