Renal part 2

Question 1

Pts taking ACE inhibitors may often go hyperkalemic, why is this?

Answer 1

ACE inhibitors blocks ANG II to decrease vasoconstriction (more K+ in ECF)

Question 2

How does insulin prevent hyperkalemia?

Answer 2

insulin moves K+ into cells by increasing activity of Na+K+-ATPase

Question 3

What is the most common electrolyte disorder?

Answer 3

hypokalemia

Question 4

What is the primary cause of hypokalemia?

Answer 4

diuretics

Question 5

_____ sets the resting membrane potential and is the major intracellular cation.

Answer 5

K+

Question 6

67% of K+ is reabsorbed at what part of the nephron?

Answer 6

proximal tubule

Question 7

25% of K+ is reabsorbed at what part of the nephron?

Answer 7

thick ascending loop of henle

Question 8

What is the transporter at the thick ascending loop of henle?

Answer 8

NKCC2

Question 9

What cells reabsorb potassium/bicarbonate and secrete H ions at the late DT and collecting ducts?

Answer 9

a intercalated cells

Question 10

What cells secrete K+ at the distal nephron?

Answer 10

principle cells

Question 11

How does aldosterone cause the reabsorption of more sodium?

Answer 11

• makes more sodium epithelial channels
• increases K+ channels in luminal mem.
• increases activity of Na+K+-ATPase

Question 12

What is alkalosis on a basic level?

Answer 12

H+ concentration is low in ECF

Question 13

What is acidosis on a basic level?

Answer 13

H+ concentration is high in ECF

Question 14

How do loop and thiazide diuretics cause hypokalemia?

Answer 14

increases K+ secretion and excretion

Question 15

Name a potassium sparing diuretic.

Answer 15

spironolactone

Question 16

Which diuretic is an aldosterone antagonist?

Answer 16

spironolactone

(inhibits action of aldosterone on principle cells)

Question 17

Which diuretic decreases the absorption of sodium chloride?

Answer 17

furosemide (lasix)

Question 18

If a pt has proteinuria, where in the kidneys is there a problem?

Answer 18

glomerular capillary (protein isn’t supposed to get through)

Question 19

If a pt has decreased hemoglobin and increased BUN/creatinine, what does this mean about the kidneys?

Answer 19

not producing EPO

Question 20

Peritoneal dialysis or CAPD (continuous ambulatory peritoneal dialysis) what serves as the semi-permeable membrane?

Answer 20

the peritoneum

Question 21

What is the most common cause of UTIs?

Answer 21

e. coli

Question 22

What does cystitis mean?

Answer 22

infection/inflammation of bladder

Question 23

What does urethritis mean?

Answer 23

infection/inflammation of urethra

Question 24

What is the most common treatment for UTI?

Answer 24

Bactrim (sulfer abx)

Question 25

What is the most common inflammatory disorder of the kidneys and what is it most commonly caused from?

Answer 25

- glomerulonephritis cause = strep (post strep glomerulonephritis)

Question 26

What syndrome is secondary to other illnesses like lupus or medications?

Answer 26

nephrosis (nephrotic syndrome)

Question 27

What is BPH? Describe it.

Answer 27

benign prostatic hyperplasia (prostate increases in size making urethra smaller in size)

Question 28

What is the most common cause of urinary tract obstruction?

Answer 28

calculi (kidney stones)

Question 29

How does calculi form?

Answer 29

when urine is too concentrated

Question 30

Why does a kidney stone cause pain?

Answer 30

stone is moving and causing pain bc of peristalsis

Question 31

Hydronephrosis is secondary to what two problems?

Answer 31

- obstructive problems (like stones) - congenital problems (like kink in ureter)

Question 32

Renal adenocarcinomas usually occur in what part of the kidney?

Answer 32

cortex of kidney

Question 33

Where does bladder cancer develop from?

Answer 33

transitional epithelium in trigone area

Question 34

50% of patients who develop bladder cancer work in what two industries?

