renal

Question 1

what is the functional part of the kidney?

Answer 1

the nephron

Question 2

what are the parts of the nephron?

Answer 2

bowman's capsule
proximal tubule
loop of henle
distal tubule 
collecting duct (shared)

Question 3

how may nephrons are there per kidney?

Answer 3

1.2 million

Question 4

what are the three types of nephrons?

Answer 4

superficial cortical nephrons
midcortical nephrons
juxtamedullary nephrons

Question 5

what are some functions of the kidneys

Answer 5

excrete metabolic wastes
regulate acid-base balance
regulate water-salt balance
secrete hormones

Question 6

what is the flow rate of fluid through the kidney?

Answer 6

125 ml/min

Question 7

what causes an increase in glomerular filtration rate GFR) due to proteinuria?

Answer 7

larger/damaged fenestrations

Question 8

what causes an increase in GFR due o decreased blood oncotic pressure?

Answer 8

water loading and liver failure

Question 9

what causes an increase in GFR due to increased glomerular capillary pressure?

Answer 9

hypertension

Question 10

what causes a decrease in GFR due to increased blood oncotic pressure?

Answer 10

severe dehydration

Question 11

what causes a decrease in GFR due to increased pressure in bowman’s capsule?

Answer 11

kidney stone

prostate hypertrophy

Question 12

what casues a decrease in GFR due to decreased glomerular capillary pressure?

Answer 12

hypotension

Question 13

what causes a decrease in GFR due to scarring and inflammation?

Answer 13

infection

Question 14

what are some values used to estimate GFR?

Answer 14

insulin clearance
creatinine clearance
plasma creatinine concentration
blood urea nitrogen (BUN)

Question 15

renal clearance

Answer 15

the amount of plasma that is cleared of a substance by the kidney per unit of time
used to estimate of GFR

Question 16

why is clearance very useful?

Answer 16

diagnose health of the kidneys

calculate how a drug is handled by the kidneys and thus he dosage and time course of administration of the drug

Question 17

why is creatine clearance an over estimation of GFR?

Answer 17

because some of it is secreted back into the urine. It doesnt all go into the body

Question 18

which is more accurate insulin clearance or creatinine clearance?

Answer 18

insulin clearance

Question 19

what are the criteria for clearance to equal GFR?

Answer 19

must be freely filtered at glomerulus

cannot be reabsorbed from the nephron or secreted into the nephron

Question 20

excretion rate equals

Answer 20

filtration rate - reabsorption rate + secretion rate

Question 21

filtration rate

Answer 21

the total rate of fluid filtration from the blood into bowman’s space

Question 22

reabsorption rate

Answer 22

the rate of movement of a substance from the urine to the blood

Question 23

secretion rate

Answer 23

the rate a substance moves from the blood to the urine

Question 24

the glomerular membrane serves as a sieve to

Answer 24

keep larger molecules in the blood but allow small molecules to enter the urine

Question 25

what regulates blood volume and serum osmolarity

Answer 25

ADH | RAAS

Question 26

ADH

Answer 26

inserts aquaporins into the wall of the collecting duct. water is then reabsorbed with ion reabsorption

Question 27

Urinary tract infection

Answer 27

Inflammation of the urinary epithelium | -invasion and colonization by pathogen within the urinary tract

Question 28

complicated UTI

Answer 28

patient has other health problems

Question 29

uncomplicated UTI

Answer 29

patient is otherwise healthy

Question 30

persistent UTI

Answer 30

stays infected even after antimicrobial therapy for greater than 3 days

Question 31

what are the causes of UTIs?

Answer 31

``` poor hygiene sexual activity catheters (most common) Diabetes mellitus neurogenic bladder urinary tract obstruction pregnancy ```

Question 32

testing for a UTI there is

Answer 32

greater than 100,000 bacteria/ml of fresh urine

Question 33

cystitis

Answer 33

bladder infection

Question 34

what are manifestations of cystitis?

Answer 34

frequent painful urgen urine lower abdominal pain

Question 35

how do you treat cystitus

Answer 35

antimicrobial therapy | increased fluid intake so that you urinate more and flush it out

Question 36

pyelonephritis

Answer 36

kidney infection

Question 37

clinical pyelonephritis

Answer 37

``` fever chills frequent and painful urination tenderness in the back bacteria in urine white blood cell casts biopsy reveals scarring and tissue destruction in chronic disease repeated episodes can cause kidney failure and high urine flow ```

Question 38

how do you treat pyelonephritis

Answer 38

antibiotics or anti-fungal agents remove urinary obstruction if present if drug toxicity, stop taking the drug

Question 39

dyssynergia

Answer 39

discoordination of bladder contraction and external sphincter relaxation

Question 40

which muscle is in charge of bladder contraction

Answer 40

trusor

Question 41

neurogenic bladder

Answer 41

damage to nervous control of bladder and urination

Question 42

detrusor hyperreflexia | lesion above C2

Answer 42

bladder constantly contracting with functional sphincters. they will feel like they need to go all the time.

Question 43

detrusor hyperreflexia with vesicophincter dyssynergia lesion below S1

Answer 43

bladder constantly contracting without functional sphincters. might not have control over muscle

Question 44

acontractile detrusor with or without urethral sphincter incompetence

Answer 44

bladder does not contract and may dysfunctional sphincters. it wont contract so they wont really be able to go. they feel like they need to go but they can't

Question 45

A patient has neurogenic detrusor overactivity. Which of the following symptoms are they most likely to have?

Answer 45

urinary urgency