GU Overview WK2 Flashcards
(39 cards)
1
Q
Stages Kidney Development
A
- Pronephros
- Mesonephros
- Metanephros
- 5-9wk ascend from pelvis to abdomen
- True kidney
- 9-10wk begins functioning
2
Q
Nephrogenesis: Period of Development
A
- 8-36wk
3
Q
Nephrogenesis: Period Critical Development
A
- 31-36wk
4
Q
Number of nephrons FT at birth
A
- 800,000-1.2mil nephrons
5
Q
Bladder Development
A
- 4-6wk begins formation
6
Q
Urethra Development
A
- 12-13wk
7
Q
GFR: Definition
A
- filtrate/min formed in glomerulus
8
Q
GFR: Rate in utero
A
low
9
Q
GFR: Increase RT
A
- Initial increase rt increase glomerular perfusion pressure
- Later increase rt increase renal blood flow
10
Q
GFR RT (3)
A
- BP peritubular capillaries*
- Hydrostatic pressure glomerular capillaries and bowman’s capsule
- Colloid osmotic pressure capillaries
11
Q
GFR Levels
- <34wk
- FT birth
- FT 2wk
- 2yr
A
<34wk
12
Q
Tubular system function RT
A
- Renal blood flow
- GFR
13
Q
Proximal Tubules: Reabsorb
A
- H2O
- Na
- K
- Glucose
- AA
- Bicarbonate
- Phos
- Mag
- Cl
- Ca
14
Q
Proximal tubules: Secrete
A
- H+
- Organic acids
15
Q
Distal convoluted tubules: Secrete
A
- K
- H+
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
Aldosterone Function
* Increases reabsorption
* Na
* CL
* H2O
* Increase intravascular volume
26
ADH: Release RT
* Decrease intravascular volume
* Increase plasma osmolality
* Increase angiotensin II
27
ADH: Function
* Increase permeability collecting ducts
* Increase H2O reabsorption
* Increase intravascular volume
28
RAAS: Inhibitors
* ANP
* BNP
29
ANP and BNP: Function
* Decrease renin, angiotensin, angiotensin II, aldosterone
* Peripheral vasodilation
* Decrease BP
* Decrease intravascular volume
* Increase diuresis
30
Kidney: Function
* Regulate BP
* Systemic
* Renal blood flow
* Remove metabolic waste
* Fluid volume and electrolytes balance
* Acid base homeostasis
* Erythropoietin
* Vitamin D metabolism
31
AKI: Incidence
* 8-24%
32
AKI: Risk Factors
* VLBW
* Low 5min apgar
* Maternal meds (esp abx, NSAIDs)
* Intubation birth
* RDS
* PDA
* Phototx
* Neonatal meds (abx, NSAIDs, diuretics)
* Congenital diaphragmatic hernia
* ECMO
33
AKI: s/s
* Oliguria
* Systemic hypotension
* Dehydration or volume overload
* Decrease activity
34
AKI: Long Term Complications
* Progressive renal disease
* CKD
* HTN
* Renal tubular acidosis w impaired renal tubular growth
35
AKI: Types
* Prerenal
* Intrinsic
* Postrenal
36
Prerenal AKI: Etiology
* Hypotension/hypoperfusion (most common)
* Congestive heart failure
* Respiratory distress/hypoxia
* Dehydration
* Hypoalbuminemia
* Nephrotoxic meds
37
Hypotension/hypoperfusion RT
* Neonatal asphyxia
* Ischemic damage
* Blood loss
* 3rd space loss
* Dehydration
* Shock
38
Prerenal AKI: Dx
* fluid challange
* NS 10-20ml/kg/30min
* determine intravascular fluid loss
39
Intrarenal: Etiology
* Prolonged prerenal injury
* Ischemic injury
* Obstructive renal injury
* Congenital abnormalities
* Congenital inflammation/infection
* Nephrotoxic meds
* Aortic thrombosis
* Artery thrombosis
* Acute tubular nephrosis
