Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PNP #2 > RENAL > Flashcards

RENAL Flashcards

1
Q

Urinary System: Review

A

Removes metabolic wastes
Removes hormones from the body
Removes drugs other foreign material from body
Regulates water, electrolyte, acid-base balance
Secretes erythropoietin
Activates vitamin D
Regulate blood pressure through the renin-angiotensin-aldosterone system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Each kidney has over a million nephrons.

A

Renal corpuscles:
Glomerulus
Bowman capsule

Renal tubules:
Proximal convoluted tubules
Loop of Henle
Distal convoluted tubules
Collecting duct
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Formation of Urine

A

Filtration
In renal corpuscles
Large volume of fluid passes from glomerular capillaries into the tubule (Bowman capsule)
Wastes, nutrients, electrolytes, other dissolved substances
Cells and protein remain in the blood.

Reabsorption
Reabsorption of essential nutrients, water, and electrolytes into the peritubular capillaries
Control of pH and electrolytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Proximal convoluted tubules

A

Most of water reabsorption
Glucose reabsorption
Nutrients and electrolytes to maintain homeostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Antidiuretic hormone (ADH)

A

Secreted by the posterior pituitary

Reabsorption of water in distal convoluted tubules and collecting ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Aldosterone

A

Secreted by adrenal cortex

Sodium reabsorption in exchange for potassium or hydrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Atrial natriuretic hormone

A

Hormone from the heart

Reduces sodium and fluid reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Afferent and efferent arterioles of the glomerulus

A

Autoregulation and hormones control pressure in the glomerular capillaries by:

Vasoconstriction of afferent arteriole
Decreased glomerular pressure—decreased filtrate

Dilation of afferent arteriole
Increased pressure in glomerulus—increased filtrate

Vasoconstriction of efferent arteriole
Increased pressure in glomerulus—increased filtrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Control of arteriolar constriction by three

factors:

A

Autoregulation
Local adjustment in diameter of arterioles
Made in response to changes in blood flow in kidneys

Sympathetic nervous system
Increases vasoconstriction in both arterioles

Renin
Secreted by juxtaglomerular cells when blood flow to afferent arteriole is reduced
Renin-angiotensin mechanism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Incontinence

A

Loss of voluntary control of the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Enuresis

A

Involuntary urination by child age older than 4 years

Often related to developmental delay, sleep pattern, psychosocial aspect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Stress incontinence (more common in women)

A

Increased intra-abdominal pressure forces urine through sphincter.
Coughing, lifting, laughing
Multiple pregnancies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Overflow incontinence

A

Incompetent bladder sphincter

Older adults
Weakened detrusor muscle may prevent complete emptying of bladder—frequency and incontinence

Spinal cord injuries or brain damage
Neurogenic bladder—may be spastic or flaccid
Interference with CNS and ANS voluntary controls of the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Retention

A

Inability to empty bladder
May be accompanied by overflow incontinence
Spinal cord injury at sacral level blocks micturition reflex
May follow anesthesia (general or spinal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Straw colored with mild odor

A

Normal urine, specific gravity 1.010 to 1.050

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Cloudy

A

May indicate the presence of large amounts of protein, blood, bacteria, and pus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Dark color

A

May indicate hematuria, excessive bilirubin, or highly concentrated urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Unpleasant or unusual odor

A

Infection or result from certain dietary components or medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Urinalysis: Urinary Infection

A

Heavy purulence and presence of gram-negative and gram-positive organisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Urinalysis: Abnormal Constituents of Urine

A

1.Blood (hematuria)-
—Small amounts:
Infection, inflammation, or tumors in urinary tract
—Large amounts:
Increased glomerular permeability or hemorrhage

2.Elevated protein level (proteinuria, albuminuria)
Leakage of albumin or mixed plasma proteins into filtrate

3.Bacteria (bacteriuria)
Infection in urinary tract

4.Urinary casts
Indicate inflammation of kidney tubules

5.Specific gravity
Indicates ability of tubules to concentrate urine
Low specific gravity—dilute urine (with normal hydration)
High specific gravity—concentrated urine (with normal hydration)
Related to renal failure

6.Glucose and ketones
Found when diabetes mellitus is not well controlled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Blood Tests

A

• Elevated serum urea and serum creatinine levels
Indicate failure to excrete nitrogen wastes
Caused by decreased GFR

• Metabolic acidosis*
Indicates decreased GFR
Failure of tubules to control acid-base balance

• Anemia*
Indicates decreased erythropoietin secretion and/or bone marrow depression
*In the absence of other problems.

