HLTH 2501: kidney review

Question 1

where are the majority of the glomeruli located?

Answer 1

in the cortex of the kidneys

Question 2

what form the filtration unit for blood?

Answer 2

the renal capsule that is the Bowman’s capsule and the glomerulus

Question 3

what happens when the filtration pressure increases?

Answer 3

more filtrate forms and more urine is produced

Question 4

transport maximum

Answer 4

is a limit of reabsorption of certain molecules, ex. glucose can only be absorbed so much so it is common for glucosuria to be present

Question 5

glucosuria

Answer 5

presence of glucose in the urine

Question 6

ADH

Answer 6

released from the posterior pituitary to alter the reabsorption of water in the DCT and CT

Question 7

aldosterone

Answer 7

is secreted by the adrenal cortex and controls sodium reabsorption and water in the DCT

Question 8

ANH

Answer 8

is released from the heart and reduces sodium and fluid reabsorption in the kidneys

Question 9

what does each renal artery pass through?

Answer 9

the renal pelvis

Question 10

why is any obstruction of blood flow in the kidneys dangerous?

Answer 10

because there are no anastomoses present between the interlobar and arcuate arteries, therefore no alternative blood supply is available to a kidney lobe is there is an obstruction

Question 11

3 factors controlling constriction in the arterioles

Answer 11

local autoregulation, the SNS, and the renin-angiotensin mechanism

Question 12

autoregulation of arterioles

Answer 12

these are small, local reflex adjustments in the diameter of the arterioles made in response to minor change in blood flow in the kidneys

Question 13

blood pressure and renal disease

Answer 13

BP is typically elevated

Question 14

ex. of a renin-blocking drug

Answer 14

beta-adrenergic blocking drugs

Question 15

why is urine flow often obstructed in older men?

Answer 15

due to hypertrophy of the prostate

Question 16

incontinence

Answer 16

is the loss of voluntary control of the bladder

Question 17

causes of incontinence

Answer 17

diabetes, pregnancy or childbirth, overactive bladder, enlarged prostate, weak bladder muscles, UTIs, diseases like parkinson’s or multiple sclerosis, spinal cord injuries, or severe constipation

Question 18

enuresis

Answer 18

is involuntary urination by a child after age 4-5 when bladder control is expected, most children only have this at night

Question 19

factors causing enuresis

Answer 19

developmental delays, sleep patterns, or psychosocial aspects

Question 20

stress incontinence

Answer 20

occurs when increased intraabdominal pressure forces urine through the sphincter and this can occur with coughing, lifting, or laughing

Question 21

overflow incontinence

Answer 21

results from an incompetent bladder sphincter, causing a dribble or leak of urine

Question 22

spinal cord injuries and miturication

Answer 22

can cause flaccid or spastic bladder due to interference with the CNS and ANS; if the injury is at the sacral level, retention may occur

Question 23

retention

Answer 23

is an inability to empty the bladder and may be accompanied by overflow incontinence; this is common after anesthesia

Question 24

catheter

Answer 24

is a tube inserted in the urethra that drains urine from the bladder to a collecting bag outside the body; this prevent kidney damage but commonly cause infections

Question 25

cloudy urine

Answer 25

may indicate large presence of protein, blood cells, bacteria, or pus

Question 26

dark coloured urine

Answer 26

may indicate hematuria, excessive bilirubin content, or highly concentrated urine

Question 27

hematuria

Answer 27

blood in urine

Question 28

unpleasant odor urine

Answer 28

may indicate infection or result from certain foods or medications

Question 29

what is hematuria associated with?

Answer 29

infection, inflammation, or tumors in the urinary tract; gross hematuria (large number of RBCs) may indicate increased glomerular permeability or hemorrhage

Question 30

proteinuria

Answer 30

indicates the leakage of mixed plasma proteins into the filtrate owing to inflammation and increased glomerular permeability; albuminuria refers to albumin

Question 31

bacteriuria or pyuria

Answer 31

indicates infection in the urinary tract; pyuria is pus

Question 32

urinary casts

Answer 32

are microscopic molds on the tubules, consisting of one or more cells, bacteria, protein, etc. and these indicated inflammation of the kidney tubules

Question 33

low specific gravity of urine

Answer 33

usually is related to renal failure (assuming normal dehydration)

Question 34

what is found in the urine when diabetes mellitus is not controlled well?

Answer 34

glucose and ketones

Question 35

what in the urine signifies a failure to excrete nitrogenous wastes?

Answer 35

urea and creatinine and these are attributed to decreased GFR

Question 36

what in the urine signifies metabolic acidosis?

