Renal

Question 1

Removal of substances from blood into renal tubule at glomerulus.

Answer 1

Filtration

Question 2

Removal of substances from blood into renal tubule at peritubular capillaries.

Answer 2

Secretion

Question 3

Return of substances from renal tubule into blood at peritubular capillaries.

Answer 3

Reabsorption

Question 4

Removal of substances from renal tubule through urine.

Answer 4

Excretion

Question 5

Nephrons contain these parts:

Answer 5

1. Renal corpuscle (glomerulus and Bowman’s capsule)
2. Proximal convoluted tubule
3. Loop of henle
4. Distal convoluted tubule
5. Collecting tubules

Question 6

This part of the nephron actively transports sodium along with glucose, amino acids, etc. Water follows by solute drag. Counter transport of H+ and Na+. Almost all reabsorption occurs here but none of it is under hormonal regulation.

Answer 6

Proximal convoluted tubule

Question 7

This part of the nephron reabsorbs sodium and potassium along with some water and generates interstitial salt gradient.

Answer 7

Loop of henle

Question 8

This part of the nephron does the reabsorption of sodium, potassium reabsorption and secretion, hydrogen ion secretion, and is the site of aldosterone action.

Answer 8

Distal convoluted tubules

Question 9

Water is reabsorbed here and it requires the interstitial salt gradient produced by the loop of henle. Site of ADH action.

Answer 9

Collecting tubules

Question 10

The volume filtered from the glomeruli into Bowman’s space per unit of time.

Answer 10

Glomerular filtration rate

Question 11

GFR is around this per day:

Answer 11

180 liters per day

Question 12

This is an index of functioning renal mass.

Answer 12

Total GFR

Question 13

The major driving force for filtration.

Answer 13

Hydrostatic pressure

Question 14

The forces opposing filtration.

Answer 14

Osmotic pressure

Question 15

Urine formed by these 3 processes:

Answer 15

1. Glomerular filtration
2. Tubular reabsorption
3. Tubular secretion

Question 16

This system helps regulate blood pressure and maintain blood volumes.

Answer 16

Renin-angiotensin system

Question 17

Is released from the posterior pituitary and acts on renal tubules to allow for water reabsorption that depends upon the formation of a salt gradient by the loop of henle.

Answer 17

ADH

Question 18

This hormone is released from cells of the cardiac atria in response to increased stretch and work to: counter fluid conserving effects to reduce blood volume and relieve blood pressure.

Answer 18

Atrial natriuretic peptide ( ANP)

Question 19

ANP works generally opposite of

Answer 19

Aldosterone

Question 20

The process of emptying the bladder.

Answer 20

Micturation

Question 21

Specific gravity of urine should be:

Answer 21

1.003 to 1.030

Question 22

A measure of urea in the blood

Answer 22

BUN

Question 23

This reflects GFR and functional capacity of kidneys.

Answer 23

Serum creatinine

Question 24

Provides an assessment of renal function.

Answer 24

GFR

Question 25

Agents that increase water excretion.

Answer 25

Diuretics

Question 26

Act at the proximal tubule to shift the osmotic balance. Ex mannitol

Answer 26

Osmotic diuretic

Question 27

These work by inhibiting transports in the loop of Henle. This destroys the salt gradient generated by the loop of Henle and prevents water reabsorption under the influence of ADH from the collecting duct. Ex Lasix

Answer 27

Loop diuretics

Question 28

These block the Na+ Cl- symporter in the DCT to block sodium reabsorption, this water remains in the lumen of the renal tubule for excretion.

Answer 28

Thiazide diuretics

Question 29

These inhibit aldosterone, blocks Na+ reabsorption and increased K+ retention. Ex spironolactone

Answer 29

Potassium sparing diuretics

Question 30

Represents several pathological states and usually involves inflammation of the glomerulus. May present with hematuria or proteinuria.

Answer 30

Glomerularnephritis

Question 31

Is characterized by the passage of both protein and red blood cells out of the urine.

Answer 31

Nephritic syndrome

Question 32

Five categories of glomerular disease:

Answer 32

1. Acute nephritic syndrome 2. Rapidly progressive glomerulonephritis (RPGN) 3. Nephrotic syndrome 4. Asymptomatic hematuria or proteinuria 5. Chronic glomerulonephritis

Question 33

Characterized by hematuria, proteinuria, azotemia, edema, and hypertension. May occur as a primary disease or secondary to other diseases such as lupus.

Answer 33

Acute nephritic syndrome

Question 34

Progression of renal failure over days to weeks, often in the context of nephritic syndrome. Does not have a specific cause, but involves proliferation of glomerular cells. Characterized by formation of crescents initiated by the passage of fibrin into the Bowman’s space as a consequence of increased permeability of the basement membrane.

Answer 34

Rapidly progressive glomerulonephritis

Question 35

An autoimmune disease caused by the formation of antibodies to the basement membrane and is an example of RPGN.

Answer 35

Goodpasture syndrome

Question 36

Not a specific disease but a constellation of findings resulting from glomerular permeability and protein loss to the urine. Characterized by massive loss of proteinuria and lipiduria.

Answer 36

Nephrotic syndrome

Question 37

Oftentimes does not present with outward signs and symptoms. May be due to the presence of IgA immune complexes that result in glomerular inflammation.

Answer 37

Asymptomatic hematuria or proteinuria

Question 38

A hereditary form of nephritis associated with mutations in the collagen biosynthesis pathway genes. Most commonly inherited as an x-linked autosomal dominant trait.