• Electrolytes
Depend on related fluid balance

• Antibody level
Antistreptolysin O or antistreptokinase titers
Used for diagnosis of poststreptococcal glomerulonephritis

• Elevated renin levels
Indicate kidney as a cause of hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Radiologic tests

A

Radionuclide imaging, angiography, ultrasound, CT, MRI, intravenous pyelography

Used to visualize structures and possible abnormalities, flow patterns, and filtration rates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Clearance tests

A

Examples: creatinine or inulin clearance

Used to assess GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Cystoscopy

A

Visualizes lower urinary tract

May be used to perform biopsy or remove kidney stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Biopsy
Used to acquire tissue specimens
26
Diuretic DrUGS
• Used to remove excess sodium ions and water from the body o Increased excretion of water though the kidneys o Reduces fluid volume in tissues and blood o Prescribed for many disorders ------ Renal disease, hypertension, edema, congestive heart failure, liver disease, pulmonary edema o Several different mechanisms to increase urine volume based on specific drug o Some drugs are potassium-wasting and some are potassium-sparing.
27
Hemodialysis
Patient’s blood moves from an implanted shunt or catheter in an artery to machine Exchange of wastes, fluids, and electrolytes Semipermeable membrane between blood and dialysis fluid (dialysate) After exchange is completed, blood returned to patient’s vein Usually required three times a week Potential complications!!! Shunt may become infected. Blood clots may form. Blood vessels involved in shunt may become sclerosed or damaged. Patient has an increased risk of infection with hepatitis B, hepatitis C, or HIV if Standard
28
Peritoneal Dialysis
Catheter with entry and exit points is implanted into the peritoneal cavity Takes more time than hemodialysis Major complication!!!! Infection resulting in peritonitis
29
With both types of dialysis
Prophylactic antibiotics with either form of dialysis Any additional problem occurring in patient such as infection may alter dialysis requirements Caution is required with many drugs because toxic level buildup can occur.
30
Urinary Tract Infections (UTIs)
Common causative organism Escherichia coli More common in women because of: Shortness of urethra Proximity to anus Other common predisposing factors: Incontinence Retention of urine Direct contamination with fecal material
31
Cystitis and Urethritis
• Bladder wall (cystitis) and urethra (urethritis) are inflamed. o Hyperactive bladder and reduced capacity • Pain is common in pelvic area • Dysuria, urgency, frequency, and nocturia • Systemic signs may be present. o Fever, malaise, nausea, leukocytosis • Urine often cloudy, with unusual odor • Urinalysis indicates bacteriuria, pyuria, microscopic hematuria
32
Pyelonephritis
One or both kidneys involved From ureter into kidney Purulent exudate fills pelvis and calyces
33
Pyelonephritis S&S
Signs of cystitis plus pain associated with renal disease Dull, aching pain in lower back or flank area Systemic signs include high temperature Urinalysis Similar to cystitis Urinary casts are present. Reflection of renal tubule involvement Treatment with antibacterials
34
Inflammatory Disorders: Glomerulonephritis
Presence of antistreptococcal (ASO) antibodies IN RESPONSE- Inflammatory response in glomeruli Increased capillary permeability—leakage of some protein and large numbers of erythrocytes
35
Disorders—Glomerulonephritis MANIS
``` • Urine becomes dark and cloudy • Facial and periorbital edema—initially o General edema follows • Elevated blood pressure o Caused by increased renin secretion and decreased GFR • Flank or back pain o Edema and stretching of renal capsule • General signs of inflammation • Decreased urine output ```
36
Inflammatory Disorders: Glomerulonephritis | TESTS
Blood tests Elevated serum urea and creatinine levels Elevation of anti-DNase B, streptococcal antibodies, antistreptolysin, antistreptokinase Complement levels decreased (use in renal inflammation) Metabolic acidosis Urinalysis Proteinuria, hematuria, erythrocyte casts No evidence of infection
37
GLOME TREATMENT
``` Sodium restriction possible Protein and fluid intake decreased in severe cases Drug treatment: 1.Glucocorticoids to reduce inflammation 2.Antihypertensives ```
38
Urolithiasis (Calculi)
Can develop anywhere in urinary tract Stones may be small or very large. Tend to form with: Excessive amounts of solutes in filtrate Insufficient fluid intake—major factor for calculi formation Urinary tract infection - Calculi composed of calcium salts, High urine calcium levels, Form readily with highly alkaline urine - Uric acid stones- Hyperuricemia, Gout, high-purine diets, cancer chemotherapy, Especially with acidic urine - Struvite and cystine stones - Stone formation depends on predisposing factor.
39
Urolithiasis (Calculi) MANIS
Manifestations only occur with obstruction of urine flow. May lead to infection Hydronephrosis with dilation of calyces If located in kidney or ureter and atrophy of renal tissue Stones in kidney or bladder often asymptomatic - Frequent infections may lead to investigation. - Flank pain possible caused by distention of renal capsule Renal colic caused by obstruction of the ureter - Intense spasms of pain in flank area,Radiating into groin area, Lasts until stone passes or is removed - Possible nausea and vomiting, cool moist skin, rapid pulse - Radiological examination confirms location of calculi.
