Patho & Pathophis Renal disorders Flashcards

(41 cards)

1
Q

What is the overall function of the kidney

A

They selectively reabsorb minerals like sodium and potassium back into the circulation to maintain body fluids

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2
Q

What is allowed through the glomeruls into the proximal convoluted tubule

A

Only plasma is allowed through red blood cells and other minerals arent

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3
Q

What is the function of the Nephron

A

This controls the amount of sodium that get reabsorbed back into the blood to maintain blood volume while also eliminating the waste material

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4
Q

What do diuretics do

A

These increase urine volume “water pills”
They remove excess sodium & water from the body by blocking reabsorption of these substances.

May also cause excessive potassium removal from body necessitating concurrent usage of drugs to prevent hypokalemia

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5
Q

What regulates the reabsorption of minerals

A
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6
Q

How do the Kidneys control PH

A

It plays a role in the bicarbonate buffering system

It also plays a role in excreting hydrogen atoms

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7
Q

What is Creatinine

A

This is a chemical waste molecule that is generated from muscle metabolism.

It is transported through the blood and filtered out by the kidneys so it can be disposed of in urine

It is mainly absorbed in the glomerular reabsorption but can also be in the proximal tubular excretion

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8
Q

How to the kidneys reabsorb water

A

They do this with the help of osmosis

This involves the reabsorption of sodium then water follows increasing blood volume

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9
Q

How does Glucose affect the body

A

Glucose is the fuel for ATP
Glucose also has an osmotic pull

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10
Q

How is Amonia made and how is it excreted through the body

A

Amonia is form when amino acids are broken down. Amonia is toxic to the body so the liver adds CO2 to it making it urea. This is then transported to the kidney and excreted via urination

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11
Q

How does potassium affect the body

A

This has a major affect on the sodium potassium pump (involved in sending action potentials)

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12
Q

What do Amino acids do in our body

A

These are the building blocks for proteins
It is also essential for muscle growth and synthesis (pretty much all amino acids r reabsorbed back into circulation)

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13
Q

What does Bi Carbonate do

A

This is heavily involved in the bicarbonate buffer
This binds with acid and created carbonic acid, this can then dissociate into water and CO2

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14
Q

Do respiratory disorders causing acidosis or alkalosis initiate a kidney response?

A

YES
Acidaemia: Kidneys excrete excess hydrogen ions and reabsorb bi carobonate

Alkalaemia: Kidneys secrete less hydrogen back into the kidney tubules and excrete more bicarbonate ions (usually with sodium ions)

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15
Q

How does the body balance water

A
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16
Q

What is Hyponatremia

A

This is a decrease in the sodium concentration

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17
Q

What is Acute renal failure

A

Both kidneys have to be involved.

This can be directly linked to reduced blood flow or inflammation and Necrosis of tubules causing obstruction and back flow

This can be reversible if detected early enough but can end up with patients having to go in dialysis

18
Q

What are the 3 main areas that Renal failure can occur in

A

Prerenal - this is the most susceptible area and can lead to metabolic acidosis

Intrinsic - this is damage or inflammation to the filtering parts of the kidney of the basement membrane causing renotoxins to accumulate in the renal cortex

Postrenal - this is an obstruction of the urine outflow from the kidney e.g. kidney stone causing damage to the filtering structures of the kidney

19
Q

What is Oliguria

A

This is the reduced urine outflow

20
Q

What is Acute Tubular Necrosis

A

This makes up 75% of acute renal failure cases.

This is where the tubular segment of the nephron injured via ischemic injuries damaging the cell membrane.

Patch necrosis at multiple points in tubules may occlude the lumen. If not fatal regeneration eventually completely reverses the damage

21
Q

What is the mortality rate for Acute tubular neucrosis

22
Q

What are UTI’s

A

These are extremely common and typically caused by E. coli

Depending on virulence infection will ascent especially if
Bacteria is not flushed out during urination
Bladder lining does not provide sufficient protection
Insufficient immune response

23
Q

How does E. coli cause UTI’s

A

E. coli can adhere to the mucosa of the bladder, which means that it is not always washed out by urination this leads infection.

UTI’s are most common in woman because their urethras are much smaller than men and men’s prostatic fluids give a natural barrier

24
Q

What are the two lower UTI’s

A

Urethritis - the urethra is inflamed, red an swollen

Cystitis - bladder wall inflamed, red, swollen
- the bladder becomes hypersensitive and has reduced capacity

25
What is Pyelonephritis
This is the flash word for Kidney infection
26
What are some risk factors for developing a UTI in children
Constipation/dehydration History of UTI's Familial history of issues Prolonged time in unchanged nappies Poor Toilet paper technique
27
What are some risk factors for developing a UTI in Adults
Poor toilet paper technique First UTI at early age Sex Adult nappies Antibiotic use History of UTI Catheter in situ
28
What is Glomerulonephritis
This is a bilateral inflammation of glomeruli, typically following streptococcal infections Previous infection creates antigen antibodies that are in the glomerular capillaries another infection triggers a type 3 hypersensitivity reaction activating complement system and inflammatory response
29
What happens with the inflammation response in Glomerulonephritis
This is when there is glomerular permeability resulting in the leakage of some proteins and erythrocytes into the filtrate making the urine dark and cloudy It also increases congestion decreasing Glomerulus filtration rate
30
Can Glomerulonephritis cause death?
Yes in severe cases Blood flow can decrease to the kidney triggering renin secretion increasing the blood pressure & oedema leading to acute kidney failure and death
31
What happens in Pyelonehritis
Sudden inflammation caused by bacterial infection can involve both kidneys or just 1 infection extends from ureter into kidney Pus fills the kidney pelvis and calyces leading to inflamed medulla If infection is severe, exudate can compress renal artery & veins and obstruct urine outflow Bi-lateral obstruction likely to cause acute renal failure Chronic infection can result in scar tissue forming
32
What are Kidney stones (Calculi)
These can form anywhere in the urinary tract but most commonly in the kidney Calculi tend to form when there are excessive amount of relatively insoluble salts in the filtrate or when insufficient fluid intake results in high concentrate filtrate Once any debris form, deposits continue to accumulate forming a large stone
33
What are most calculi composed of
75% are composed of calcium salts which can be from a parathyroid tumor or other metabolic disorders. The Urines PH can increase stone formation
34
Chronic Renal Failure
This may result from hypertension & diabetes It represents loss of functioning kidney nephrons This is usually asymptomatic until greatly advanced
35
What are the stages of chronic Renal failure
36
Overview of chronic Kidney disease
37
What are some treatment plans for Chronic Renal faliure
Kidney transplant / dialysis These are treatment for someone who has advanced uremia Transplant surgery and dialysis is dictated by age, donor availability & personal preference Transplantation is the preferred method of treatment
38
What is the difference between Hemodialysis & Peritoneal dialysis
Hemodialysis - Blood is taken out from a vein and goes through a dialyzer then pumped back into the body Peritoneal dialysis - this is where you pump dialysis fluid into the peritoneum
39
When can rejection occur with a kidney transplant
Acute rejection - typically occurs in the first several months after transplantation Chronic rejection - occurs months or years after transplant
40
What sort of questions to ask when treating a patient on dialysis
41
What are some important vitals to check for a patient on dialysis