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SRNAAnatomy II > EXAM 3- RENAL SYSTEM > Flashcards

EXAM 3- RENAL SYSTEM Flashcards

1
Q

Most of the absorption takes place in the

A

Proximal tubule

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2
Q

Electrolyte homeostasis

A

Na+ K+ Ca2+ Cl- HPO4

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3
Q

Regulation of blood pH

A

 Removes H+from blood  maintains bicarbonate ions (HCO3-) in blood

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4
Q

Regulation of Blood Volume/Blood Pressure

A

 Retention of water = increases BP  Elimination of water = decreases BP

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5
Q

Osmoregulation art ______mOsm/L

A

 at 300 mOsm/L

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6
Q

Hormones Produced by the Kidney  Calcitriol -  Renin – Blood pressure regulation

A

form of Vitamin D and calcium homeostasis

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7
Q

Hormones Produced by the Kidney  Erythropoietin responsible for

A

RBC production

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8
Q

Hormones produced by kidney Renin –

A

Blood pressure regulation

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9
Q

Excretion of Wastes

A

Ammonia & Urea (protein metabolism)

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10
Q

Arthritis known as Gout –

A

excess uric acid

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11
Q

Kidney role Performs gluconeogenesis:

A

Synthesis of glucose from amino

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12
Q

Superficial cortical nephrons:

A

Make up 85% of all nephrons, which extend partially into the medulla.

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13
Q

Juxtamedullary nephrons: Where it lies and importance?

A

Lie close to and extend deep into the medulla and are important for the process of concentrating urine; secrete renin.

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14
Q

Afferent arteriole

A

Bring blood toward kidney

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15
Q

Explain Glomerular filtration:

A

Water & small solutes in blood plasma move across the wall of the glomerular capillaries into glomerular capsule and then renal tubules (PCT –> loop of Henle –> DCT –> Collecting duct)

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16
Q

Explain Tubular reabsorption:

A

As “filtrate” moves along tubule water and many useful solutes reabsorbed = returned to blood

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17
Q

Explain Tubular secretion:

A

“filtrate” moves along tubule other molecules (wastes, drugs, & excess ions) are secreted into fluid

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18
Q

Any solutes that remain in the fluid that drains into the renal pelvis are

A

excreted as urine

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19
Q

Brush border villi role

A

for reabsorption

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20
Q

H2O absorption occur at the

A

thin ascending limb of henle

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21
Q

Electrolytes reabsorbed in the thick ascending loop of limb ratio

A

Na+ K+ Cl- reabsorbtion

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22
Q

Distal convoluted tubule : hormone and action

A

PTH stim.s reabsorption of Ca++

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23
Q

Intercalated cell function

A

Regulation of pH via H+ & HCO3-

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24
Q

Principal cell secretes

A

ADH & Aldosterone

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25
Q

Majority reabsorption of Na occur in the

A

Proximal tubule

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26
Q

What is reabsorbed in the proximal tubule

A

Na, Glucose, potassium Amino acid, bicarb, phosphate Urea and water (ADH not required)

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27
Q

Secretion in proximal tubule

A

H+ Foreign substance

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28
Q

Tonicity of the fluid in the proximal tubule

A

ISOTONIC

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29
Q

LOOP of HENLE (CADU)

A

Concentration of urine (countercurrent mechanism) Ascending loop sodium reabsorbed (active transport water stays in ) Descending loop water reabsorption Na+ diffuse in Urea secretion in thin segment

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30
Q

Tonicity of loop of henle fluid

A

Isotonic Hypotonic hypertonic

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31
Q

Distal Tubule Reabsorption of which electrolyte

A

Na+ H2O (ADH required) HCO3

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32
Q

Secretion of distal tubule (KUHNS)

A

K+ Urea H+ NH3 Some drugs

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33
Q

Tonicity of distal tubule

A

Isotonic or hypotonic

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34
Q

Collecting duct reabsorption

A

H2O (ADH required)

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35
Q

Collecting duct reabsorption or secretion of NKHN

A

Na K+ H+ NH3

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36
Q

Collecting duct there is

A

Urea absorption in the medulla

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37
Q

Tonicity of collecting duct

A

Final concentration

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38
Q

Nephron must reabsorb ______of the filtrate (as a result: ______of urine per day)

A

99% ‘ 1-2 Liters

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39
Q

______with _______Does most of the reabsorption (remainder of nephron fine-tunes)

A

PCT; microvilli

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40
Q

In PCT, Solutes are reabsorbed by both _____And ____

A

active transport and passive diffusion

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41
Q

In PCT, _______amino acids, urea and ions (Na+, K+, Ca2+, Cl-, bicarbonate, phosphate)

A

Glucose

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42
Q

In PCT, 65% of water follows by

A

osmosis

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43
Q

** 100% of_____ , -_______________GALWO are reabsorbed in the first half of the **____

A

Glucose, amino acids, lactic acid, water-soluble vitamins, and other nutrients PCT

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44
Q

Reabsorption of Na+ produces an electrical gradient that

A

caused Cl- to follow by passive transport

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45
Q

Accumulation of NaCl outside of tubule produces an osmotic gradient:

A

• Helps “pull” water out of tubule

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46
Q

Desending Limb of Loop of Henle:

A

– 15% of the filtered water is reabsorbed in the descending limb – High solute content of the medulla “pulls” water out – Low permeability to solutes = little reabsorption of solutes

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47
Q

Asending Limb of Loop of Henle:

A

– Variety of transporters reclaim more Na+, Cl-, & K+ ions and other ions by diffusion – Thin, ascending segment: Is more permeable to solutes and almost impermeable to water. – Thick portion of the ascending segment: Is highly permeable to sodium, potassium, and chloride and significantly less permeable to water and urea.

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48
Q

DCT: .

A

– Moderately permeable to solutes but absorbs about 15% of water – reabsorption of Na+ and Cl- continues – 15% of water reabsorption by osmosis

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49
Q

– The DCT serves as the major site where

A

parathyroid hormone stimulates reabsorption of Ca+2

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50
Q

*By end of DCT,

A

95% of solutes & water have been reabsorbed **

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51
Q

Collecting duct contains ________and ________makes final adjustments

A

Intercalated and Principal cells

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52
Q

Principal cells:

A

• Target of 2 hormones that promote reabsorption of more water and ions

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53
Q

ADH role

A

increases water reabsorption (retention)

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54
Q

Aldosterone @

A

collecting duct:

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55
Q

Aldosterone role

A

 increases reabsorption of Na+ and Cl-  Therefore water will also be reabsorbed!

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56
Q

Secretion of K+ (adjust for dietary intake of K+) done by

A

Aldosterone

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57
Q

Intercalated cells role

A

help regulate pH of body fluids • Proton pumps (H+ATPases)secrete protons(H+) into tubule • Reabsorb bicarbonate ions(buffers blood pH)

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58
Q

Tubular secretion:

A

– Transfer of materials from blood into filtrate/urine

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59
Q

Major stimuli that trigger release of Angiotensin II

A

Low blood volume, or BP, stimulates renin-induced production of angiotensin II

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60
Q

Major stimuli that trigger release of Aldosterone

A

Increased angiotensin II level, and increased plasma levels of K+ promote release of aldosterone by adrenal cortex.

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61
Q

Major stimuli that trigger release of Vasopressin (ADH)

A

increased osmolarity of ECF or decrease BV, promotes release of ADH from the posterior pituitary gland

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62
Q

Major stimuli that trigger release of ANP

A

Stretching of atria of heart stimulates secretion of ANP

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63
Q

Major stimuli that trigger release of PTH

A

Decreased level of plasma Ca2+ promotes release of PTH from parathyroid glands

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64
Q

Mechanism and site of action of Angiotensin II

A

Stimulates activity of Na+/H+ antiporters in PCT cells

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65
Q

Mechanism and site of action of Aldosterone

A

Enhances activity of Na-K+ potassium pump in basolateral membrane and Na+ channels in apical membrane of principals in collecting duct.

