Patho Unit 7 Flashcards by Lauren Gilmore

muscular tubes that carry urine to the bladder

ureters

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external sphincter the controls urine outflow under voluntary control

urethra

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functional unit of the excretory kidney

nephron

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two types of nephrons

cortical

juxtamedullary

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4 processes of the renal system

filtration
reabsorption
excretion
secretion

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all substances found in the urine that are not reabsorbed back into the body (left in the filtrate)

excretion

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accumulation of potassium, acids, fluid, and waste products that should have been removed in urine

anuria

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results in fluid overload, acid-base disturbances, electrolyte abnormalities, and build up of waste products

renal failure (uremia)

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in severe hypoglycemia, when the liver and kidneys make glucose from other substances

gluconeogenesis

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filtrate flows down the ______ ______ in the cortex and reabsorption takes place here

proximal tubule

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movement of fluids from filtrate back into the peritubular capillaries

reabsorption

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things that are reabsorbed back into the peritubular capillaries

Na and Cl
water
amino acids
glucose
phosphate
proteins

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movement from peritubular capillaries back into the filtrate

secretion

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a measure of renal glomular filtration

creatinine clearance

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part of juxtamedullary nephron that creates a very salty environment in the medulla of the kidney

Loop of Henle

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part of J nephron that monitors the filtrate to indirectly assess vascular volume

macula densa (dense body)

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type of cells that release renin to activate the RAS

juxtaglomular apparatus

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part of loop of Henle that prevents the rapid flow and washout of the concentration gradient

hairpin loop

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once filtrate can no longer be changed by reabsorption or secretion, the filtrate is now called _____

urine

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where is ADH synthesized

hypothalamus neurons

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where is ADH stored

posterior pituitary gland

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three reasons ADH would be released

elevated osmolarity
peripheral baroreceptor activation with hypotension
angiotensin 2 stimulation via RAS activity

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mineralcorticoid hormone made by the adrenal gland that affects mineral homeostasis

aldosterone

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disease caused by lowering production of aldosterone. involves Na wasting (hyponatremia) from excess loss of Na into the urine, K accumulation (hyperkalemia), and acidosis

Addison’s disease

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disease caused by overproduction of aldosterone, Na and water retention (edema), K wasting (hypokalemia), and alkalosis

Cushing's disease

two types of natriuretic peptides

brain (BNP) and atrial (ANP)

type of drug that interferes with the body's sodium excretion resulting in increased sodium and water loading the increases overall blood volume and therefore blood pressure

NSAID's

what is satisfied when our osmolality returns to normal and mouth dryness is relieved.

thirst response

stimulates salt eating

hyponatremia

metabolic waste product of muscle creatine that is filtered out in the urine

creatinine

amount of creatinine cleared out by filtration is a measure of

glomerular filtration rate

acute or chronic disease that can be caused by many things and deceases the GFR or tubular function

renal failure

two types of acute renal syndromes

acute kidney injury | acute renal failure

3 types of chronic renal syndromes

chronic kidney disease (CKD) chronic renal failure (CRF) renal insufficiency

3 labs run to test renal function

BUN creatinine cystatin

when there is BUN protein in the blood

uremia (azotemia)

risk of acute renal failure, injury to the kidney,failure of renal function, loss of function, end stage renal failure

RIFLE

caused by use of contrast dyes used in radiology studies - damages the kidneys

contrast induced nephropathy

caused by any condition that reduces perfusional pressure to the glomerulus (hypovolemia, sepsis, cardiogenic shock, low output HF, dehydration, severe hemorrhage, liver failure)

pre-renal AKI (acute kidney injury)

acute renal failure when there is nothing wrong with the kidneys (can occur due to liver failure)

hepatorenal syndrome

any condition that damages STRUCTURES of the kidneys

intra-renal AKI

feeling that you have to urinate very soon

urgency

having to urinate often but only a small amount is expelled

frequency

waking up to urinate more than normal

nocturia

death of skeletal muscle cells realeases cell contents into circulation - myoglobin, calcium, potassium, proteins, creatine, acid - can be fatal caused by extreme exertion. febrile, tenderness of large muscles

