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Patho > Chapter 26 > Flashcards

Chapter 26 Flashcards

1
Q

In order to maintain homeostasis, the kidneys do what?

A

fluid volume, electrolytes, acid-base balance

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2
Q

Kidneys secret:

A

renin, Erythropoetin, Calcitrol (active form of vitamin D)

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3
Q

kidney functions (4)

A
  1. Filtration
  2. Reabsorption
  3. Secretion
  4. Excretion
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4
Q

when kidneys fail:

A
  1. less waste is removed
  2. can’t regulate fluid, electrolyte, PH balance
  3. Nitrogenous waste builds up (BUN, creatinine)
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5
Q

Renal function is approximated by testing the blood levels of what?

A
  1. BUN levels (blood urea nitrogen)

2. Creatinine levels (metabolic waste from muscle breakdown)

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6
Q

Acute Kidney Failure is usually ___

A

secondary to another disease or cause.

heart failure, dehydration, etc

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7
Q

What is secondary to diabetes and ^BP?

A

chronic kidney disease

* destroys nephrons and cant filter GFR

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8
Q

The most common form of AKI is?

A

Prerenal injury

  • caused by decreased blood flow and is usually reversible
  • shock, dehydration, vasoconstriction
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9
Q

Which type of kidney injury is caused by obstruction of some form?

A

Postrenal Injury

  • obstruction below kidney: ureter, bladder, urethra
  • enlarged prostate, tumors, stones
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10
Q

Intrinsic or Intrarenal injury is a result of what?

A

Acute Tubular necrosis
*death of epithelial cells in kidney tubules
Ischemia, toxins, intratubular obstruction

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11
Q

What are the 3 phases of ATN (acute tubular necrosis)

A
  1. Initiating phase- damage has happened
  2. Maintenance phase- oliguria, ^waste products, edema
  3. Recovery phase - tissue remodeling
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12
Q

What happens in tubular obstruction during acute tubular necrosis?

A
  • castes are made

- clumping together of dead epithelial cells obstructs tubules

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13
Q

There are ___ stages of kidney disease

A

5
Stage 1: still able to compensate
Stage 5: GFR <15mL/minute

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14
Q

Chronic Kidney Manifestation

A
  • Uremia/Azotemia #1
  • altered fluid/electrolyte/ acid-base balance
  • cardiovascular problems
  • GI disorders
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15
Q

In chronic kidney disease, the kidneys lose their ability to reabsorb ____

A

Sodium: Salt water wasting

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16
Q

In CKD you also can’t filter ___ out of blood

A

Potassium: Hyperkalemia

17
Q

With CKD, you lose your ability to regulate your PH. What does this cause?

A
  • Metabolic Acidosis-

* heart palpitations, muscle weakness, bone pain*

18
Q

Patients with CKD are more likely to die from ___ than CKD itself

A

Heart failure

19
Q

in a healthy kidney, calcitrol does what?

A

helps the kidneys maintain blood calcium levels and promotes the formation of bone.

20
Q

When the kidneys do not function properly, extra ______ is released into the blood to move ___ from inside the bones into the blood.

A

parathyroid hormone

calcium

21
Q

when the kidneys aren’t functioning correctly they do what 2 things to end up leaching calcium fro bones?

A
  1. stop activating calcitriol. The low levels of calcitriol in the body create an imbalance of calcium in the blood.
  2. do not remove the phosphorus in the blood properly, so phosphorus levels rise in the blood. The extra phosphorus pulls calcium out of the bones, causing them to weaken.
22
Q

Decreased Vitamin D activation increases: ___ and impairs ____

A 
Parathyroid hormone (PTH) 
and impairs Osteoblasts
23
Q

low bone turnover in osteoblasts

A

Osteomalacia

24
Q

^ bone turnover in osteoclasts

A

Osteodystrophy

25
Q

chronic kidney disease primarily effects what 2 systems:

A

blood and bone

26
Q

Hematologic complications from CKD

A
  • Anemia- hemolysis, bone marrow suppresion, decreased erythropoeitin
  • decreased platelets- bleeding
27
Q

the build up of nitrogenous waste products (uremia) suppresses ___ and the creation of __-

A

bone marrow and the creation of megarkyocytes: platelets

28
Q

CKD manifestations: (4)

A
  1. Suppressed immune response
  2. Sexual Dysfunction
  3. Neurological Alterations- Restless leg syndrome
  4. Skin disorders- flakey skin, Terry Nails

Patho (18 decks)

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