Quiz 2 Flashcards
(163 cards)
The upper pole of each kidney is near the level of which vertebra?
12th thoracic
The kidneys process how much blood per minute?
Per day?
1 Liter (20% of total cardiac output)
1500L
What functions do the kidneys perform?
- Excrete metabolic waste
- Regulate electrolytes
- Buffer acid-base in blood
- Activate vitamin D
- Secrete renin
- Secrete erythropoietin
Structural and functional unit of the kidney:
consists of:
Nephron
- glomerular capsule
- proximal convoluted tubule
- loop of Henle
- distal convoluted tubule
- collecting duct
Capillary tuft surrounded by Bowman’s capsule:
Blood supply in and out:
Glomerulus
Blood IN via Afferent arteriole
Blood OUT via Efferent arteriole
What is the GFR?
Glomerulur filtration rate
blood filtration rate, utilizing pressure gradient btw afferent and efferent arterioles to drive filtration
Risk of CAKUT:
CAKUT - congenital abn of kidneys and urinary tract
1/3 of anomalies noted on prenatal US
predisposed adult HTN & CVD
40% of childhood end-stage renal failure
Failure of kidney(s) to develop to normal size/weight:
Renal hypoplasia
unilateral MC than bilateral
smaller kidney prone to infx & scarring
Kidneys fused at the upper or lower pole:
Horseshoe kidney
lower pole MC
often asx
infx may occur d/t urinary stasis
Abnormal location of one/both kidney(s):
Ectopic kidney
MC locations - lower abdomen, pelvis
Cystic lesions of the kidneys are (common/rare) and most are (asx/severe).
common
asx - found incidentally on imaging or post-mortem
T/F: Simple cysts predispose an individual to developing chronic renal failure and/or neoplasia.
False
mb multiple, but never as numerous as polycystic kidney dz
Autosomal recessive form of PKD:
ARPKD
childhood PKD
autosomal dominant - adult (ADPKD)
Histopathology of childhood PKD:
multiple large cysts
lined by flattened cuboidal epithelium
fibrotic intervening parenchyma
islands of bluish cartilage
T/F: The adult form of PKD is more commonly associated with concurrent liver cysts than is childhood PKD.
True
cysts not usu present at birth, develop slowly over time
assoc w/oxalate crystals in urine and cysts
Presumed mechanism for adult PKD:
Abnormal collagen and elastin that results in diminished integrity
Familial recurrence rate of ADPKD:
50%
Patients on ________ commonly form kidney cysts, and are at increased risk for _________________.
dialysis
renal cell carcinoma
Most forms of glomerular injury are found to be __________ mediated. Histo findings include:
immunologically
WBC infiltration
inflammatory cell infiltration
Proliferation of mesangial, endothelial and epithelial cells is (common/uncommon) in glomerular dz.
Common
In glomerular dz, thickening of the ___________ is a common and important finding.
basement membrane
usu d/t deposition of immune complexes on epithelial side of the membrane
Immune complexes are often the result of specific antibodies to the glomerular basement membrane aka:
anti-GBM antibodies
Glomerular dz’s presenting as nephrotic syndrome:
Lipoid nephrosis
Membranous glomerulopathy
Focal-segmental glomerulosclerosis
Nodular and diffuse glomerulosclerosis
Characteristic findings of nephrotic syndrome (4):
Proteinuria (>3 gm per 24 hrs.)
Decreased serum proteins
Increased serum lipid levels
Generalized edema