rhabdomyolysis

any condition that BLOCKS urinary outflow (kidney stone in ureter, bladder tumor)

post-renal AKI

condition/disease that is usually caused by DM and HTN (or analgesic abuse) where pt is anemic, has elevated BUN, PTH, hyperphosphatemia, hyperkalemia, hypocalcemia, hyponatremia, low bicarbonate, and low pH (acidosis)

chronic kidney disease (CKD) aka chronic renal failure (CRF) aka end stage renal disease (ESRD)

type of diet has low sodium, restricted protein intake, low acid

diabetic diet

what will patient need if CKD reaches stage 5

Renal Replacement Therapy (RRT)

two types of renal replacement therapy

peritonial/ hemodialysis | kidney transplant

3 types of dialysis

hemodialysis peritoneal dialysis hemofiltration

used to remove toxins from the blood, such as: drugs, potassium, calcium, urea, and acidosis that were not filtered out by the kidney

dialysis

type of dialysis that allows rapid access in the critically ill patient via a catheter in a large vein

hemodialysis

longterm access where an artery and a vein are joined either in the arm or hand

arterio venous fistula (AV fistula)

catheter pushes fluid into the peritoneal cavity and the peritoneum serves as the semi-permeable membrane

peritoneal dialysis

test strip with chemical reagents that demonstrate abnormalities in urine

urinalysis (dip stick)

normal range of specific gravity in urinalysis

1.005- 1.025

leukocytes in urine

pyuria

positive in urine infection

nitrite

blood in the urine (gross or microscopic)

hematuria

large amounts of albumin in the urine, losing water along with albumin, presenting with edema, pulmonary edema, pleural effusion, complications of infection

nephrotic syndrome / severe proteinuria

pediatric condition where acidosis presents with HYPOkalemia, and failure to thrive. either impairment in bicarbonate reabsorption or reduced acid secretion

Renal Tubule, Acidosis (RTA)

means excessive urine production

diabetes

deficiency of ADH (pituitary), can be genetic or idiopathic, and acquired from trauma or a tumor in the pituitary. presents with polydipsia, polyuria, nocturia, dehydration with volume contraction if unable to keep up with fluid losses

CENTRAL Diabetes Insipidus

genetic, acquired disorder that is a renal resistance to ADH. presents with thirst, dilute urine, hypernatremia if water not available to unable to drink

NEPHROGENIC Diabetes Insipidus

condition where too much ADH secretion results in over reabsorption of free water resulting in dilutional hyponatremia of the blood. presents with neurological symptoms such as ataxia (abnormal gait) and confusion

syndrome of inappropriate ADH secretion (SIADH)

LOWERED production of aldosterone, Na wasting from excess loss of Na into the urine, K accumulation, and acidosis

Addison's disease

OVERPRODUCTION of aldosterone, Na and water retention (edema), K wasting, alkalosis

Cushing's disease

normal bladder voids how many times per day?

4-8 times

adult bladder can hold about ___ ml

600

normal adult bladder gets urge to void at ___ ml

300

painful urination

dysuria

needing to strain or bear down on the external sphincter to urinate

straining

newborn abdominal masses (enlarged kidneys)

hydronephrotic kidneys (hydronephresis)

pediatric diagnosis where the vesicoureteral junction is incontinent and allows urine to pass backward toward the kidneys

vesicoureteral reflux

disorder associated with undescended testicles where there is a severe reduction in abdominal musculature and the gut hangs our because there is nothing to keep it tight

prune belly syndrome (eagle-barrett syndrome)

when the prepuce of the penis cannot be retracted over the glans

phimosis

when the prepuce of the penis is retracted beyond the coronal sulcus and cannot be returned

papaphimosis

septum develops in vagina that can go all the way up through the cervix and uterus

septate vagina

exposure to androgens in fetal life can masculinize the female infant

masculinization

disease presents with painless hematuria, with risk factors being exposure to certain chemicals and smoking

bladder cancer