Answer 34

rubber or dye material industry

Question 35

What is nephrosclerosis?

Answer 35

XS hardening and thickening of renal blood vessels

Question 36

Nephrosclerosis is secondary to what two conditions?

Answer 36

HTN and DM

Question 37

What is vesicoureteral reflux? (hint: its a congenital disorder)

Answer 37

defective valve between ureter and bladder

Question 38

What is agenesis?

Answer 38

where 1 kidney doesn't form

Question 39

What is hypoplasia in regard to kidneys?

Answer 39

where kidneys are too small

Question 40

Acute polycystic kidney disease is an autosomal dominant disorder on what chromosome?

Answer 40

chromosome 16

Question 41

What is polycystic kidney disease?

Answer 41

multiple cysts develop in both kidneys

Question 42

What is the treatment for polycystic kidney disease?

Answer 42

kidney transplant

Question 43

Acute renal failure is ______, while chronic renal failure is _______.

Answer 43

reversible; irreversible

Question 44

What is the first sign of acute renal failure?

Answer 44

rapidly increasing BUN

Question 45

What is azotemia?

Answer 45

accumulating huge amounts of nitrogen waste products

Question 46

What is anuria?

Answer 46

lowest urine output (pt stops urinating)

Question 47

What are some major causes of renal failure?

Answer 47

- glomerulonephritis - calculi - tumors - heart failure - damaged RBCs - damaged skin - nephrotoxins

Question 48

What is being released if erythrocytes are severely damaged?

Answer 48

hemoglobin (toxic to epithelial cells of tubules)

Question 49

What is being released if skeletal muscle is severely damaged?

Answer 49

myoglobin (toxic to epithelial cells of tubules)

Question 50

Give examples of nephrotoxins:

Answer 50

NSAIDS (ibuprofen/aspirin), penicillin

Question 51

What is the most common cause of chronic renal failure?

Answer 51

chronic HTN, DM

Question 52

What is the first stage of chronic renal failure?

Answer 52

decreasing renal reserve

Question 53

What is the second stage of chronic renal failure?

Answer 53

renal insufficiency

Question 54

What is the final stage of chronic renal failure?

Answer 54

ESRD (end stage renal disease)

Question 55

What stage of chronic renal failure will you see an increase in BUN and creatinine?

Answer 55

second stage

Question 56

What stage of chronic renal failure will you see a decrease in EPO?

Answer 56

second stage

Question 57

What stage of chronic renal failure will a pt start to lose weight?

Answer 57

second stage

Question 58

What stage of chronic renal failure will you see a decrease in bone marrow depression?

Answer 58

second stage

Question 59

What stage of chronic renal failure will a patients blood pressure start to rise?

Answer 59

first stage

Question 60

What stage of chronic renal failure will your patient have uremia?

Answer 60

final stage

Question 61

What stage of chronic renal failure will your patient have systemic infections like peripheral neuropathy?

Answer 61

final stage

Question 62

Why is kidney function important for vitamin D?

Answer 62

kidneys convert vitamin D to active vitamin D3

Question 63

Why is vitamin D important?

Answer 63

need vitamin D to reabsorb calcium from GI tract

Question 64

A lack of vitamin D due to chronic renal disease can cause what?

Answer 64

hypocalemia

Question 65

If the kidneys can't secrete ions due to a lack of vitamin D, what can occur?

Answer 65

hyperphosphatemia

Question 66

If a pt has hypocalcemia and hyperphosphatemia, what 3 things will cascade?

Answer 66

- stimulate PTH - increase calcium reabsorption from bones - brittle bones = osteoporosis

Question 67

What is it called when a pt has osteoporosis and fractures due to kidney disease?

Answer 67

osteodystrophy

Question 68

List the 5 treatments for a patient with chronic kidney disease:

Answer 68

- synthetic EPO (to retain RBCs) - phosphate binders - anti-hypertensives - dialysis - kidney transplant