Answer 38

Alport syndrome

Question 39

Characterized by persistent proteinuria with or without hematuria and slowly progresses to chronic renal failure. Characterized by irreversible and progressive glomerular and tubulointerstitial fibrosis.

Answer 39

Chronic glomerulonephritis

Question 40

Disorders that affect interstitial space surrounding the renal tubules. May be either acute or chronic.

Answer 40

Tubulointerstitial disease

Question 41

An infection of the kidney tissue and pelvis, usually by bacteria. Bacteria are usually gram negative and come from GI tract.

Answer 41

Acute pyelonephritis

Question 42

Often occurs as a result of hematogenous spread of bacteria and infection via the urethra or instrumentation.

Answer 42

Acute pyelonephritis

Question 43

May be idiopathic or associated with renal obstruction or reflux (substances that have descended down the ureter then come back up). Obstructions may be kidney stones, neurogenic or congenital such as strictures. Represents a progressive disease characterized by scarring and deformation of the renal calyces.

Answer 43

Chronic pyelonephritis

Question 44

Most common cause of acute kidney injury characterized by a rapid decline in renal function. Typically see elevations in BUN levels and creatinine with a decline in urine output.

Answer 44

Acute tubular necrosis

Question 45

Acute tubular necrosis is classified into these 2 categories:

Answer 45

1. Ischemic | 2. Nephrotoxic

Question 46

Results from a decreased perfusion or inadequate oxygenation to the renal tubules.

Answer 46

Ischemic atn

Question 47

Results from a number of agents that directly and specifically damage the renal tubules .

Answer 47

Nephrotoxic atn

Question 48

Three phases of ATN:

Answer 48

1. Initiation 2. Maintenance 3. Recovery

Question 49

This phase of ATN is dominated by the initiating cause of ATN and azotemia. Usually lasts for several years.

Answer 49

Initiation phase

Question 50

This phase of ATN is characterized by oliguria. Lasts for about a week. Most fatalities occur in this phase.

Answer 50

Maintenance

Question 51

This phase of ATN is characterized by profuse diuresis with continues recovery of renal function. Full recovery may take years.

Answer 51

Recovery phase

Question 52

2 forms of poly cystic kidney disease:

Answer 52

1. Adult autosomal dominant form | 2. Infantile autosomal recessive form

Question 53

This is one of the most common life-threatening genetic diseases.

Answer 53

PKD

Question 54

Involves the obstruction of urine flow as it exits from the kidney toward the bladder.

Answer 54

Obstructive disorders

Question 55

Obstruction of urine outflow can also give rise to:

Answer 55

Hydronephrosis or dilation of the renal pelvis resulting in atrophy of kidney

Question 56

Most common cause of upper urinary tract obstruction.

Answer 56

Renal calculi

Question 57

This is released by the posterior pituitary and is released in response to either low blood pressure or increased concentration of salts.

Answer 57

ADH

Question 58

This results in fluid overload or a dilution syndrome.

Answer 58

SIADH

Question 59

A condition in which kidneys are unable to conserve water. Patients have polydipsia and polyurea.

Answer 59

Diabetes insipidus

Question 60

Diabetes insipidus is caused by a lack of:

Answer 60

ADH

Question 61

Types of diabetes insipidus:

Answer 61

1. Central | 2. Nephrogenic

Question 62

Is characterized by a decrease in kidney function resulting in insufficient filtration of products from the blood.

Answer 62

Renal failure

Question 63

This is characterized by an acute insult that produces a rapid loss of function. It is often reversible with adequate treatment.

Answer 63

Acute renal failure

Question 64

This is the progressive deterioration of function. Is usually not reversible.

Answer 64

Chronic renal failure

Question 65

Renal failure is determined by a decrease in this:

Answer 65

GFR

Question 66

Indicated that the underlying cause is due to the blood supply to the kidney.

Answer 66

Prerenal

Question 67

Indicates that the underlying cause is within the kidney itself.

Answer 67

Intrinsic or intrarenal

Question 68

Indicates that there are problems with the urinary tract or the outflow from the kidney.

Answer 68

Postrenal

Question 69

Is manifested by oliguria and a disproportionate elevation of BUN relative to serum creatinine levels.

Answer 69

Prerenal failure

Question 70

Most common cause of intrinsic or intrarenal disease is:

Answer 70

ATN

Question 71

Results from obstruction of urine outflow from the kidneys:

Answer 71

Postrenal diseas

Question 72

The progressive loss of renal function over a period of months or years.

Answer 72

Chronic kidney disease

Question 73

As kidney function decreases:

Answer 73

1. Bp may increase 2. Urea accumulates leading to azotemia 3. Hyperkalemia 4. Anemia and fatigue 5. Fluid volume overload 6. Elevated phosphate 7. Hypocalcemia

Question 74

Refers to a general condition of elevated serum levels of nitrogen containing substances in the blood including urea, creatinine, and Uric acid.

Answer 74

Azotemia

Question 75

Refers to the clinical syndrome of renal failure with azotemia:

Answer 75

Uremia

Question 76

The lack of bladder control due to a neurologic condition.

Answer 76

Neurogenic bladder

Question 77

The bladder is innervated by this but under the control of this.

Answer 77

Autonomic nervous system | CNS

Question 78

This is characterized by a failure to store urine and results from neural lesions above the level of the sacral cord.

Answer 78

Spastic bladder

Question 79

This is characterized by failure to empty the bladder and results from neural disorders affecting the motor neurons in the sacral cord or peripheral nerves.

Answer 79

Flaccid bladder

Question 80

Most bladder cancers are from these:

Answer 80

Transitional cell carcinomas