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66
Q

Mechanism and site of action of ADH (vasopressin) Stimulates _______Of_________into the _________of _______in _______

A

Stimulates insertion of water channel proteins (AQUAPORIN-2) into the apical membrane of principal cells In COLLECTING duct

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67
Q

Mechanism and site of action of ANP

A

Suppresses reabsorption of NA and water in proximal tubule and collecting duct; also inhibits secretion of ALDOSTERONE and ADH

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68
Q

Mechanism and site of action of PTH

A

Stimulates opening of Ca2+ channels in apical membrane of early distal tubule cells

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69
Q

Angiotensin Hormone effects

A

Increases reabsorption of Na and other solutes, and water which increases BV

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70
Q

Aldosterone Hormone effects

A

Increases secretion of K+ and reabsorption of Na+, Cl-, increases reabsorption of water , which increases BV

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71
Q

ADH Hormone effects

A

Increases facultative reabsorption of water , which decreases osmolarity of body fluids

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72
Q

ANP Hormone effects

A

Increases excretion of Na in URINE (NATRIURESIS); increases urine output (DIURESIS) and thus DECREASES BV

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73
Q

PTH Hormone effects

A

Increase reabsorption of Ca2+

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74
Q

Filtration: Average adult male rate is_____ ml/min and female is____ ml/min

A

125; 105

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75
Q

What drives filtration

A

BP

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76
Q

____Liters/day in males; ____Liters/day in females

A

180; 150

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77
Q

Glomerulus is a

A

Set of fenestrated capillaries

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78
Q

Glomerulus is supplied by the ______And drained by _______

A

afferent arteriole and drained by the efferent arteriole

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79
Q

Bowman’s (glomerular) capsule

A

• Circular space between visceral and parietal epithelium

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80
Q

Mesangial cells

A

support the glomerular capillaries and respond to ANP to regulate glomerular capillary flow.

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81
Q

Glomerular endothelial cells

A

• Synthesize nitric oxide (a vasodilator). • Synthesize endothelin-1 (a vasoconstrictor). • Regulate glomerular blood flow.

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82
Q

Visceral epithelium of the Bowman capsule • Is composed of cells called_____ are______ forms ________called _______ they modulate_____

A

podocytes. o Are footlike processes. o Form an elaborate network of intercellular clefts called filtration slits; modulate filtration.

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83
Q

Water, Ions, small molecules & small proteins move through the membrane and become

A

“primary urine” or “filtrate”

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84
Q

Blood cells, large/medium sized proteins

A

cannot normally be filtered

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85
Q

Fenestration of glomerular endothelial cells prevents

A

filtration of blood cells but allows all components of blood plasma to pass

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86
Q

Basal lamina of glomerulus prevents what?

A

filtration of larger proteins

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87
Q

Slit membrane between ________ prevents

A

Pedicels, prevent filtration of medium-sized proteins

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88
Q

Control of renal blood flow (RBF), glomerular filtration, and renin secretion occurs at this site.

A

JUXTAGLOMERULAR APPARATUS

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89
Q

Juxtaglomerular cells located where?

A

These specialized cells are located around the afferent arteriole where the afferent arteriole enters the glomerulus.

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90
Q

Mesangial cells

A

specialized contractile cells that support glomerulus and help regulate glomerular blood flow; and remove macromolecules from filtration

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91
Q

Macula densa is a portion of _________Tubule with Specialized _______And ________ cells located where?

A

Portion of the distal convoluted tubule with specialized sodium and chloride sensing cells is located between the afferent and efferent arterioles.

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92
Q

Macula Densa cells detect what?

A

o Detect high flitrate rate in the DCT which results in a decrease of nitric oxide and vasoconstriction in the afferent arterioles.

93
Q

Kidneys receive of______to______ blood (____of CO).

A

1000 to 1200 ml/min ; 20-25%

94
Q

_____ to ______ml as plasma (renal plasma flow [RPF])

A

600 to 700

95
Q

Glomerular filtration rate (GFR) • _______of the RPF (120 to 140 ml/min) is filtered into

A

20%; Bowman’s space

96
Q

GFR is Directly related to the

A

perfusion pressure in the glomerular capillaries

97
Q

• If mean arterial pressure decreases or vascular resistance increases, then

A

the RBF decreases.