40
Urolithiasis (Calculi) (Cont.) | TREATMENT
Small stones will be passed eventually. Extracorporeal shock wave lithotripsy (ESWL) Laser lithotripsy Drugs may be used to dissolve stones partially. Surgery
41
Urolithiasis (Calculi) (Cont.) | PREVENTION
Treatment of underlying condition Adjustment of urine pH through dietary modifications Consistent increased fluid intake
42
Hydronephrosis
Secondary problem caused by: Complication of calculi (Tumors, prostatic enlargement, Developmental abnormalities) Frequently asymptomatic in early stages Can be diagnosed with ultrasonography, radionucleotide imaging, CT, or renal scan If cause is not removed—chronic renal failure
43
Tumors: Renal Cell Carcinoma
arising from the tubule epithelium Tends to symptomatic in early stages Often has metastasized to liver, lung, bone, or central nervous system at time of diagnosis Treatment!!! is removal of kidney.
44
Tumors: Renal Cell Carcinoma | MANIS
Painless hematuria initially- Gross or microscopic Dull, aching flank pain Palpable mass Unexplained weight loss Anemia or erythrocytosis Paraneoplastic syndromes- Hypercalcemia or Cushing’s syndrome
45
Tumors: Bladder Cancer
Most bladder tumors are malignant and commonly arise from transitional epithelium of the bladder. !!!Diagnosed by urine cytology and biopsy
46
Tumors: Bladder Cancer MANIS
Early signs Hematuria, dysuria Infection common Tumor is invasive through wall to adjacent structures. Metastasizes to pelvic lymph nodes, liver, and bone
47
Predisposing factors | Tumors: Bladder Cancer
Working with chemicals in laboratories and industry Particularly aniline dyes, rubber, aluminum Cigarette smoking Recurrent infections Heavy intake of analgesics
48
Treatment | Tumors: Bladder Cancer
Surgical resection of tumor Chemotherapy and radiation Photoradiation successful in some early cases
49
Vascular Disorders: Nephrosclerosis
Thickening and hardening of the walls of arterioles and small arteries Narrowing of the blood vessel lumen Stimulation of renin Increased blood pressure ``` Treatment Antihypertensive agents Diuretics Beta blockers Sodium intake should be reduced. ```
50
Congenital Disorders
Vesicoureteral reflux Agenesis -Failure of one kidney to develop Hypoplasia -Failure to develop to normal size Ectopic kidney -Kidney and ureter displaced out of normal position “Horseshoe” kidney -Fusion of the two kidneys
51
Adult Polycystic Kidney
Autosomal dominant gene on chromosome 16 First manifestations usually around age 40 years Multiple cysts develop in both kidneys. Enlargement of kidneys
52
Wilms’ Tumor
Most common tumor in children | Defects in tumor suppressor genes on chromosome 11
53
Acute Renal Failure | CAUSES
Acute bilateral kidney diseases Severe, prolonged circulatory shock or heart failure Nephrotoxins (Drugs, chemicals, or toxins) Mechanical obstruction (occasionally) Calculi, blood clots, tumors (Block urine flow beyond kidneys)
54
Acute Renal Failure (Cont.)
Sudden onset Blood tests -Elevated serum urea nitrogen and creatinine levels Metabolic acidosis and hyperkalemia Treatment -Identify and remove or treat primary problem. To minimize risk of necrosis and permanent kidney damage -Dialysis To normalize body fluids and maintain homeostasis
55
Chronic Renal Failure
Gradual irreversible destruction of the kidneys over a long period of time Asymptomatic in early stages
56
Chronic Renal Failure: Stages
Decreased renal reserve - Decrease in GFR - Higher than normal serum creatinine levels - No apparent clinical symptoms Renal insufficiency - Decreased GFR to about 20% of normal - Significant retention of nitrogen wastes - Excretion of large volumes of dilute urine - Decreased erythropoiesis - Elevated blood pressure End-stage renal failure - Negligible GFR - Fluid, electrolytes, and wastes retained in body - Azotemia, anemia, and acidosis (three As) - All body systems affected - Marked oliguria or anuria - Regular dialysis or kidney transplantation To maintain patient’s life
57
Early signs OF CRF
Increased urinary output ``` General signs: Anorexia Nausea Anemia Fatigue Unintended weight loss Exercise intolerance ``` Bone marrow depression and impaired cell function Caused by increased wastes and altered blood chemistry Elevated blood pressure
58
Complete failure | OF CRF
``` • Oliguria • Dry, pruritic, hyperpigmented skin, easy bruising • Peripheral neuropathy • Impotence in men, menstrual irregularities in women • Encephalopathy • Congestive heart failure, dysrhythmias • Failure to activate vitamin D • Possible uremic frost on the skin • Systemic infections • ```
59
Diagnostic tests
Anemia, acidosis, and azotemia are the key indicators of chronic renal failure.
60
Treatment—all body systems are affected.
* Difficult to maintain homeostasis of fluids, electrolytes, and acid-base balance * Drugs to stimulate erythropoiesis * Drugs to treat cardiovascular problems * Intake of fluid, electrolytes, protein must be restricted * Dialysis or transplantation

PNP #2 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions