Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clinical Pathology > Renal > Flashcards

Renal Flashcards

(65 cards)

Start Studying
1
Q

Renal Function

A
  • Clear metabolic wastes from blood
  • Conserve nutrients
    • glucose
    • protein
  • Maintain water, electrolyte, and acid-base balance
  • Hormone production
    • erythropoietin
    • Vitamin D
    • Renin
  • Hormone degredation/excretion
  • Enzyme degradation / Excretion
    • amylase, lipase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Healthy Glomerulus:

Stays in blood

A

Cells: RBC, WBC, Platelets

Plasma proteins (albumin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Healthy Glomerulus:

Passes thru barrier

A

water

solutes: electrolytes, glucose, urea, small proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Healthy Glomerulus:

What determins what gets through

A

size: >68,000 not filtered

Charge: Basement membrane negatively charged, Negatively charged molecules may be repelled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Physiologic Functions of the Nephron:

Glomerular filtration

A

Passive:

Substances move from plasma to tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Physiologic Function of the nephron:

Tubular resorption

A

Passive and Active:

Solutes move from tubules to plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Physiologic Functions of Nephron:

Tubular secretion

A

Passive and Active:

Substances move from plasma to tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Physiologic function of Nephron:

Water regulation

A

Maintain water balance, May go to or from the plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Glomerular Filtration Rate (GFR)

A

Volume of plasma filtered form glomerular capillaries into bowman’s space per unit time

Measured by determining rate of clearance of a substance from plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Glomerular Filtration Rate:

Dependent on?

A

Renal blood flow

of functional nephrons

Hydrostatic pressure in Bowman’s capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Osmometer

A

Measures osmolality

Freezing point assay, not convenient, but more accurate

Measure depends on the number of particles in a volume of water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Refractometer

A

Measures Urine specific Gravity

Depends ofn particle weight and how each particle bends light

Prone to interference

Differences between how glucose, electrolytes, urea, proteins, lipids, and other substances refract light

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Antidiuretic Hormone (ADH)

A

Synonym: Vasopressin

Synthesized in the hypothalamus

Secreted form the posterior pituitary glands

Interacts with receptors ont he cells of hte distal tubules and collecting ducts

Opens water channels via aquaporin proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Stimuli for ADH secretion

A

Plasma hyperosmolality

Decreased cardiovascular pressure

increased concentration of angiotensin

Result: Conserve body water to decrease plasma osmolality and increase blood volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Major events of Nephron Segments:

Proximal Tubule

A

Revomes volume

No change in concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Major events of nephron segments

Descending Loop of Henle

A

Removes water

Increases concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Major Events of Nephron Segments”

Ascending Loop of Henle

A

removes solutes

Dilutes (decreases concentration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Major events of Nephron segments

Distal nephron

A

removes water

Increases concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

To produce conentrated Urine

A

Adequate number of functional nephrons

Adequate production of ADH from pituitary

Distal nephron epithelial cells must be responsive to ADH

Hypertonic interstitium in the renal medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Anuria

A

Lack of urine production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

dysuria

A

painful or difficult urination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

oliguria

A

production of an abnormally small amount of urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Pollakiuria

A

indicating increased frequency of urination. Doesn’t indicate urine volumes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Polydipsia