98
Q

FF = Filtration Fraction FF =

A

GFR/RPF

99
Q

GFR is regulated by 3 mechanisms:

A

– autoregulatory – neural – hormonal

100
Q

Myogenic mechanism (pressure/stretch) If arterial pressure increases, stretch of the afferent arterioles_______, smooth muscle______ to _________ (aff/eeff) arteriole and perfusion

A

increases; contracts ; constrict afferent ;decreases.

101
Q

Myogenic mechanism If arterial pressure declines, stretch of the afferent arterioles_______, smooth muscle ______ to_______ (eff/afferent)arteriole and perfusion_______

A

decreases; relaxes to dilate afferent; increases.

102
Q

Tubuloglomerular feedback (sodium chloride content) • If sodium filtration increases, GFR_______ – Macula densa cells stimulate afferent arteriolar_______ • If sodium filtration decreases, the opposite occurs—GFR

A

decreases; vasoconstriction; increases

103
Q

Sympathetic nervous system • Sympathetic stimulation of ______via _______receptors causes vasoconstriction, (GFR)________

A

afferent arterioles alpha-1 (α-1); decreases

104
Q

Inhibition of Sympathetic nerves causes_____. GFR ____

A

Vasodilation; increases

105
Q

Severe hypoxia: Stimulation of chemoreceptors • Decreases RBF by means of__________

A

sympathetic stimulation

106
Q

RAAS role

A

Renin-angiotensin-aldosterone system (RAAS) Increases systemic arterial pressure, and increases sodium reabsorption

107
Q

• Renin: stored and formed where ?

A

Enzyme is formed and stored in afferent arterioles of the juxtaglomerular apparatus

108
Q

Explain RAAS mechanism

A

• Renin helps form angiotensin I (physiologically inactive). • In the presence of angiotensin-converting enzyme (ACE), angiotensin I is converted to angiotensin II.

109
Q

Stimulates the secretion of aldosterone by the adrenal cortex.

A

Angiotensin II

110
Q

Angiotensin II is a potent vasoconstrictor. constricts both ______and ______with greater affect on______arteriole

A

afferent & efferent arterioles in kidney; efferent arteriole

111
Q

____________is secreted from myocardial cells in the atria

A

Atrial natriuretic peptide (ANP)

112
Q

Stimulates antidiuretic hormone (ADH) secretion and thirst.

A

Angiotensin II

113
Q

ANP and BNP on sodium and water

A

• Inhibit sodium and water reabsorption by kidney tubules.

114
Q

ANP and BNP on renin and aldosterone

A

Inhibit secretion of renin and aldosterone.

115
Q

ANP and BNP on kidney arterioles Which one they constrict, which one gets dilated

A

Vasodilate the afferent arterioles; constrict the efferent arterioles.

116
Q

ANP and BNP on UO, BV, BP, and sodium and H2O

A

Increase urine output, leading to decreased blood volume and blood pressure; promote sodium and water loss.

117
Q

_____________is secreted from myocardial cells in the ventricles

A

Brain natriuretic peptide (BNP)

118
Q

Major stimulus to MYOGENIC MECHANISM

A

Increased stretching of smooth muscle fibers in afferent arterioles walls due to increase BP

119
Q

Mechanism and site of action: MYOGENIC MECHANISM

A

Stretched smooth muscle fibers contract, thereby narrowing the lumen of the AFFERENT ARTERIOLES

120
Q

Major stimulus to TUBULOGLOMRULAR FEEDBACK

A

Rapid delivery Na+ and Cl- to the macula densa due to high SBP

121
Q

Mechanism and site of action TUBULOGLOMERULAR FEEDBACK

A

Decrease release of NO by the juxtaglomerula apparatus causes constriction of the AFFERENT ARTERIOLES

122
Q

Major stimulus to NEURAL REGULATION

A

Increase in level of activity of RENAL sympathetic nerves releases NE.

123
Q

Mechanism and site of action NEURAL REGULATION

A

Constriction of AFFERENT ARTERIOLES through activation of Alpha 1 receptors and INCREASED RELEASE of RENIN

124
Q

HORMONE Regulation : ANGIONTENSIN II Major stimulus

A

Decrease BP and BV, stimulates production of angiotensin II

125
Q

HORMONE Regulation : ANGIONTENSIN II Mechanism of site of action

A

Constriction of both afferent and efferent arterioles

126
Q

HORMONE Regulation :ANP Mechanism of site of action

A

Relaxation of mesangial cells in glomerulus increases capillary surface area available for filtration

127
Q

HORMONE Regulation :ANP Major Stimulus

A

Stretching of the atria of the heart stimulates secretion of ANP

128
Q

Effect of Angiotensin II on GFR

A

Increase

129
Q

Effect of ANP on GFR

A

Increase

130
Q

Regulations that increases GFR are

A

Myogenic Mechanims Tubuloglomerular feedback Neural regulation

131
Q

Too large to pass through capillary fenestration

A

Albumin

132
Q

Albuminemia is caused by

A

injury or disease, increase BP and irritation of kidney cells lead to increase permeability

133
Q

Indicates DM

A

Glucosuria

134
Q

As a result of kidney irritation from kidney stones

A

Hematuria

135
Q

Indicates anorexia, Starvation, too little carb in diet

A

Ketonuria

136
Q

Tiny masses of material that have hardened and assumed the shape of the lumen of the tubule

A

CASTs

137
Q

Specific infections in the urinary tract

A

Microbes

138
Q

What is renal clearance

A

How much of a substance can be cleared from the blood by the kidneys during a given unit of time.

139
Q

Permits an indirect measure of GFR

A

Renal clearance

140
Q

GFR is the

A

best estimate for the functioning of renal tissue

141
Q

Inulin (a fructose polysaccharide) is often used – All inulin filtered is

A

excreted in urine (requires constant infusion to maintain stable plasma level)

142
Q

Creatinine:

A

Provides a good estimate of GFR since only a small amount enters urine.

143
Q

Is a poor measure of GFR.

A

BUN

144
Q

Is most valuable for monitoring the progress of chronic rather thannacute renal disease.

A

Plasma creatinine concentration

145
Q

Clearance is used to determine renal plasma flow and blood flow

A

Para-Aminohippuric acid

146
Q

Prerenal caused by

A

inadequate renal perfusion

147
Q

Intrarenal caused by

A

injury or damage to renal parenchyma

148
Q

Postrenal caused by

A

acute obstruction to the outflow of urine

149
Q

Inflammation of the glomerulus leads to _____-and -_____

A

Increased permeability & dysfunction:

150
Q

Nephrotic syndrome is associated with

A

proteinuria

151
Q

Nephritic syndrome is associated with______and ____

A

proteinuria & hematuria

152
Q

Urine protein normally:

A

60-100 mg/day

153
Q

Nephrotic Syndrome protein per day

A

> 3.5 g/day =

154
Q

Nephrotic syndrome is characterized by (MAH)

A

• massive Proteinuria • Hypoalbuminemia • Anasarca – Usually begins in the face

155
Q

In nephrotic syndrome there is Hyperlipidemia why?

A

Liver increases lipoprotein production in response to low plasma proteins

156
Q

In nephrotic syndrome there is Hyponatremia (dilutional)

A

Occurs with low fractional sodium excretion

157
Q

In nephrotic syndrome there is Thrombophilia

A

Due to loss of Antithrombin III in the urine

158
Q

Nephrotic syndrome classified as

A

Primary glomerulonephritis Secondary glomerulonephritis

159
Q

Primary glomerulonephritis: MFMM

A

– Minimal change disease (MCD) – Focal segmental glomerulosclerosis (FSGS) – Membranous glomerulonephritis (MGN) – Membranoproliferative glomerulonephritis (MPGN)

160
Q

Minimal change disease (MCD) is most common cause of nephrotic syndrome in

A

Children

161
Q

Causes MCD • Tx: ______

A

Lithium NSAIDs, CA, Infx. Steroids

162
Q

Focal segmental glomerulosclerosis (FSGS) • Most common cause of nephrotic syndrome in

A

adults

163
Q

Causes of Focal segment Glomerulosclerosis (MUPTHH)

A
  • unilateral renal agenesis – morbid obesity – previous kidney injury – Toxins – HIV – Heroine
164
Q

