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Pathophys - Nat > Renal > Flashcards

Renal Flashcards

1
Q

part of nephron

A

renal corpuscle (Bowman’s capsule and glomerulus)
proximal tubule
loop of Henle (descending and ascending portions)
distal tubule
feed into collecting ducts

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2
Q

metabolites filtered in glomerulus

A

creatinine
uric acid
urea

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3
Q

increased serum NaCl detected by JGA will lead to:

A

increased GFR and vasoconstriction to retain water

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4
Q

normal GFR

A

120-140 mL/min, 180 L/day

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5
Q

ADH effects on collecting ducts and urine

A

increases permeability of collecting ducts, which allows water to escape back into interstitium rather than being excreted (retains water)

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6
Q

aldosterone function

A

increases Na+ and K+ exchange in distal tubule of nephron: causes Na+ retention (and therefore, water retention), and K+ excretion

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7
Q

presence of protein in urine (above 150 mg/day) indicates:

A

increased glomerular permeability; always pathological!

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8
Q

normal urine specific gravity

A

1.020

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9
Q

normal urine pH

A

4.5-8.0

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10
Q

pH is always lowest at what time of day?

A

through the night, leading to lowest urine pH at first voidance in the morning

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11
Q

normal plasma creatinine

A

0.7-1.5 mg/100 mL

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12
Q

normal BUN

A

10-20 mg/dL

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13
Q

renal dysfunction/disease causes ___ in creatinine and BUN

A

increase

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14
Q

azotemia def

A

renal insufficiency –> nitrogenous substrates increased in the blood

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15
Q

morphologic examination of renal function

A

urine microscopy; urine bacteriologic exam; radiologic kidney exams

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16
Q

presence of cellular casts in urine indicates:

A

pyelonephritis

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17
Q

presence of red blood cells indicates:

A

glomerulonephritis

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18
Q

presence of fatty casts and/or protein in urine indicates:

A

nephrotic syndrome

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19
Q

lead nephropathy pathophysiology

A

causes interstitial nephritis –> inflammation impairs nephron function –> slow and progressive renal failure

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20
Q

stage I renal failure characteristics

A

decreased renal reserve, asymptomatic

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21
Q

stage II renal failure characteristics

A

renal insufficiency, azotemia; occurs after 75% of nephrons are destroyed/nonfunctional

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22
Q

stage III renal failure characteristics

A

end stage failure; occurs after 90% of nephrons are destroyed/nonfunctional; aka uremic syndrome

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23
Q

most common cause of stage III/end stage renal failure

A

diabetic nephropathy

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24
Q

(creatinine/BUN) is better indicator of renal function; why?

A

creatinine; because BUN is affected by dietary intake and so may not accurately represent extent of renal insufficiency

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25
Q

acute oliguric renal failure urine output

A

less than 400 mL/day

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26
Q

early symptoms of kidney disease are ___ and ___, caused by ___

A

polyuria; nocturia; inability of kidneys to concentrate urine, aka letting out a whole lot of water

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27
Q

uremia symptoms present when GFR falls to ___% of normal

A

5-10%

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28
Q

80% of UTIs are caused by

A

E. coli

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29
Q

predisposing factors for UTIs

A

urinary calculi; neurogenic bladder; bladder instrumentation (i.e. foley cath); prostatic hypertrophy

30
Q

treatment of acute pyelonephritis

A

antibiotics – very effective!

31
Q

glomerulonephritis is usually (bilateral/unilateral)

A

bilateral

32
Q

patho of acute glomerulonephritis

A

usually follows b-hemolytic strep infection; antigen-antibody complexes form in glom basement membrane; phagocytes and lysosomes attack basement membrane directly

33
Q

rapidly progressive glomerulonephritis prognosis

A

<2 years

34
Q

patho of chronic glomerulonephritis

A

similar to acute, but due to a long-standing disease (i.e. diabetes); progresses gradually over time

35
Q

hypertensive nephrosclerosis etio

A

arteriosclerosis of afferent arterioles (entering glomerulus) due to long-standing hypertension

36
Q

nephritis resulting from SLE has similar clinical manifestations of ___

A

acute glomerulonephritis

37
Q

gout etio

A

increased uric acid in plasma; deposits and crystallizes in joints and kidneys

38
Q

uric acid calculi predisposing factors

A

gout

chemotherapy

39
Q

> 90% of kidney stones contain ___

A

calcium

40
Q

nephrotoxic substances

A

glycols
spot remover (inhalation) and beer
mercury bichloride
IV contrast media (in pts with preexisting renal insufficiency)

