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Pathophysiology 2 > Urinary System > Flashcards

Urinary System Flashcards

(62 cards)

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1
Q

What is the major culprit for stubborn UTI?

A

Obstruction to urination

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2
Q

List functions of Kidneys

A

Excrete waste in urine
Regulate blood volume
Regulate blood composition
Regulate blood pH, osmolarity & glucose
Regulate blood pressure
Release erythropoietin
Participate in Vitamin D synthesis (calcitriol)

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3
Q

How does the KD regulate blood pressure?

A

secrete renin

adjust renal resistance

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4
Q

The KD is located __________ and is protected by ______ ribs and by layers of ______ and ________

A

above the waist between peritoneum and; posterior wall of abdomen
11th and; 12th
adipose tissue
fascia.

*extend from T12-L3

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5
Q

Describe the path of urine drainage in the KD (level of nephron)

A

Papillary duct in renal pyramid

minor calyx

major calyx

renal pelvis

ureter

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6
Q

The KD receives ___% of resting cardiac output via renal arteries

A

25%

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7
Q

In the KD nephron, __________are formed between the afferent and efferent arterioles. Efferent arterioles give rise to _______ and ______

A

glomerular capillaries
peritubular capillaries
vasa recta

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8
Q

Glomerular filtration is where ________ occurs
Peritubular capillaries function to ________
Vasa recta supplies _________

A

filtration of blood

carry away reabsorbed substances from filtrate

nutrients to renal medulla w/o disrupting its osmolarity

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9
Q

KD has over ______ nephrons composed of a _______ and ______

A

1 million

corpuscle

tubule

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10
Q

80-85% of nephrons are _____ nephrons. The remaining 15-20% are _______ nephrons.

A

cortical

juxtamedullary

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11
Q

In Juxtamedullary nephrons, the renal corpuscles are located ________ and long loops of Henle extend into ________ enabling _________ of dilute or concentrated urine.

A

close to medulla
deepest medulla
excretion

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12
Q

The Juxtamedullary nephron is the structure where ______ makes contact w/ ________ of loop of Henle. The ______ is the thickest part of the ascending limb. Juxtaglomerular cells are modified _______ in arteriole.

A

afferent arteriole
ascending limb
macula densa
muscle cells

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13
Q

Dysfunction of KD nephrons is not evident until function declines by ________

A

25% of normal

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14
Q

Nephrons and collecting ducts perform 3 basic processes. List them

A

glomerular filtration
tubular reabsorption
tubular secretion

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15
Q

Rate of excretion in renal physiology is defined as ________

A

rate of filtration + rate of secretion - rate of reabsorption

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16
Q

Glomerular filtrate is produced by _________

Filtering capacity is enhanced by _________

A

blood pressure

thinness of membrane, large surface area of glomerular capillaries, glomerular BP

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17
Q

Glomerular blood pressure is high due to ______

A

small size of efferent arteriole

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18
Q

In glomerular filtration the net filtration pressure is defined as _________

A

Glomerular blood hydrostatic pressure - capsular hydrostatic pressure - blood colloid osmotic pressure

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19
Q

KD nephron must reabsorb ____% of glomerular filtrate. Most tubular reabsorption occurs mostly in _______

A

99%

proximal convoluted tubules

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20
Q

Distal convoluted tubule is major site where ______ hormone stimulates reabsorption of ____. It is also where _____ are reabsorbed via symporters

A

parathyroid
Ca2+
Na+, Cl-

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21
Q

The best index of GFR is ________

A

serum creatinine

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22
Q

BUN stands for __________. It reflects the cumulative amount of ________ in _________

A

Blood Urea Nitrogen
ammonia
blood compartment

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23
Q

Specific gravity of urine can be defined as ______. It indicates ability of ________ to _________

A

the osmolarity of urine relative to the osmolarity of plasma

kidney tubules to concentrate urine

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24
Q

Normal urinary output is _____ per 24 hours. Minimum urinary output is _____ per one hour