Tx of Focal segment Glomerulosclerosis

A

ACEI, Diuretics, salt restriction

165
Q

Antibodies bind to antigens in basement membrane

A

Membranous glomerulonephritis (MGN)

166
Q

Causes of Membranous glomerulonephritis :

A

SLE, Hep B,C, NSAIDs, Gold, Mercury

167
Q

Tx of Membranous glomerulonephritis

A

Immune suppressors (Cyclophosphamide) & steroids

168
Q

in MGN Immune complexes trigger

A

MAC of complement system

169
Q

Membranoproliferative glomerulonephritis Causes

A

Auto-immune ds., Hep B, C, cryoglobulinemia, SBE

170
Q

Membranoproliferative glomerulonephritis Type I

A

Discrete immune complexes are found in the mesangium and subendothelial space.

171
Q

Membranoproliferative glomerulonephritis Type II

A

also called dense deposit disease. Continuous, dense ribbon-like deposits found along basement membranes of the glomeruli, tubules, & Bowman’s capsule

172
Q

NEPHROTIC SYNDROME CAUSES Diabetic nephropathy

A

– SLE – Sarcoidosis – Syphilis – Hepatitis B – Sjögren’s syndrome – HIV – Amyloidosis – Multiple myeloma – Vasculitis – Cancer – Genetic disorders – Drugs

173
Q

IgA Nephropathy

A

Most common cause of Nephritic Syndrome worldwide Abnormal IgA binds to mesangium of glomerulus activating complement MAC damaging vessel wall

174
Q

• “Cola” colored hematuria

A

IgA Nephropathy

175
Q

Treatment of Iga Nephropathy

A

Steroids – ACEi – (Immunosuppressives) • Cyclophosphamide – onlyin recurrent episodes

176
Q

Post-streptococcal glomerulonephritis

A

Anti-streptococcal antibodies – antigen-antibody complexes deposit in glomeruli – Activate complement MAC = vessel damage – Increased capillary permeability – leakage of protein and large numbers of erythrocytes

177
Q

Treatment of post streptococcal glomerulonephritis

A

BP meds, Diuretics, ABX if needed

178
Q

Triad of Hemolytic Uremic syndrome

A

Triad of Hemolytic anemia, ARF & Thrombocytopenia

179
Q

Often preceded by food poisoning

A

Hemolytic uremic syndrome

180
Q

In Hemolytic Uremic syndrome, bacterial toxins ___

A

Bacterial toxins bind to glomerular endothelium – trigger apoptosis & binding of leukocytes

181
Q

Hemolytic Uremic syndrome tx

A

• Tx: ABX & hemodialysis prn

182
Q

Henoch–Schönlein purpura aka

A

IgA vasculitis, self limiting

183
Q

Treatment of Henoch–Schönlein purpura

A

same as nephropathy IgA (Steroids, ACEI, immunosuppressive)

184
Q

What is good pasture syndrome

A

Attack basement membrane of kidney and lung

185
Q

Tx of good pasture syndrome

A

treatment w/ monoclonal antibodies

186
Q

SLE

A

Autoantibodies attack mesangial cells of juxtaglomerular apparatus leading to lupus nephritis

187
Q

• Tx of SLE

A

steroids, antimalarials, cyclophosphamide

188
Q

Assoc’d. with Goodpasture’s Syndrome or SLE

A

Rapidly progressing glomerulonephritis

189
Q

Rapidly progressing Glomerulonephritis there is rapid loss of

A

Rapid loss of renal function: 50% decline in GFR within 3 months

190
Q

• ANCA (antineutrophil cytoplasmic antibodies) causes an early degranulation

A

Rapidly progressing glomerulonephritis

191
Q

Tx of Rapidly progressing glomerulonephritis

A

Tx: steroids, cyclophosphamide, plasmapheresis

192
Q

Release of lytic enzymes damage glomerulus • Causes glomerular crescent formation

A

Rapidly progressing glomerulonephritis

193
Q

Inflammation of tissue between renal tubules

A

Interstitial Nephritis

194
Q

Causes of Interstitial Nephritis Allergic reaction to medications

A

RPPP - CNSQ Rifampin Phenytoin PCN PPIs Cephalosporins NSAIDs Sufanemides Quinolones