A

increased water consumption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Polyuria
production of excessive amounts of urine
26
Azotemia
Increased concentration of Urea Nitrogen and/or creatinine
27
Urea Nitrogen
Urea diffuses readily across most cell membranes along a concentration gradient Rapid equilibrium amont intercellular and extracellular fluid compartemnts (~90) Whole blood urea nitrogen = serum urea nitrogen Urea contributes to the renal medullary concentration gradient This drives recovery of water / cocnentration of urine in the collecting ducts
28
Creatinine Metabolism
Creatinine is a wast product from the normal breakdown of musscle tissue Freely filtered thru glomerular barrier into ultrafiltrate NOT RESORBED BY TUBULES excreted in urine
29
Urea Nitrogen Assay
Serum or plasma Stable for 1 day at room temp 203 months if frozen
30
Creatinine Assay
Serum or plasma (NO whole blood)
31
Increased Creatinine (Ct)
Decreased GFR
32
Decreased Creatinine
May not be clinically significant Consider: Decreased muscle mass Hypoproteinemia
33
Pre-Renal Azotemia
UN and creatinine are increased Urine is concentrated
34
Pre-renal Azotemia: Possible Causes:
* Decreased Renal Blood Flow = decreased GFR * **Dehydration** * hypovolemia / fluid maldistribution * Severly decreased cardiac output * Increased production of urea / creatinine * Urea: * high protein diet * GI hemorrhage * Cretinine: * heavily muscled animals
35
Renal Azotemia
Primary causes is within the nephron UN and creatinine are increased Urine is NOT concentrated in the face of dehydration decreased concentrating ability Isothenuric urine (1.007-1.013) indicates an inability to concentrate and dilute
36
Post-renal Azotemia
Primary problem is after the nephron Problem that interferes with excretion UN and creatinine are increased
37
Uremia
Cliical Syndrome associated with renal failure Azotemia plus severe physical consequences fo renal failure * Polyuria / polydipsia * Vomiting / diarrhea * Ammonia odor of breath * GI ulcers * Nonregenerative anemia * Weight loss * Convulsions * Coma
38
Abnormal Laboratory Results in Azotemic Animals: Sodium and chloride
increased with prerenal azotemia Low or WRI with renal failure due to decreased resorption
39
Abnormal Laboratory Results in Azotemic Animals: Potassium
Usually high in oliguric and anuric renal failure Low in cats and cows with polyuric renal failure
40
Abnormal Laboratory Results in Azotemic Animals: Phosphate
Excretion is decreased when GFR is decreased for any reason (Prerenal, renal, postrenal) Usually high in animals with moderates to marked azotemia
41
Abnormal Laboratory Results in Azotemic Animals: Magnesium
Increased with decreased GFR
42
Abnormal Laboratory Results in Azotemic Animals: Calcium: Dogs, cats, cows
Usually WRI or slightly decreased with renal failure Hypercalcemia in dogs and cats with azotemia is more likely to be the cuase for renal disease then the result of renal disease
43
Abnormal Laboratory Results in Azotemic Animals: Calcium: Horses
Rely on renal excretion of calcium Calcium is high in most horses with renal failure due to decreased excretion and a species difference in calcium metabolism
44
Abnormal Laboratory Results in Azotemic Animals: Hematocrit
WRI or high in pre-renal azotemia and ARF Non-regenerative anemia in CRF
45
Abnormal Laboratory Results in Azotemic Animals: Total Protein, Albumin
WRI or high in pre-renal azotemia +/- ARF Within reference interval or low in CRF
46
Abnormal Laboratory Results in Azotemic Animals: Acid/base abnormalities
Yes!
47
Mechanisms of Polyuria
1. Lack of ADH production 1. central diabetes insipidus 2. Phychogenic polydipsia 2. Distal tubule/Collecting Duct cells cannot respond ot ADH 1. nephrogenic biabetes insipidus 3. Must be a conentration gradient between tubular fluid and interstitium 1. solute diuresis 2. Reduced medullary intersitium osmolality
48
Major initial/primary pathogenic mechanisms for Polyuria Chart
49
Decreased Renal Reserve
GFR is about 50% of normal capacity Clinically healthy: NOT azotemic or polyuric – susceptible to insult
50
Chronic Renal Insufficiency
25-50% function Azotemic, Anemia, Decreased concentrating ability, Polyuria
51
Chronic Renal Failure
\<20-25% function Azotemic, anemia, decreased concentrating ability, Electrolyte imbalance, clinical signs fo uremia
52
End-Stage Renal disease:
\<5% function Terminal uremia signs and oliguria or anuria
53
Causes of Polyuria in Chronic Renal Disease?
Loos of functional nephrons * More solute presented to remaining functional nephrons * Increased load through nephrons * Solute diuresis * Medullary hypertonicity is not maintained * medullary tissue damage or abnormal blood flow * Decreased sodium, chloride and urea reabsorption * Damaged cells less responsive to ADH
54
Acute Renal Failure
Reversible or Irreversible Abrupt insult or disease Marked decrease in GFR → Azotemia → Uremia Degree of azotemia does NOT differentiate chronic vs. acute Toxins, ischemia, infection Vascular supply, glomerular, tubular, interstitial disease
55
Mechanisms of Proteinuria: Hemorrhagic or inflammatory
This is the most common mechanism for addition of protein to urine Hemorrhage anywhere in the urinary tract Inflammation causing exudation of plasma proteins intohte urinary tract Magnitide of Proteinuria varies but it DOES NOT lead to hypoalbuminemia
56
Mechanisms of Proteinuria: Funcitonal
Transient mild increase in urine protein content Exercise, fever, seizures, stress Mechanism unclear
57
Mechanism of Proteinuria Overload
Increased plasma concentration of small protiens that pass through glomerular filtration barrier and exceed capacity for tubular resorption Hemoglobin, myoglobin, immunoglobin light chains, Overload proteinuria DOES NOT lead ot hypoproteinemia
58
Mechanisms of Proteinuria: Tubular
Proximal tubular injury causing failure to reabsorb small proteins Usually associated with Acute renal tubule damage Tubular damage = exposure to neprothoxins DOES NOT result in hypoproteinemia
59
Mechanisms of Proteinuria: Glomerular
* Damage/disruption of the glomerular filtration barrier * immune complex deposition * Amyloid deposition * Inflammatory cells contribute - release cytokines and other mediators that can damage the glomerulus * Increased permeability to large and or negatively charged proteins * albumin first, globulins later with progressiive damage * Glomerular damage often leads to sleective hypoproteinemia * Progressive glomerular disease * can lead to tubular damage and tubular proteinuria, loss of nephrons → azotemia, renal failure
60
Severe Glomerular Disease
The entire nephron may become nonfuncitonal Severe, persistent proteinuria can lead to the nephrotic syndrome Proteinuria hypoproteinemia Hypercholesterolemia Ascited or edema
61
Urine Protein: Urine Creatinine Ratio: UPC \< 0.2
Healthy dogs and cats
62
Urine Protein: Urine Creatinine Ratio: UPC 0.1-0.4, 0.1-0.5
Is borderline - not conclusive evidence of proteinuric renal disease
63
Urine Protein: Urine Creatinine Ratio: 0.4-3, 0.5-3
Proteinuria is present in this range proteinuria could result form glomerular or tubular damage
64
Urine Protein: Urine Creatinine Ratio: UPC \>3
Indicative of glomerular disease Tubular disease may also be present, but it is not the whole story
65
Urine Protein: Urine Creatinine Ratio: UPC ~15
Most indicative of amyloidosis

Clinical Pathology (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions