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nnp i > GU Overview WK2 > Flashcards

GU Overview WK2 Flashcards

1
Q

Stages Kidney Development

A
  • Pronephros
  • Mesonephros
  • Metanephros
    • 5-9wk ascend from pelvis to abdomen
  • True kidney
    • 9-10wk begins functioning
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2
Q

Nephrogenesis: Period of Development

A
  • 8-36wk
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3
Q

Nephrogenesis: Period Critical Development

A
  • 31-36wk
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4
Q

Number of nephrons FT at birth

A
  • 800,000-1.2mil nephrons
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5
Q

Bladder Development

A
  • 4-6wk begins formation
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6
Q

Urethra Development

A
  • 12-13wk
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7
Q

GFR: Definition

A
  • filtrate/min formed in glomerulus
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8
Q

GFR: Rate in utero

A

low

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9
Q

GFR: Increase RT

A
  • Initial increase rt increase glomerular perfusion pressure
  • Later increase rt increase renal blood flow
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10
Q

GFR RT (3)

A
  • BP peritubular capillaries*
  • Hydrostatic pressure glomerular capillaries and bowman’s capsule
  • Colloid osmotic pressure capillaries
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11
Q

GFR Levels

  • <34wk
  • FT birth
  • FT 2wk
  • 2yr
A

<34wk

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12
Q

Tubular system function RT

A
  • Renal blood flow
  • GFR
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13
Q

Proximal Tubules: Reabsorb

A
  • H2O
  • Na
  • K
  • Glucose
  • AA
  • Bicarbonate
  • Phos
  • Mag
  • Cl
  • Ca
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14
Q

Proximal tubules: Secrete

A
  • H+
  • Organic acids
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15
Q

Distal convoluted tubules: Secrete

A
  • K
  • H+
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16
Q

Distal convoluted tubules: Reabsorb

A
  • H2O (w ADH)
  • Na (w aldosterone)
17
Q

Loop of Henle and collecting ducts: Function

A
  • Concentrate vs dilute urine
18
Q

FT vs adult kidney

A
  • Decrease ability concentrate urine
  • Decrease ability respond to fluid load
  • Altered tubular function
19
Q

PT vs FT kidney

A
  • Decrease GFR
  • Decrease response renal tubules to aldosterone
20
Q

RAAS: Function

A
  • Increase NaCl and H2O reabsorption peritubular capillaries →
    • Increase intravascular volume
    • Increase CO
    • Increase BP
21
Q

RAAS cycle

A
  • Renin
    • Convert angiotensinogen (liver) → angiotensin
  • Angiotensin
    • ACE (lungs, renal endothelium) converts angiotensin → angiotensin II
  • Angiotensin II
  • Aldosterone
22
Q

Renin released RT

A
  • Decrease renal blood flow
23
Q

Angiotensin II: Function

A
  • Vasoconstrictor
    • Peripheral blood vessels
    • Efferent arteriole
  • Increase reabsorption
    • Na
    • Cl
    • H2O
  • Release aldosterone
24
Q

Aldosterone Release RT

A
  • Angiotensin II
  • Adrenocorticotropic hormone
  • hyperK
25
Q

Aldosterone Function

A
  • Increases reabsorption
    • Na
    • CL
    • H2O
  • Increase intravascular volume
26
Q

ADH: Release RT

A
  • Decrease intravascular volume
  • Increase plasma osmolality
  • Increase angiotensin II
27
Q

ADH: Function

A
  • Increase permeability collecting ducts
    • Increase H2O reabsorption
    • Increase intravascular volume
28
Q

RAAS: Inhibitors

A
  • ANP
  • BNP
29
Q

ANP and BNP: Function

A
  • Decrease renin, angiotensin, angiotensin II, aldosterone
  • Peripheral vasodilation
  • Decrease BP
  • Decrease intravascular volume
  • Increase diuresis
30
Q

Kidney: Function

A
  • Regulate BP
    • Systemic
    • Renal blood flow
  • Remove metabolic waste
  • Fluid volume and electrolytes balance
  • Acid base homeostasis
  • Erythropoietin
  • Vitamin D metabolism
31
Q

AKI: Incidence

A
  • 8-24%
32
Q

AKI: Risk Factors

A
  • VLBW
  • Low 5min apgar
  • Maternal meds (esp abx, NSAIDs)
  • Intubation birth
  • RDS
  • PDA
  • Phototx
  • Neonatal meds (abx, NSAIDs, diuretics)
  • Congenital diaphragmatic hernia
  • ECMO
33
Q

AKI: s/s

A
  • Oliguria
  • Systemic hypotension
  • Dehydration or volume overload
  • Decrease activity
34
Q

AKI: Long Term Complications

A
  • Progressive renal disease
  • CKD
  • HTN
  • Renal tubular acidosis w impaired renal tubular growth
35
Q

AKI: Types

A
  • Prerenal
  • Intrinsic
  • Postrenal
36
Q

Prerenal AKI: Etiology

A
  • Hypotension/hypoperfusion (most common)
  • Congestive heart failure
  • Respiratory distress/hypoxia
  • Dehydration
  • Hypoalbuminemia
  • Nephrotoxic meds
37
Q

Hypotension/hypoperfusion RT

A
  • Neonatal asphyxia
  • Ischemic damage
  • Blood loss
  • 3rd space loss
  • Dehydration
  • Shock
38
Q

Prerenal AKI: Dx

A
  • fluid challange
    • NS 10-20ml/kg/30min
    • determine intravascular fluid loss
39
Q

Intrarenal: Etiology

A
  • Prolonged prerenal injury
  • Ischemic injury
  • Obstructive renal injury
  • Congenital abnormalities
  • Congenital inflammation/infection
  • Nephrotoxic meds
  • Aortic thrombosis
  • Artery thrombosis
  • Acute tubular nephrosis

nnp i (9 decks)

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