Renal exam 3

Question 1

What does the renin angiotensin system do?

Answer 1

helps regulate B/P and maintain blood volumes

Question 2

angiotensin II

Answer 2

potent vasoconstrictor

Question 3

aldosterone

Answer 3

facilitates salt reabsorption

Question 4

Antidiuretic hormone (ADH)

Answer 4

acts on renal tubules to allow water reaborption that depends upon the formation of the salt gradient in the loop of henle

Question 5

where is ADH released from

Answer 5

the posterior pituitary

Question 6

Atrial Natriuretic Peptide (ANP)

Answer 6

released from cardiac cells in response to an increase in stretch or work to counter fluid-conserving effects to reduce blood volume and relieve B/P

Question 7

Osmotic diuretics

Answer 7

act a proximal tubule to shift the osmotic balance

ex) mannitol

Question 8

Loop diuretics

Answer 8

work by inhibiting transporters in the loop of henle

ex) lasix

Question 9

thiazide diuretic

Answer 9

blocks sodium-calcium symport in the distal convoluted tubule to block salt reabsorption causing water to remain the lumen for excretion

Question 10

Potassium-sparing diuretics

Answer 10

inhibits aldosterone
blocks salt reabsorption
increases potassium reabsorption
ex) spironolactone

Question 11

what is a nephritic syndrome characterized by?

Answer 11

proteinuria and hematuria

Question 12

what is acute nephritic syndrome caused by and what are some symptoms?

Answer 12

caused by increased glomerular permeability and loss of plasma proteins in urine
hematuria, proteinuria, azotemia, edema, HTN

Question 13

Nephrotic syndrome is characterized by ?

Answer 13

only proteinuria

Question 14

what happens in nephrotic sydrome?

Answer 14

glomerular permeability, protein loss in the urine causes hypoalbuminemia and massive loss of proteins and lipids

Question 15

What are the symptoms of nephrotic syndrome?

Answer 15

edema, pleural effusion, pulomnary edema, hyperlipidemia related to the liver trying to compensate for albumin loss which increases risk for clots

Question 16

Rapidly progressing glomerulonephritis

Answer 16

occurs over days/weeks due to formation of crescents initiated by the passage of fibrin into the Bowman’s capsule causing an influx of monocytes

Question 17

Chronic glomerulonephritis

Answer 17

persistent proteinuria, irreversible-progressive glomerular and tubulointerstitial fibrosis
can lead to CKD, ESRD, cardiac issues

Question 18

what are some symptoms of glomerulonephritis?

Answer 18

decreased GFR, increased toxins, uremic syndrome

Question 19

What are the functions of the renal system?

Answer 19

1) remove waste/toxins
2) water and ion homeostasis
3) hormones (EPO, renin, activates D3, gluconeogenesis)

Question 20

Filtration

Answer 20

removal of substances from the blood into the renal tubule at the glomerulus

Question 21

Secretion

Answer 21

removal of substances from the blood into the renal tubules at the peritubular cavities

Question 22

Reabsorption

Answer 22

return of substances from renal tubules into the blood at the peritubular cavities

Question 23

Excretion

Answer 23

removal of substances form the renal tubule through urine

Question 24

Proximal Convoluted Tubule is the site of?

Answer 24

reabsorption occurs here; sodium actively transported w/ glucose-water follows by solute drag

Question 25

What happens at the Loop of Henle?

Answer 25

sodium and potassium are reabsorbed, generation of interstitial salt gradient

Question 26

What happens at the distal convoluted tubule?

Answer 26

sodium reabsorption potassium and hydrogen secretion site of aldosterone action

Question 27

What happens at the collecting ducts?

Answer 27

water is reabsorbed | site of ADH action

Question 28

What is glomerular filtration?

Answer 28

movement of fluid and solutes across the glomerular capillary membrane into Bowman's space

Question 29

What is the driving force of glomerular filtration?

Answer 29

hydrostatic pressure

Question 30

What opposes filtration?

Answer 30

osmotic/oncotic forces

Question 31

GFR

Answer 31

index of functioning renal mass

Question 32

Creatinine clearance measures what?

Answer 32

the amount of some substance that is cleared from the blood by the kidney per unit time

Question 33

What is normal for a urinalysis?

Answer 33

color: yellow-amber consistency: clear-slightly hazy specific gravity: 1.003-1.030 pH: acidic 5-6.5 Negative for glucose, ketones, nitrates, heme, protein negative for casts, crystals, cells

Question 34

what does BUN measure

Answer 34

urea in the blood

Question 35

what does creatinine measure

Answer 35

a reflection of GFR and functional capacity of the kidneys

Question 36

what is the cause of asymptomatic hematuria and proteinuria?

Answer 36

IgA immune complexes that result in glomerular inflammation

Question 37

What is acute tubular necrosis characterized by?

Answer 37

decline in renal function, decreased urine output, increased BUN and creatinine, metabolic acidosis, CHF

Question 38

What are the risk factors for getting acute tubular necrosis?

Answer 38

blood transfusion, rhabdo, hypotensive shock, surgery, nephrotoxic drugs, infection

Question 39

What are the 3 stages to acute tubular necrosis?

Answer 39

1) initiation 2) maintenance 3) recovery

Question 40

What are polycystins?

Answer 40

gene products that regulate growth in the differentiation of tubular epithelium defects can lead to cyst formation, obstruction, and loss of nephrons

Question 41

Autosomal dominant polycystic kidney disease

Answer 41

presents late in childhood, inherited mutation of PKD-1 and PKD-2 chromosomes

Question 42

Autosomal Recessive polycystic kidney disease

Answer 42

rare, noted in infants. gene mutations of PKHD-1 cause decreased or absent function of fibrocystin, leading to cysts

Question 43

Renal calculi

Answer 43

masses of crystals, protein, substances that form an obstruction

Question 44

Risk factors of kidney stones

Answer 44

age, sex, fluid intake, pH changes, gout, HTN, DM, UTI, diet, gout, infection

Question 45

SIDAH is caused by?

Answer 45

excess levels of ADH from the posterior pituitary or ectopic cause(tumor, head injury, SSRI's)

Question 46

What are the symptoms of SIDAH?

Answer 46

water retention causes hyponatremia, headache, confusion, n/v, convulsions, coma

Question 47

What is the treatment for SIDAH?

Answer 47

water restriction | meds to block ADH effect on kidneys (tetracycline, democlocycline)

Question 48

Diabetes Insipidous happens when?

Answer 48

kidneys can't conserve water causing excessive thirst and large amounts of diluted urine

Question 49

Central DI is caused by?

Answer 49

damage to the hypothalamus or pituitary gland

Question 50

Nephrogenic DI is caused by?

Answer 50

defect in renal tubules- typically inherited

Question 51

Renal failure is characterized by?

Answer 51

decrease in kidney function such that there insufficient filtration of waste products in the blood, a decrease in GFR, no urine production, build up of wastes

Question 52

Prerenal failure is due to?

Answer 52

blood supply to kidney

Question 53

Intrarenal failure is due to?

Answer 53

within the kidney itself

Question 54

Postrenal failure is due to?

Answer 54

issues with urinary tract or outflow from kidney

Question 55

Azotemia occurs when?

Answer 55

elevated serum levels of nitrogen-containing substances

Question 56

Uremia occurs when?

Answer 56

blood is not being filtered by the kidneys due to ARF

Question 57

Uremic syndrome is? What are some symptoms?

Answer 57

the accumulation of urea that causes a group of symptoms associated with renal failure Altered CNS, neuropathy, GI ulcers, pruitis, pericarditis, poor blood clotting