Answer 36

low pH and low HCO3- and this indicates decreased GFR and failure of the tubules to control the acid-base balance

Question 37

what in the urine signifies bone marrow depression?

Answer 37

low hemoglobin

Question 38

what in the urine signifies decreased erythropoietin secretion?

Answer 38

low hemoglobin

Question 39

what in the urine may be used for a diagnosis of postreptococcal glomerulonephritis?

Answer 39

antibody levels of antistreptolysin O or antistreptokinase

Question 40

what do high renin levels indicate?

Answer 40

hypertension

Question 41

what is used to asses GFR?

Answer 41

clearance tests like creatinine or inulin clearance or radioisotope studies

Question 42

what can be used to visualize the structures and any abnormalities of the urinary system?

Answer 42

radiologic tests, angiography, ultrasound, CT, MRI, and intravenous pyelography

Question 43

cystoscopy

Answer 43

visualizes the lower urinary tract and may be used in performing a biopsy or removing kidney stones

Question 44

diuretics

Answer 44

are "water pills" used to remove excess sodium ions and water from the body, therefore increasing the excretion of water, also causes edema to decrease

Question 45

what are diuretics commonly prescribed for?

Answer 45

hypertension, edema, CHF, liver disease, and pulmonary edema

Question 46

most common action of diuretics and 2 examples

Answer 46

inhibit NaCl reabsorption; ex. hydrochlorothiazide and furosemide

Question 47

major side effects of diuretics

Answer 47

excessive loss of electrolytes which may cause muscle weakness or cardiac arrhythmias

Question 48

what is important to replace when taking diuretics?

Answer 48

potassium and other electrolytes

Question 49

example of a potassium sparing diuretic

Answer 49

spironolactone; this is often taking in combination with thiazides

Question 50

hydrochlorothiazide

Answer 50

inhibits reabsorption of Na+ and H20 in DCT; it helps with hypertension, CHF, and edema

Question 51

furosemide

Answer 51

decreases reabsorption of Na+ and H20 in PCT, loop of henle, and the DCT; it works with hypertension, CHF, edema, renal disease, and liver disease

Question 52

spironolactone

Answer 52

is an aldosterone antagonist and blocks reabsorption of Na+ and K+ in the DCT; it works for CHF, hypertension, and liver disease

Question 53

acetazolamide

Answer 53

carbonic anhydrase inhibitor that blocks reabsorption of Na+ and secretion of H+; is used for CHF and glaucoma

Question 54

example of a thiazide type drug

Answer 54

hydrochlorothiazide

Question 55

example of a loop diuretic

Answer 55

furosemide

Question 56

example of a potassium sparing diuretic

Answer 56

spironolactone

Question 57

mannitol

Answer 57

is given intravenous and increases osmotic pressure and water in the filtrate and reduces Na+ reabsorption; is used for cerebral edema and glaucoma

Question 58

example of an osmotic diuretic

Answer 58

mannitol

Question 59

risks of diuretics

Answer 59

xerostomia (dry mouth), dental caries, dizziness, and orthostatic hypotension

Question 60

dialysis

Answer 60

provides an artificial kidney which can be used to sustain life after the kidneys fail

Question 61

how much kidney do you need to survive?

Answer 61

half of one

Question 62

who is dialysis used for?

Answer 62

to treat someone who has acute renal failure, for those in end-stage renal failure until a transplant is available, or those experiencing rejection from a transplant

Question 63

what is restricted for those with dialysis?

Answer 63

diet, protein, fluid intake, and electrolytes

Question 64

two forms of dialysis

Answer 64

hemodialysis and peritoneal dialysis

Question 65

hemodialysis

Answer 65

is provided in a hospital, dialysis center, or home with special equipment; the patients blood usually from the arm is attached to a machine where the exchange of wastes, fluid, and electrolytes takes place

Question 66

what separates the patients blood from the dialysis fluid in a hemodialysis?

Answer 66

a semipermeable membrane

Question 67

dialysate

Answer 67

the dialysis fluid

Question 68

how often does hemodialysis take place?

Answer 68

three times a week for sessions about 3-4 hours

Question 69

potential complications of dialysis

Answer 69

infected shunt, blood clots, and a risk for hep B, C, or HIV; peritonitis is a risk for peritoneal dialysis

Question 70

peritoneal dialysis

Answer 70

is administered in a dialysis unit or at home, in which a catheter is implanted in the peritoneal cavity, allowing for the exchange of wastes and electrolytes to occur here

Question 71

what serves as the exchange membrane in peritoneal dialysis?

Answer 71

the peritoneal membrane

Question 72

is hemodialysis or peritoneal dialysis longer?

Answer 72

peritoneal