41
Q 
renal insufficiency (stage 2) effects:
GFR?
urine frequency?
acid/base?
sodium?
potassium?
toxins/nitrogenous substrates?
CV function?
respiratory changes?
hematocrit?
A 
GFR - slightly decreased
urine frequency - polyuria/nocturia
acid/base - mild acidosis
sodium - decrease
potassium - decrease
toxins/nitrogenous substrates - increase
CV function - none
respiratory changes - mild tachypnea; compensatory response to mild acidosis
hematocrit - minimal change
42
Q 
renal failure (stage 3) effects:
GFR?
urine frequency?
acid/base?
sodium?
potassium?
toxins/nitrogenous substrates?
CV function?
respiratory changes?
hematocrit?
A 
GFR - dramatically decreased (5-10% of normal)
urine frequency - oliguria/anuria
acid/base - moderate to severe acidosis
sodium - increase
potassium - increase
toxins/nitrogenous substrates - increase
CV function - HTN and arrhythmias
respiratory changes - Kussmaul respirations
hematocrit - decrease d/t diminished EPO
43
Q

example of prerenal patho

A

CV disease: HTN, heart failure, atherosclerosis

44
Q

example of renal patho

A

any disease that impacts the nephron and interstitial space itself: nephrotoxicity, glomerulonephritis

45
Q

example of postrenal patho

A

any disease of urinary conduction tubes: calculi, infection, BPH

46
Q

when a pt presents with anuria, start by doing assessments for ___ problems first

A

postrenal - obstructions, infections, etc

47
Q

post obstructive diuresis def

A

after relief of obstruction, kidneys kick into diuresis and may cause hypovolemia

48
Q

treat noninfective cystitis with:

A

muscle relaxants, anticholinergics, antiparasympathetics

49
Q

noninfective pyelonephritis can be caused by:

A

radiation, chronic inflammation, chronic illness, infection elsewhere

50
Q

glomerulonephritis patho

A
  1. increased glomerular permeability –> proteinuria, hematuria
  2. glomerular injury by immune complexes –> decreased GFR, oliguria
51
Q

long-term manifestations of glomerulonephritis

A

HTN, edema, pleural effusion, ascites, electrolyte imbalances, CV sequelae

52
Q

treatment goals of glomerulonephritis

A

stop inflammation, treat underlying inflammatory disease, restore fluid/electrolyte balance

53
Q

two causes of acute tubular necrosis

A

ischemic, nephrotoxic

54
Q

acute tubular necrosis def

A

dying tubular cells of nephrons, inability to concentrate urine

55
Q

kidney disease 2 major problems

A
  1. unable to concentrate urine, for whatever reason – polyuria and nocturia, plus all the fluid/electrolyte and CV problems that go with it
  2. decreased GFR – result of RAAS kicking in to compensate for #1, or direct injury to glomeruli
56
Q

short-term manifestations of glomerulonephritis

A

hematuria, proteinuria, decreased GFR, oliguria

57
Q

most important treatment goal of managing acute tubular necrosis is:

A

maintaining fluid/electrolyte balance

58
Q

(men/women) are more susceptible to renal cell carcinoma

A

men

59
Q

renal cancer has (known/unknown) etiology

A

unknown

60
Q

most common renal vascular anomaly

A

multiple renal arteries

61
Q

a person on a low protein diet is unable to concentrate urine as well as a person on a high protein diet because:

A

decreased production of urea

62
Q

factors that contribute to the development of congestive heart failure in chronic renal failure include:

A

anemia, sodium retention, HTN

63
Q

major bladder cancer risk factor:

A

smoking

64
Q

causes of hemolytic uremic syndrome

A

E. coli, shigella, drugs, tumors

65
Q

renal cyst vs renal neoplasm

A

fluid densities are different

66
Q

horseshoe kidneys are congenital anomalies associated with what disorder?

A

trisomies

67
Q

true or false: cause of polycystic kidney disease is unknown

A

false

68
Q

kidneys become (smaller/larger) in end-stage renal disease

A

smaller

69
Q

Wilms tumor is the result of:

A

genetic defect on chromosome 11

70
Q

common side effects of dialysis

A

hyperkalemia, hypotension, muscle cramps

Pathophys - Nat (6 decks)

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