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NPLEX I > Renal - Urinary System > Flashcards

Renal - Urinary System Flashcards

1
Q

How much blood goes from the aorta to the kidneys?

A

20% of blood goes to the kidneys through the renal arteries

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2
Q

Kidney anatomy

A

Renal vein, renal artery, kidneys (renal capsule, cortex, renal columns between the renal pyramids, renal papillae at the apex of the pyramid, minor renal calyx, renal major calyx, pelvis) ureter

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3
Q

Vasa recta

A

Peritubular capillaries - efferent arteriole

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4
Q

What is the afferent arteriole sensitive to?

What is the efferent arteriole sensitive to?

A

Epinephrine

Angiotensin 2

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5
Q

What does epinephrine do to the afferent arteriole?

A

Epinephrine constricts the arteriole decreasing glomerular filtration rate (GFR)

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6
Q

Remember

A

At the glomerulus, there is one physiological physical activity.
Pure filtration. Pressure, fluid, and pore size.

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7
Q

Osmoregulation

A

Receptors are in the hypothalamus.

Hyperosmorality results in thirst and ADH release to dilute solutes more, trying to thing the blood out.

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8
Q

Volume regulation

A

baroreceptors in the macula densa.

When there is blood loss, then there is sympathetic activation and renin release from JGA

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9
Q

Where are most of the sodium reabsorbed in the kidney?

A

67% in the proximal tubule, 25% in the thick ascending loop of Henle

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10
Q

Is glucose, amino acid, bicarbonate reabsorbed into the bloodstream?
How much of it?

A

Almost all of the glucose, amino acid, and bicarbonate are reabsorbed in the proximal tubule

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11
Q

Where is calcium mostly reabsorbed?

A

It is reabsorbed throughout the whole nephron, but primarily in the proximal convoluted tubule

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12
Q

Where do you find the tri-cotransporter?

A

The NA-K-Cl transporter is found in the thick ascending loop of Henle

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13
Q

How does the potassium (K) reabsorption behave in the nephron?

A

Same as Sodium with the exception that in the distal convoluted tubule, it can be reabsorbed or excreted depending on the level of potassium in the blood

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14
Q

Remember

A

The liver produces angiotensinogen.

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15
Q

What is angiotensinogen cleaved to? by what?

A

Angiotensinogen is cleaved to angiotensin-I by renin

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16
Q

Who releases renin?

A

juxtaglomerular cells

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17
Q

What is ACE and what releases it?

A

The lung releases ACE. It stands for Angiotensin Converting Enzyme. It converts angiotensin I to Angiotensin II

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18
Q

What are the two activities of angiotensin 2?

A

Glomerular efferent arteriole constriction thus increasing GFR
and
ZOna glomerulosa activation of Aldosterone. It goes to the distal tubule and causes sodium reabsorption and potassium excretion.

19
Q

Why do I want reabsorption of sodium?

A

Water follows sodium thus increasing the blood volume

20
Q

When you drink water, what happens?

A

Decreases plasma osmolarity
Inhibits osmoreceptors in the anterior pituitary
Decreases secretion of ADH from the posterior pituitary
Decreases water permeability of late distal tubule and collecting duct

21
Q

What organ does most transamination?

A

Liver, but the kidneys are also responsible for transamination

22
Q

What is transamination?

A

Transamination is the process by which amino groups are removed from amino acids and transferred to acceptor keto-acids to generate the amino acid version of the keto-acid and the keto-acid version of the original amino acid

23
Q

What do the transaminases use?

A

Vitamin B6

24
Q

Urea cycle

Known this

A

where does it occur? Liver cell
What does it do? A way the liver takes two very dangerous metabolites (carbon dioxide and ammonia) combines them together forming urea that can go out into the blood and be filtered out from the tubular system

25
Q

What part of the Urea Cycle happens in the mitochondria?

A

Carbon dioxide and ammonia are put together to form carbamoyl phosphate inside the mitochondria by carbamoyl phosphate synthase.
Carbamoyl synthase and L-ornithine is converted into L-citrulline by ornithine transcarbamoylase

26
Q

What happens in the cytosol?

A

L-citrulline is converted into argininosuccinate and then into L-arginine and then arginase and then finally into urea.

27
Q

Acute nephritis

Inflammation

A

Red cell casts, 1-2 weeks after recovery from sore throat, children 6-10 years, moderate proteinuria

28
Q

IgA Nephropathy

A

Abnormal IgA
Damage to the cells in the glomerulus allowing blood to come in causes hematuria
Chronic GN
Usually in adults

29
Q

Henoch-Schonlein Purpura

A

Purpuric skin lesion on the exterior surface of extremities and buttock
IgA precipitation after a respiratory infection, kids 3-8 years
Hematuria recurrences for years

30
Q

Goodpasture’s syndrome

A

Rapid GN with auto-antibodies to the basement membrane
Young men who smoke
Death due to renal failure or lung hemorrhage

Type II antibody attack on the base membrane of glomerulus and alveoli so u have hematuria and hemoptysis together

31
Q

Nephrotic syndrome

A

Heavy proteinuria, hypoalbuminemia, severe edema, hyperlipidemia
Kids due to primary kidney disease
Adults > SLE DM, amyloidosis, membranous GN most common cause
More in men, Immune complexes in the basement membrane, food allergy

32
Q

Pyelonephritis

deadly

A

Affects tubules or interstitium
Ascending fecal flora, females, pregnancy, BPH, secondary to stasis or urine)
It is in the renal pelvis, infectious
It can kill you by seeding the blood and bacteria or by shutting your kidneys down.
Fever, dysuria, deadly

33
Q

Hydronephrosis

finding

A

Dilation of the renal pelvis and calyces associates with progressive atrophy of the kidney due to obstruction of urine outflow

34
Q

Urolithiasis

A

75% Ca oxalate, radiopaque (showup on x-ray)
25% radiolucent (no X-ray)
Proteus or Staph infection causes alkaline urine. increase crystal formation
Staghorn calculi = large obstructive stones in pelvis

35
Q

Intrinsic causes of obstruction

A

renal calculi, strictures tumors, blood clots

36
Q

Extrinsic causes of obstruction

A

Pregnancy, periureteral inflammation/salpingitis/peritonitis, tumors of the rectum, bladder prostate, ovaries, uterus

37
Q

Cystitis

A

Bladder inflammation is usually due to infectious reasons
E.coli, urethral trauma, bacterial contamination
Can lead to Pyelonephritis, chronic cystitis

38
Q

Interstitial cystitis

A

autoimmune disease
Usually women, chronic cystitis, inflammation of all layers of blader normal urinalysis
Suprapubic pain when the bladder is full which is relieved by voiding

39
Q

Adenocarcinoma/Hyperphrenoma

A

Cigarette, pipe, and cigar smokers, upper kidney pole solitary, unilateral
Metastasize to lung and bone before sx appear
Painless hematuria

40
Q

Wilm’s tumor

Nephroblastoma

A

Most common malignant kidney tumor in children
Large abdominal mass, painless hematuria, good prognosis with tx

aka nephroblastoma
Kidney disease of children

41
Q

Rememeber

A

Painless hematuria is cancer until proven otherwise.

Most hematuria are painful

42
Q

Benign Ureteric tumors

A

Polyps. May be too small to cause obstruction

43
Q

Tumors of bladder

A

Risk factors; industrial solvents, cigarette smoking
Transitional cell tumors, benign papilloma; 90% transitional cell carcinoma, squamous cell carcinoma
Painless hematuria, HCG in urine is marker of aggressive tumor

NPLEX I (12 decks)

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