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Pathophys > Renal part 2 > Flashcards

Renal part 2 Flashcards

1
Q

Pts taking ACE inhibitors may often go hyperkalemic, why is this?

A

ACE inhibitors blocks ANG II to decrease vasoconstriction (more K+ in ECF)

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2
Q

How does insulin prevent hyperkalemia?

A

insulin moves K+ into cells by increasing activity of Na+K+-ATPase

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3
Q

What is the most common electrolyte disorder?

A

hypokalemia

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4
Q

What is the primary cause of hypokalemia?

A

diuretics

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5
Q

_____ sets the resting membrane potential and is the major intracellular cation.

A

K+

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6
Q

67% of K+ is reabsorbed at what part of the nephron?

A

proximal tubule

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7
Q

25% of K+ is reabsorbed at what part of the nephron?

A

thick ascending loop of henle

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8
Q

What is the transporter at the thick ascending loop of henle?

A

NKCC2

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9
Q

What cells reabsorb potassium/bicarbonate and secrete H ions at the late DT and collecting ducts?

A

a intercalated cells

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10
Q

What cells secrete K+ at the distal nephron?

A

principle cells

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11
Q

How does aldosterone cause the reabsorption of more sodium?

A
  • makes more sodium epithelial channels
  • increases K+ channels in luminal mem.
  • increases activity of Na+K+-ATPase
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12
Q

What is alkalosis on a basic level?

A

H+ concentration is low in ECF

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13
Q

What is acidosis on a basic level?

A

H+ concentration is high in ECF

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14
Q

How do loop and thiazide diuretics cause hypokalemia?

A

increases K+ secretion and excretion

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15
Q

Name a potassium sparing diuretic.

A

spironolactone

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16
Q

Which diuretic is an aldosterone antagonist?

A

spironolactone

(inhibits action of aldosterone on principle cells)

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17
Q

Which diuretic decreases the absorption of sodium chloride?

A

furosemide (lasix)

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18
Q

If a pt has proteinuria, where in the kidneys is there a problem?

A

glomerular capillary (protein isn’t supposed to get through)

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19
Q

If a pt has decreased hemoglobin and increased BUN/creatinine, what does this mean about the kidneys?

A

not producing EPO

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20
Q

Peritoneal dialysis or CAPD (continuous ambulatory peritoneal dialysis) what serves as the semi-permeable membrane?

A

the peritoneum

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21
Q

What is the most common cause of UTIs?

A

e. coli

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22
Q

What does cystitis mean?

A

infection/inflammation of bladder

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23
Q

What does urethritis mean?

A

infection/inflammation of urethra

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24
Q

What is the most common treatment for UTI?

A

Bactrim (sulfer abx)

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25
Q

What is the most common inflammatory disorder of the kidneys and what is it most commonly caused from?

A
  • glomerulonephritis
    cause = strep (post strep glomerulonephritis)
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26
Q

What syndrome is secondary to other illnesses like lupus or medications?

A

nephrosis (nephrotic syndrome)

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27
Q

What is BPH? Describe it.

A

benign prostatic hyperplasia
(prostate increases in size making urethra smaller in size)

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28
Q

What is the most common cause of urinary tract obstruction?

A

calculi (kidney stones)

29
Q

How does calculi form?

A

when urine is too concentrated

30
Q

Why does a kidney stone cause pain?

A

stone is moving and causing pain bc of peristalsis

31
Q

Hydronephrosis is secondary to what two problems?

A
  • obstructive problems (like stones)
  • congenital problems (like kink in ureter)
32
Q

Renal adenocarcinomas usually occur in what part of the kidney?

A

cortex of kidney

33
Q

Where does bladder cancer develop from?

A

transitional epithelium in trigone area

34
Q

50% of patients who develop bladder cancer work in what two industries?

A

rubber or dye material industry

35
Q

What is nephrosclerosis?

A

XS hardening and thickening of renal blood vessels

36
Q

Nephrosclerosis is secondary to what two conditions?

A

HTN and DM

37
Q

What is vesicoureteral reflux? (hint: its a congenital disorder)

A

defective valve between ureter and bladder

38
Q

What is agenesis?

A

where 1 kidney doesn’t form

39
Q

What is hypoplasia in regard to kidneys?

A

where kidneys are too small

40
Q

Acute polycystic kidney disease is an autosomal dominant disorder on what chromosome?

A

chromosome 16

41
Q

What is polycystic kidney disease?

A

multiple cysts develop in both kidneys

42
Q

What is the treatment for polycystic kidney disease?

A

kidney transplant

43
Q

Acute renal failure is ______, while chronic renal failure is _______.

A

reversible; irreversible

44
Q

What is the first sign of acute renal failure?

A

rapidly increasing BUN

45
Q

What is azotemia?

A

accumulating huge amounts of nitrogen waste products

46
Q

What is anuria?

A

lowest urine output (pt stops urinating)

47
Q

What are some major causes of renal failure?

A
  • glomerulonephritis
  • calculi
  • tumors
  • heart failure
  • damaged RBCs
  • damaged skin
  • nephrotoxins
48
Q

What is being released if erythrocytes are severely damaged?

A

hemoglobin (toxic to epithelial cells of tubules)

49
Q

What is being released if skeletal muscle is severely damaged?

A

myoglobin (toxic to epithelial cells of tubules)

50
Q

Give examples of nephrotoxins:

A

NSAIDS (ibuprofen/aspirin), penicillin

51
Q

What is the most common cause of chronic renal failure?

A

chronic HTN, DM

52
Q

What is the first stage of chronic renal failure?

A

decreasing renal reserve

53
Q

What is the second stage of chronic renal failure?

A

renal insufficiency

54
Q

What is the final stage of chronic renal failure?

A

ESRD (end stage renal disease)

55
Q

What stage of chronic renal failure will you see an increase in BUN and creatinine?

A

second stage

56
Q

What stage of chronic renal failure will you see a decrease in EPO?

A

second stage

57
Q

What stage of chronic renal failure will a pt start to lose weight?

A

second stage

58
Q

What stage of chronic renal failure will you see a decrease in bone marrow depression?

A

second stage

59
Q

What stage of chronic renal failure will a patients blood pressure start to rise?

A

first stage

60
Q

What stage of chronic renal failure will your patient have uremia?

A

final stage

61
Q

What stage of chronic renal failure will your patient have systemic infections like peripheral neuropathy?

A

final stage

62
Q

Why is kidney function important for vitamin D?

A

kidneys convert vitamin D to active vitamin D3

63
Q

Why is vitamin D important?

A

need vitamin D to reabsorb calcium from GI tract

64
Q

A lack of vitamin D due to chronic renal disease can cause what?

A

hypocalemia

65
Q

If the kidneys can’t secrete ions due to a lack of vitamin D, what can occur?

A

hyperphosphatemia

66
Q

If a pt has hypocalcemia and hyperphosphatemia, what 3 things will cascade?

A
  • stimulate PTH
  • increase calcium reabsorption from bones
  • brittle bones = osteoporosis
67
Q

What is it called when a pt has osteoporosis and fractures due to kidney disease?

A

osteodystrophy

68
Q

List the 5 treatments for a patient with chronic kidney disease:

A
  • synthetic EPO (to retain RBCs)
  • phosphate binders
  • anti-hypertensives
  • dialysis
  • kidney transplant

Pathophys (6 decks)

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