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Pathophysiology > Lecture 15 and 16: Renal > Flashcards

Lecture 15 and 16: Renal Flashcards

1
Q

True or False: The calyces collect urine while the ureters carry urine to the bladder

A

True

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2
Q

True or False: Glomerular filtration favors net filtration because the Pgc is > in the afferent end

A

True

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3
Q

True or False: Healthy kidneys are important for maintaining acid-base balance, arterial blood pressure, and water/electrolyte balance

A

True

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4
Q

How do kidneys respond to sudden drop in blood pressure (as in case of hemorrhage)?

A
  • Increase secretion of: renin and Ang II
  • Renal arterioles constrict
  • Decreased RBC and GFR
  • Increased tubular Na/H2O reabsorption
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5
Q

____, which is important for RBC, and ______ vit D3 are made in kidneys

A

Erythropoietan; 1,25-Dihydroxy Vit D3

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6
Q

Oliguria or Anuria, as well as elevation in blood urea nitrogen level (azotemia) are features of:
A. Acute Renal Failure
B. Chronic Renal Failure

A

A. Acute Renal Failure

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7
Q

True or False: Chronic renal failure is irreversible

A

True

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8
Q

Does normal GFR increase or decrease with age?

What is a novel biomarker for progressive chronic kidney disease?

A

Decrease
KIM-1

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9
Q

What are three features of azotemia?

A
  1. Elevated BUN
    (blood urea nitrogen)
  2. Elevated creatinine
  3. Decreased GFR
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10
Q

Azotemia, accompanied by clinical signs and biochemical abnormalities, as well as secondary involvement is characteristic of…

A

Uremia

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11
Q

Which condition is associated with lipiuria, high proteinuria, but NO blood in urine?
A. Nephritic Syndrome
B. Nephrotic Syndrome

A

B. Nephrotic Syndrome

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12
Q

true or False: Nephritic Syndrome is associated with damage to the glomeruli

A

False - inflammation of glomeruli

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13
Q

True or False: While both nephritic and nephrotic syndrome are characterized by proteinuria, Nephritic Syndrome has mild to moderate protein in urine

A

True

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14
Q

True or False: Nephrotic syndrome is characterized by rapid onset of blood in urine

A

False - Nephritic Syndrome is

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15
Q

What are two symptoms associated with to renal tubule defects?

A
  1. Polyuria
  2. Nocturia
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16
Q

Damage to renal tubules can cause electrolyte disorders, such as…

A

Met acidosis

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17
Q

Decreased blood supply to kidneys suggests what type of acute renal failure?

Abnormalities within kidneys suggests what type of acute renal failure?

Obstruction of urinary collecting system (from calyces to bladder) suggests what type of acute renal failure?

A

Pre-renal ARF
Intra-renal ARF
Post-renal ARF

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18
Q

A patient gets a severe 4th degree burn. What type of acute renal failure may he have?

A

Pre-renal

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19
Q

A patient goes on a long plane ride and develops an embolism that traveled to his kidneys, resulting in renal artery stenosis. What type of acute renal failure may he have?

A

Pre-renal

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20
Q

A patient takes a lot of aspirin, leading to excess blockage of PG synthesis. What type of acute renal failure may he have?

A

Pre-renal

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21
Q

Anaphylactic shock, sepsis, or severe infection may lead to which type of acute renal failure?
A. Pre-renal
B. Inter-renal
C. Post-renal

A

A. Pre-renal

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22
Q

What is the primary mechanism of renal dysfunction?

A

Decreased RBF => Decreased GFR => Reduced urinary output

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23
Q

True or False: Acute reduction in RBF is a common cause of acute renal failure in hospitalized patients

A

True

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24
Q

Which areas within the kidneys are subject to damage (thereby leading to intra-renal ARF)?