A

700-2000mL

30-55mL

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25
Excess H+ ions are deposited into the urine during which stage of urine formation?
Secretion
26
How is bicarbonate ion reabsorbed into blood?
Na+ antiporters reabsorb Na+ and secrete H+ into tubular fluid. For each H+ secreted one filtered bicarbonate ion returns to blood via facilitated diffusion
27
List normal constituents of urine
urobilinogen, electrolytes, ammonia, hormones, creatinine
28
List abnormal constituents of urine
proteins, glucose, formed elements of blood
29
Normal pH range of urine is _________
4.5-8
30
What are general etiologies of: 1) respiratory acidosis? 2) metabolic acidosis? 3) respiratory alkalosis? 4) metabolic alkalosis?
1) Lungs not exhaling 2) Kidney not filtering/reabsobing 3) hyperventilation 4) persistent vomiting/diarrhea
31
List signs and symptoms of urinary system disorders
dysuria, hesitancy of urination, urgency of urination, hematuria, hematospermia, albuminuria, edema, hyperlipidemia, turbid urine, excessively dilute/dark urine, pruritus, anemia, abnormal respiration pattern, elevated levels of creatinine/BUN
32
Dysuria generally indicates ________ | Hesitancy of urination generally indicates _______
inflammation obstruction!!
33
Hyperlipidemia in urinary system disorders generally indicates __________ Anemia in urinary system disorders generally indicates _______ Pruritus in urinary system disorders generally indicates ________
lipoproteins leaking through Kidney Kidney not secreting EPO Kidney not excreting bile salts
34
List the modes of inheritance for: 1) Adult Polycystic Kidney Disease 2) Childhood Polycystic Kidney Disease
1) autosomal dominant | 2) autosomal recessive
35
Describe pathogenesis of ADPKD
Formation of cysts in Kidney -> cysts accumulate fluid, enlarge, separate from nephron, compress neighboring renal parenchyma (nephrons), progressively compromising renal function
36
List clinical presentations of ADPKD
abdominal discomfort, hematuria, UTI, hypertension, abdominal mass, elevated serum creatinine, cystic kidneys on imaging studies
37
Complications of ADPKD are ________
cerebral hemorrhage from ruptured intracranial aneurysm, renal cell carcinoma, nephrolithiasis, abdominal hernia, inguinal hernia
38
List diagnostic methods for ADPKD
30+ years- renal ultrasonography | less than 30 years - CT, MRI
39
List treatment methods of ADPKD
palliative care, hypertension medication, antibiotics for infected kidney cysts, kidney transplantation, medication to inhibit renin-angiotensin system
40
Major risk factors for urolithiasis/nephrolithiasis are ______
hypercalcuria, hypercalcemia (parathyroid), hyperthyroidism, excessive/deficient intake of calcium supplements and oxalates, excessive Vitamin C supplementation, increase in global temperatures, Crohn's disease, malignancies, persistent UTI, excessive protein-based diet, metabolic acidosis
41
The most common kidney/urinary stones are ______ . What type of stones are radiolucent?
Calcium urinary stones (calcium oxalate) Uric Acid stones
42
What type of stones are radio-opaque? What is the composition of struvite stones? What is the origin/etiology of struvite stones?
- calcium urinary stones - magnesium-ammonium-phosphate - urea-splitting bacteria in UTI
43
Uric acid stones are associated with what disease?
gout
44
What does pruritus indicate?
Excessive bile salts from LV or KD failure/issues.
45
T/F blood in urine is not a red flag for referral
False - could indicate cancer!
46
The kidneys are situated at the level of what vertebrae?
T12 - L3
47
Glomerulonephritis is ____________ Pyelonephritis is ____________
- auto-immune inflammation of glomeruli | - UTI affecting Kidney where all of nephron is inflamed except glomerulus
48
In children with frequent UTI, one should suspect the following causes: ____________
- anatomical abnormality - poor hygiene - immune deficiency - sexual abuse
49
UTI in the elderly can present with ________ symptoms such as __________ How to treat an elderly patient with asymptomatic bacteriuria? Why?
psychiatric agitation, anxiety no treatment, treatment wiht antibiotics can later lead to antibiotic resistant pneumonia
50
UTI in pregnancy is an emergency situation because ________
UTI can ascend to kidney causing preeclampsia and possible miscarriage
51
List clinical presentation of UTI
- urinary frequency - urgency - dysuria - lower abdominal and flank pain - urethral discharge (mostly males) - systemic symptoms (fever, nausea, vomiting, chills)
52
The most common renal cancer is _______. It is most common in what population?
Renal Cell Carcinoma males aged 30-50's
53
List risk factors for renal cell carcinoma
smoking, obesity, ADPKD, acquired cystic KD disease in dialysis patients, radiopaque contrast dyes, asbestos exposure, cadmium exposure, leather tanning exposure, petroleum product exposure
54
List risk factors for Urinary Bladder cancer
smoking, chemotherapy, UB stones, industrial chemical exposure
55
The most common cause of acute renal failure is ________
acute tubular necrosis
56
Major causes of acute tubular necrosis are _______. Describe the pathogenesis of acute tubular necrosis
ischemia, toxins Ischemia or toxins cause tubular damage with inability to secrete and reabsorb filtrate of glomeruli
57
The clinical syndromes of glomerulonephritis are known as _______.
1) Nephritic syndrome | 2) Nephrotic syndrome
58
Describe etiology of Nephritic Syndrome and clinical presentations
- damaged fenestration membranes of glomerul - presents with hematouria, HTN, slight proteinuria, periorbital edema, petechial skin hemorrhage, fever, flank pain, malaise
59
Describe etiology of Nephrotic Syndrome and clinical presentations
- damaged fenestration membranes and basement membranes of glomeruli - presents with severe proteinuria, generalized edema, hyperlipidemia, loss of albumins in blood compartment (hypoalbuminemia)
60
Post-streptococcal glomerulonephritis results in ______ syndrome
nephritic
61
What are some paraneoplastic effects of renal cell carcinoma?
secondary absolute polycythemia - excess EPO HTN - excess renin
62
Renal colic is a type of abdominal pain caused by ______. Describe the pain.
kidney stones extreme flank pain often radiating to the hypochondrium or the groin

Pathophysiology 2 (8 decks)

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