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ZZZ-Patho 2 > Week 9 and 10- Urinary System > Flashcards

Week 9 and 10- Urinary System Flashcards

1
Q

functional unit of the kidney

A

nephron

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2
Q

flow through the nephron

A

Proximal Convulted Tuble (PCT)

Descending limb of Henle (DLH)

Thin Ascending limb of Henle (tALH)

Thick ascending limb of Henle (TAL)

Distal Convoluted Tububle (DCT)

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3
Q

The _______- filters selected blood components through its three layers

A

glomerular filtration membrane

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4
Q

what components of blood are not filtered and shouldn’t be in urine

A

blood cells
plasma proteins

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5
Q

a portion of the distal convoluted tubule with specialized sodium- and chloride-sensing cells known as the

A

macula densa

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6
Q

The wall of the proximal convoluted tubule consists of one layer of cuboidal epithelial cells with a surface layer of microvilli (a brush border) that increases reabsorptive surface area

A

The wall of the proximal convoluted tubule consists of one layer of cuboidal epithelial cells with a surface layer of microvilli (a brush border) that increases reabsorptive surface area

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7
Q

only surface inside the nephron where the cells are covered with microvilli

A

wall of proximal convoluted tubule

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8
Q

composed of squamous cells, and is highly permeable to water but less permeable to ions. It has no active transport functions.

A

thin descending segment

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9
Q

permeable to ions but not to water.

A

thin ascending segement

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10
Q

actively transports ions into the interstitium and passes urine into the distal convoluted tubule

A

thick ascending

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11
Q

helps to regulate extracellular fluid volume and electrolyte homeostasis.

A

distal convoluted tubule

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12
Q

principal cells that reabsorb sodium and water and secrete potassium, and intercalated cells that secrete hydrogen and reabsorb potassium

A

in collecting duct

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13
Q

downward peristaltic activity propels urine into the

A

bladder

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14
Q

bag composed of a basket weave of smooth muscle fibers that forms the detrusor muscle and its smooth lining of transitional epithelium (uroepithelium)

A

bladder

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15
Q

which sphincter is composed of striated skeletal muscle and is under voluntary control

A

external

-internal is smooth muscle and not under volunartry control

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16
Q

he kidneys are highly vascular organs and receive about 20% to 25% of the cardiac
output,

A

he kidneys are highly vascular organs and receive about 20% to 25% of the cardiac
output,

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17
Q

provides the best estimate of functioning renal tissue.

A

GFR (glomerular filtration rate)

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18
Q

BUN stands for

A

Blood Urea Nitrogen

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19
Q

Because urea is filtered at the glomerulus, ________ levels increase as glomerular filtration drops

A

blood urea nitrogen (BUN)

-if GFR isn’t working properly, there will be more nitrogen

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20
Q

pyuria

A

WBC in urine
-sign of UTI

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21
Q

pain and/or burning, stinging, or itching of the urethra or urethral meatus with urination

A

dysuria

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22
Q

most common cause of urinary retention

A

bening prostatic hyperplasia (BPH)

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23
Q

Hematuria

A

blood in urine

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24
Q

painless vs painful hematuria

A

-Painless hematuria is classically associated with the underlying malignancies
-painful= UTI, stone

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25
Q

Persons who regularly consume an adequate volume of water and those who are physically active are at reduced risk for KD stones

A

Persons who regularly consume an adequate volume of water and those who are physically active are at reduced risk for KD stones

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26
Q

Most kidney stones are______ and are a risk factor for chronic kidney disease and an increased risk for myocardial infarction.

A

unilateral

27
Q

composition of most common kidney stones

A

calcium oxalate or phosphate (70% to 80%)

28
Q

what stone is large and fill the minor and major calyces.

A

staghorn calculi

29
Q

are of variable size and are located in the calyces, in the renal pelvis, or at different sites along the ureter

A

non-stagorn calculi

30
Q

Stones smaller than 5 mm have about a 50% chance of spontaneous passage, whereas stones that are 1 cm have almost no chance of spontaneous passage

A

Stones smaller than 5 mm have about a 50% chance of spontaneous passage, whereas stones that are 1 cm have almost no chance of spontaneous passage

31
Q

Clinical Manifestations of kidney stones

A

-renal colic (moderate to severe pain- hypochondriac)
-n/v
-hematuria (blood in urine)

32
Q

is an inflammation of the urinary epithelium usually caused by bacteria from gut flora.