A
  1. Blood vessels
  2. Glomeruli
  3. Tubules
  4. Renal Interstitium
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25
What is the primary cause of acute intra-renal failure? A. Acute Glomerular Nephritis B. Vasculitis C. Malignant HTN
A. Acute Glomerular Nephritis
26
Which of the following conditions is characterized by lodging of circulating Antigen-Antibody complexes in glomeruli? A. Acute Glomerular Nephritis B. Vasculitis C. Malignant HTN
A. Acute Glomerular Nephritis - Note: induces inflammation
27
~95% cases of Acute Glomerular Nephritis damage occurs 1-3 weeks post-infection. What pathogen is usually the culprit?
Group A - beta streptococci
28
True or False: A patient with SLE or Viral Hepatitis (Hep B or Hep C) may have prolonged or recurrent Acute Glomerular Nephritis
True
29
If Acute Glomerular Nephritis is left untreated, what can occur?
Chronic kidney failure
30
When Ag-Ab complexes deposit in glomeruli during Acute Glomerular Nephritis.... 1. which two cells proliferate? 2. which cells get entrapped in glomeruli, leading to blockage of some glomeruli?
1. Endothelial and mesengial cells proliferate 2. WBC's get entrapped in glomeruli
31
In Acute Glomerular Nephritis, some glomeruli get blocked due to WBC being trapped, which can lead to excess permeability in other glomeruli. What is the effect of this excess glomerular permeability?
1. Proteins/RBC in urine 2. Excess damage due to phagocytes trying to remove Ag-Ab complex
32
A patient has been exposed to Cd and other heavy metals of her lifetime as a miner. Which type of acute renal failure might she develop??? A. Pre-renal Acute Renal Failure B. Intra-renal Failure C. Post-renal Failure
B. Intra-renal Failure
33
True or False: Abx, chemo, NSAID's, and antiviral agents can cause drug-induced kidney disease
True
34
What two conditions that cause acute tubular necrosis?
Ischemia and Toxins
35
In tubular necrosis, there is DIRECT injury to tubular epithelial cells, which lead cells to slough off into the tubule and, ultimately, _____
block outflow
36
Under which conditions can tubular necrosis be treated?
If BM is intact, epithelial cells may regrow and repair tubule in 10-20 days
37
A patient with Acute Pylonephritis has which type of acute renal failure? A. Intra-renal B. Post-renal C. Pre-renal
A. Intra-renal
38
Obstruction of which tissues can lead to acute post-renal kidney failure?
- Ureters/Renal Pelvis - Bladder - Urethra
39
What are the clinical features of acute renal failure?
Nausea Loss of appetite SOB Skin rash Swelling Fatigue
40
If a patient with reduced GFR, how might this present on clinical exam?
Oliguria or Anuria
41
Why might a person with acute renal failure display edema? HTN?
Edema = Reduced osmotic pressure in blood due to proteinuria HTN = Volume overload due to decreased GFR and elevated electrolytes
42
Why might a person who acute renal failure have metabolic acidosis? retention of electrolytes?
Metabolic Acidosis: Reduced H+ excretion and HCO3 reabsorption Retention of Electrolytes: Reduced GFR and Na/K excretion
43
Edema, overt uremia, hyperkalemia, and metabolic acidosis suggests.... A. Chronic renal failure B. Acute renal failure
A. Chronic renal failure
44
True or False: Glomerular Nephritis, Heavy Metal exposure, or Pyelonephritis can suggests acute or chronic renal failure
True
45
True or False: Lupus, DM, or Tb suggests chronic renal failure
True
46
Why is chronic renal failure a vicious cycle of disease progression?
Primary kidney disease leads to fewer functional nephrons As a result... - Increase arterial pressure - Hypertrophy and vasodilation of surviving nephrons As a result... - Increased GLOMERULAR pressure and filtration in surviving glomerular capillaries = Glomerular sclerosis
47
What are two ways to slow progression of chronic renal disease?
48
Three most common causes of chronic renal failure?
Atherosclerosis of large renal arteries Fibromuscluar Hyperplasia Nephrosclerosis (sclerotic lesions of the smaller arteries, arterioles, and glomeruli)
49
What is the most common form of kidney disease--characterized by decrease in RBF and GFR?
Nephrosclerosis
50
In Arteriolar Nephrosclerosis, there are lesions in smaller interlobular ___ and afferent ____ In focal segmental glomerular sclerosis, the lesion disrupts ____ cells
arteries; arterioles
51
How can arteriolar nephrosclerosis lead to scar tissue?
Leakage of plasma through intimal membrane leads fibinoids to deposit in medial layer Deposits lead to thickening of vessel wall, which leads to occlusion, destruction of nephrons, and scar tissue
52
Pyelonephritis is an infectious cause of chronic renal failure, caused by bacterial infection. What is the causal agent?
E. coli
53
Inability to empty bladder completely, obstructed urine outflow, or cystitis can make one more prone to ____
Pyelonephritis
54
If there is bacteria in the medulla, as in pyelonephritis, what cannot occur?
Cannot concentrate urine - therefore: polyuria
55
True or False: The presence of WBC's in casts indicates acute tubular inflammation of the kidneys
True
56
In which conditions are necrotic papillae seen?
1. Diabetes 2. Acute pyelonephritis w/obstruction
57
Three causes of nephrotic syndrome?
1. Amyloidosis 2. Minimal change disease 3. Chronic glomerulo nephritis
58
____ is a nephrotic syndrome in children that is characterized by loss of foot processes and is caused by T cell dysfunction or epithelial cell injury
Minimal Change Disease (Lipid Nephrosis)
59
What are clinical symptoms of chronic renal disease?
Edema Hyperkalemia/phosphate Anemia Hypocalemia HTN Myopathy/Neuropathy Bleeding
60
True or False: 90% of people with renal cell carcinoma have hematuria
True

Pathophysiology (26 decks)

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