Renal Function

Question 1

Kidney function

Answer 1

Excretion of metabolic waste products 
Regulation of water and electrolyte balance 
Regulation of acid-base balance 
Regulation of arterial blood pressure 
Secretion of hormones

Question 2

Patho of the kidney

Answer 2

Filtration
Reabsorption
Secretion
Excretion

Question 3

Filtration

Answer 3

Diffusion of plasma molecules across the glomerular membrane. 20% of plasma in glomulerus is filtered into globular capsule

Question 4

Reabsorption

Answer 4

Diffusion or active transport of molecules in the urine filtrate from the renal tubules to the peritubular capillaries. Molecules reabsorbed include sodium, water, and glucose

Question 5

Secretion

Answer 5

Active transport of plasma molecules to the filtrate in the renal tubules. Molecules secreted include potassium and hydrogen

Question 6

Excretion

Answer 6

Any filtered molecule that is not reabsorbed + the secreted molecules are excreted in the urine

Question 7

Clinical measures of renal function

Answer 7

Volume of fluid filtered (per minute) by the glomeruli in the kidneys

Question 8

Plasma creating

Answer 8

Normally 110% of filtered creatinine is excreted, therefore decreased GFR results in an increased in plasma creatinine levels

Question 9

Creatinine clearance

Answer 9

Can be calculated based on 24 hour urine collections or estimated using urine and plasma creatinine levels

Question 10

Plasma blood urea nitrogen (BUN)

Answer 10

A reflection of plasma urea levels

Decreased GFR results in an increased in plasma BUN levels

Question 11

Kidney stones

Answer 11

Aggregarates of crystals, protein or other substance as in the urinary tract. Also known as renal calculus, urinary stones, or urolithiasis

Question 12

Patho of kidney stones

Answer 12

Supersaturation of calcium in urine filtrate leads to precipitation of small calcium based crystals.
Once the Indus has formed, the supersaturated urine causes larger stones

Question 13

Consequences of kidney stones

Answer 13

Urinary tract obstruction 
Acute pain
Hematuria 
Hydronophrosis 
Chronic kidney disease

Question 14

UTI

Answer 14

Inflammation of the bladder caused by infection, usually bacterial

Question 15

Patho of a UTI

Answer 15

Bacterial contamination
Retrograde movement of bacteria from urethra to bladder
Inflammation leads to cystitis

Question 16

Clinical manifestations of UTI

Answer 16

Asymptomatic 
Dysuria 
Frequency 
Suprapubic pain 
Fever
Urinalysis

Question 17

Complications of UTI

Answer 17

Acute pyelonephritis: upper ureter infection

Bacterium and sepsis: bacteria migrate into the bloodstream and cause a systemic inflammatory response

Question 18

Acute glomerulonephritis

Answer 18

Acute inflammation of the globular membrane caused by an autoimmune response to untreated group A beta-hemolytic streptococcal infection

Question 19

Primary etiology of Acute Glom

Answer 19

Untreated group A beta-hemolytic streptococcal infections

Can also lead to heart valve damage

Question 20

Patho of Acute glom

Answer 20

Antibodies against strep cross react with the glomerular endothelial cells
Inflammatory response causes damage to the glomerular endothelium as neutrophils try to phagocytosis the immune complexes and antibodies

Question 21

Clinical consequences and urinalysis findings in acute glom

Answer 21

Acute hemturia
Prteinuria
Oliguria

Question 22

Nephrotic syndrome

Answer 22

Excretion of 3 g or more or protein urine output

Question 23

Causes of NS

Answer 23

Glomerulonephritis 
Genetic mutations that cause alterations in the structure of the glomerular membrane 
Systemic diseases 
Drugs 
Infections

Question 24

Patho of nephrotic syndrome

Answer 24

Increased glomerular membrane permeability to protein leads to proteinuria
Hypoalbuminemia: results in decreased plasma oncotic pressure which can cause systemic edema

Question 25

Acute renal failure

Answer 25

Abrupt reduction in renal function usually associated with oliguria

Question 26

Prerenal acute failure

Answer 26

Caused by impaired renal blood flow Causes: obstruction renal artery, hypotension PathoL decreased glomerular pressures leads to decreased GFR and urine output

Question 27

Internal acute failure

Answer 27

Renal failure caused by direct injury to the glomerulus and renal tubules Cause: acute glomerulonephritis , Malignant hypertension, Infection Patho: ischemia or other direct injury to glomerulus and renal tubules

Question 28

Postrenal acute failure

Answer 28

Urinary tract obstruction that affects kidneys bilaterally Cause: kidney stones, bladder outlet obstruction Patho: obstruction causes increased pressures in glomerular capsule and back flow of urine filtrate

Question 29

Clinical consequences of acute renal failure

Answer 29

``` Oliguria Elevated creatinine, and BUN levels Elevated plasma K Metabolic acidosis Fluid overload and hypertension ```

Question 30

Chronic renal failure

Answer 30

Progressive and loss of renal function Cause: diabetes M, atherosclerosis of renal arteries, diabetic nephropathy, hypertension Patho: increase creatinine Anemia, hyperkalemia, acidosis, oliguria