A

UTI

33
Q

can a UTI occur anywhere in the tract

A

yes

34
Q

a pathogen’s ability to evade or overwhelm the host defense mechanisms and cause disease in a host

A

virulence

35
Q

Uropathic strains of Escherichia coli have type-1 pili. Type-1 pili have adhesins that allow them to bind to mucosal cellular receptors and enter uroepithelial cells

A

Uropathic strains of Escherichia coli have type-1 pili. Type-1 pili have adhesins that allow them to bind to mucosal cellular receptors and enter uroepithelial cells

36
Q

inflammation of the bladder and is the most common site of UTI.

A

acute cystitis

37
Q

most common microorganicsm of UTI

A

uropathic strains of E. coli (80% to 85%)

38
Q

Symptoms include frequency, urgency, dysuria (painful urination), and suprapubic and low back pain.

A

acute cystitis (bladder infection)

39
Q

Pyelonephritis

A

an infection of one or both upper urinary tracts (ureter, renal pelvis, and kidney interstitium).

40
Q

most common cause of pyelonephritis

A

Urinary obstruction and reflux of urine from the bladder (vesicoureteral reflux)
-most common in young women

41
Q

Acute Pyelonephritis sxs

A

-fever, chills, and flank or groin pain.
-frequency, dysuria, and costovertebral tenderness, may precede systemic signs and symptoms.
-CVA (costalvertebral angle) tenderness

42
Q

White blood cell casts (inflammation of the kidney) indicate pyelonephritis or cystitis?

A

pyelonephritis

43
Q

loss of bladder control, affects more females than males

A

urinary incontinence

44
Q

things that can help with incontinence

A

proper nutrition
avoidance of constipation
weight loss
physical activity

45
Q

help with control of detrusor muscle overactivity through the inhibition of M2 and M3 muscarinic (acetylcholine) receptors on the bladder.

A

Anticholinergic (Antimuscarinic) Drugs

46
Q

Contraindications to the use of anticholinergic agents include uncontrolled narrow-angle glaucoma.

A

Contraindications to the use of anticholinergic agents include uncontrolled narrow-angle glaucoma.

47
Q

Glomerulonephritis

A

inflammation of the glomeruls

48
Q

primary glomerular causes

A

including immunologic responses, ischemia, free radicals, drugs, toxins, vascular disorders, and infection.

49
Q

causes of secondary glomerular

A

injury as a consequence of systemic diseases, including diabetes mellitus, systemic lupus erythematosus, and, less commonly, congestive heart failure and HIV-related kidney disease.

50
Q

___________ is a significant cause of chronic kidney disease and end-stage renal failure worldwide.

A

Glomerular disease

51
Q

caused by immune mechanisms that damage the glomerular capillary filtration membrane including the endothelium, basement membrane, and epithelium (podocytes).

A

glomerular inflammation

52
Q

s/s of glomerular inflammation

A

blood and protein in the urine
-severe cases its accompanied by edema, hypertension, and impaired renal function.

53
Q

the excretion of 3.0 g or more of protein in the urine per day
hypoalbuminemia (less than 3.0 g/dl), and peripheral edema.

A

nephrotic syndrome

54
Q

Nephrotic syndrome is characteristic of_______ injury.

A

glomerular

55
Q

Chronic Kidney Disease (CKD)

A

Progressive loss of renal function associated with systemic diseases
-hypertension, diabetes mellitus, systemic lupus erythematosus, or intrinsic kidney disease, including kidney stones, acute kidney injury, chronic glomerulonephritis, chronic pyelonephritis, obstructive uropathies, or vascular disorders.

56
Q

definition of chronic kidney disease

A

-GFR less than 60 ml/min/1.73 m2 for 3 months or more

57
Q

factors that contribute to the pathogenesis of CKD

A

-proteinuria
-Angiotensisn 2 (increases glomerular hypertension and hyperfiultration)

58
Q

Azotemia

A

buildup/high nitrogen

59
Q

Azotemia is a sign of

A

chronic kidney disease

60
Q

how does CKD effect calcium

A

leads to Hypocalcemia
impaired renal synthesis of vitamin D

-But in chronic kidney disease (CKD), the kidneys are less able to make active vitamin D. Without enough active vitamin D, you absorb less calcium from the food you eat

61
Q

he combined effect of hyperparathyroidism and vitamin D deficiency can result in

A

renal osteodystrophies (i.e., osteomalacia and osteitis fibrosa with increased risk for fractures.

62
Q

is dyslipidemia and insulin issues common in CKD

A

yes

63
Q

Management of CKD

A

management of protein intake, vitamin D supplementation, sodium and fluid maintenance, potassium restriction, adequate caloric intake, management of dyslipidemias, and erythropoietin as needed

64
Q
A

ZZZ-Patho 2 (8 decks)

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