195
Q

Infection that can cause Interstitial Nephritis

A

• pyelonephritis

196
Q

Blood Tests of interstitial nephritis – ~25% of pts. have

A

eosinophila

197
Q

UA for interstitial nephritis shows

A

– Hematuria, Proteinuria – Sterile Pyuria – Eosinophila

198
Q

– Gallium-67 scan

A

60%-100% positive

199
Q

Tx of interstitial nephritis

A

Treat underlying cause

200
Q

First manifestation of PKD

A

around 40

201
Q

S/S of PKD

A

HHHPE (HTN, HA, Pain, Excessive urination, Hematuria)

202
Q

Rhabdomyolysis

A

Damaged skeletal muscle leaks myoglobin into the circulation.

203
Q

Myoglobin interacts with

A

interacts with Tamm–Horsfall protein in the nephron to form casts that obstruct flow.

204
Q

In rhabdomyolosis, Fe from ____

A

Fe++ from heme generates reactive oxygen species which damages the kidney cells

205
Q

Blood tests in Rhabdo

A

Blood Tests: – Increased CK – Increased LDH – Hyperkalemia

206
Q

Fanconi syndrome

A

Dysfunction of the proximal tubules – multichannel transport failure results in excretion of most solutes

207
Q

In fanconi syndrome_____Excretion of ____

A

Increased excretion of bicarb. = Renal Tubular Acidosis (RTA)

208
Q

Electrolyte disturbances in Fanconi syndrome

A

Hypokalemia Hypophosphatemia

209
Q

Hypophosphatemia can result in bone diseases

A

– Rickets, Osteomalacia

210
Q

TX of Fanconi syndrome

A

• Tx: fluid & electrolyte replacement

211
Q

In fanconi syndrome Hypokalemia occurs b/c

A

large load of filtered solute reaching distal nephron stim.s K+ excretion (similar to action of loop & thiazide diuretics)

212
Q

TUMOR LYSIS syndrome is when

A

CA cells killed during treatment release their contents into bloodstream: K+, Phosphorus, Uric acid (nucleics)

213
Q

Electrolytes abnormalities in Tumor Lysis syndrome

A

Hyperkalemia • Hyperphosphatemia / Hypocalcemia • Hyperuricemia • ELEVATED BUN

214
Q

In TLS, Hyperphosphatemia causes________Secondary to deposition of

A

acute kidney failure 2 ; calcium phosphate crystals in the kidney parenchyma.

215
Q

In TLS , Hyperuricosuria -

A

uric acid crystals obstruct tubules

216
Q

Acute Tubular Necrosis Classified as_____ or ___

A

• Classified as Toxic or Ischemic

217
Q

Tx of TLS

A

Hemodialysis

218
Q

Color of casts in ATN

A

Muddy brown casts

219
Q

Treatment of ATN

A

Tx: underlying cause – Hydration – Stop offending drug

220
Q

Toxic ATN involves ______only

A

PCT

221
Q

Drugs that cause ATN

A

CRA (Cisplastin, Aminoglycosides, Radiographic contrast) MASEH – Methotrexate – Amphotericin B – Statins – Ethylene glycol – Heavy metals

222
Q

Ischemic ATN characterized by________

A

Patchy PCT & DCT necrosis

223
Q

Ischemic ATN Caused by

A

prolonged hypotension (Hypovolemia, Shock)

224
Q

PCT and ascending thick limb require increase ATP for nutrient and electrolyte reabsorption

A

highly susceptible to ischemic damage

225
Q

Identify the parts

A

A- Filtration

B- Pedicel

226
Q

Identify A and B

A

A- Neutrophils

B- Hump-like Subendothelial cells

Immune Complex deposits

227
Q

Identify A and B

A

A- Normal Glomerulus (normal podocytes)

B- Glomerulus affected by minimal changes (damaged podocytes)

228
Q

What is this disorder?

A

Henoch–Schönlein purpura • a.k.a. “IgA Vasculitis”

SRNAAnatomy II (16 decks)

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