Week 9 and 10- Urinary System

Question 1

functional unit of the kidney

Answer 1

nephron

Question 2

flow through the nephron

Answer 2

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)

Question 3

The _______- filters selected blood components through its three layers

Answer 3

glomerular filtration membrane

Question 4

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

Answer 4

blood cells
plasma proteins

Question 5

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

Answer 5

macula densa

Question 6

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

Answer 6

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

Question 7

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

Answer 7

wall of proximal convoluted tubule

Question 8

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

Answer 8

thin descending segment

Question 9

permeable to ions but not to water.

Answer 9

thin ascending segement

Question 10

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

Answer 10

thick ascending

Question 11

helps to regulate extracellular fluid volume and electrolyte homeostasis.

Answer 11

distal convoluted tubule

Question 12

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

Answer 12

in collecting duct

Question 13

downward peristaltic activity propels urine into the

Answer 13

bladder

Question 14

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

Answer 14

bladder

Question 15

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

Answer 15

external

-internal is smooth muscle and not under volunartry control

Question 16

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

Answer 16

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

Question 17

provides the best estimate of functioning renal tissue.

Answer 17

GFR (glomerular filtration rate)

Question 18

BUN stands for

Answer 18

Blood Urea Nitrogen

Question 19

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

Answer 19

blood urea nitrogen (BUN)

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

Question 20

pyuria

Answer 20

WBC in urine
-sign of UTI

Question 21

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

Answer 21

dysuria

Question 22

most common cause of urinary retention

Answer 22

bening prostatic hyperplasia (BPH)

Question 23

Hematuria

Answer 23

blood in urine

Question 24

painless vs painful hematuria

Answer 24

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

Question 25

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

Answer 25

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

Question 26

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

Answer 26

unilateral

Question 27

composition of most common kidney stones

Answer 27

calcium oxalate or phosphate (70% to 80%)

Question 28

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

Answer 28

staghorn calculi

Question 29

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

Answer 29

non-stagorn calculi

Question 30

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

Answer 30

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

Question 31

Clinical Manifestations of kidney stones

Answer 31

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

Question 32

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

Answer 32

UTI

Question 33

can a UTI occur anywhere in the tract

Answer 33

yes

Question 34

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

Answer 34

virulence

Question 35

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

Answer 35

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

Question 36

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

Answer 36

acute cystitis

Question 37

most common microorganicsm of UTI

Answer 37

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

Question 38

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

Answer 38

acute cystitis (bladder infection)

Question 39

Pyelonephritis

Answer 39

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

Question 40

most common cause of pyelonephritis

Answer 40

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

Question 41

Acute Pyelonephritis sxs

Answer 41

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

Question 42

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

Answer 42

pyelonephritis

Question 43

loss of bladder control, affects more females than males

Answer 43

urinary incontinence

Question 44

things that can help with incontinence

Answer 44

proper nutrition avoidance of constipation weight loss physical activity

Question 45

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

Answer 45

Anticholinergic (Antimuscarinic) Drugs

Question 46

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

Answer 46

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

Question 47

Glomerulonephritis

Answer 47

inflammation of the glomeruls

Question 48

primary glomerular causes

Answer 48

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

Question 49

causes of secondary glomerular

Answer 49

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

Question 50

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

Answer 50

Glomerular disease

Question 51

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

Answer 51

glomerular inflammation

Question 52

s/s of glomerular inflammation

Answer 52

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

Question 53

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.

Answer 53

nephrotic syndrome

Question 54

Nephrotic syndrome is characteristic of_______ injury.

Answer 54

glomerular

Question 55

Chronic Kidney Disease (CKD)

Answer 55

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.

Question 56

definition of chronic kidney disease

Answer 56

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

Question 57

factors that contribute to the pathogenesis of CKD

Answer 57

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

Question 58

Azotemia

Answer 58

buildup/high nitrogen

Question 59

Azotemia is a sign of

Answer 59

chronic kidney disease

Question 60

how does CKD effect calcium

Answer 60

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

Question 61

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

Answer 61

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

Question 62

is dyslipidemia and insulin issues common in CKD

Answer 62

yes

Question 63

Management of CKD

Answer 63

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