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PAT202 > Week 6 > Flashcards

Week 6 Flashcards

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1
Q

What is the normal renal blood flow?

A

~ 1000 to 1200 mL/min, or 20% to 25% of the cardiac output

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2
Q

What is GFR?

A

Filtration of plasma per unit of time, directly related to the perfusion pressure of renal blood flow

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3
Q

What regulates renal blood flow?

A

Sympathetic noradrenergic nerves that regulate vasoconstriction

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4
Q

What is the role of renin in renal function?

A

Secreted from juxtaglomerular cells, converts angiotensin I to angiotensin II, a potent vasoconstrictor

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5
Q

What do natriuretic peptides do?

A

Antagonize the RAAS and promote sodium chloride and water excretion

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6
Q

What are the three processes of urine formation?

A
  • Glomerular filtration
  • Tubular reabsorption
  • Tubular secretion and excretion
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7
Q

What is renal clearance?

A

How much of a substance can be cleared from blood by the kidneys per given amount of time

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8
Q

What is renal insufficiency?

A

Decline of renal function to approximately 25% of normal or a GFR of 25-30 mL/min

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9
Q

What is uremia?

A

Syndrome of renal failure characterized by elevated blood urea and creatinine levels

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10
Q

What is azotemia?

A

Increased serum urea levels and frequently increased creatinine levels due to renal insufficiency or failure

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11
Q

What defines acute kidney injury (AKI)?

A

Sudden decline in kidney function with decreased glomerular filtration and urine output

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12
Q

What are common causes of AKI?

A
  • Extracellular volume depletion
  • Decreased renal blood flow
  • Toxic/inflammatory injury to kidney
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13
Q

What is the most common cause of prerenal AKI?

A

Renal hypoperfusion

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14
Q

What is acute tubular necrosis (ATN)?

A

A type of intrarenal AKI caused by ischemia or nephrotoxicity

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15
Q

What is the typical urine output in oliguria?

A

Less than 30 mL/hr

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16
Q

What is the pathophysiology of post-ischemic ATN?

A

Persistent hypotension, hypoperfusion, and hypoxemia leading to ischemia and tubular injury

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17
Q

What factors can cause nephrotoxic ATN?

A
  • Radiocontrast media
  • Antibiotics (aminoglycosides)
  • Heavy metals
  • Anesthesia
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18
Q

What is the result of post-renal AKI?

A

Urinary tract obstructions affecting both kidneys leading to increased intraluminal pressure

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19
Q

What are the phases of clinical progression in ATN?

A
  • Initiation phase
  • Extension phase
  • Maintenance phase
  • Recovery phase
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20
Q

What is the significance of nonoliguric renal failure?

A

Represents less severe injury and is associated with toxin exposure or drug toxicity

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21
Q

What diagnostic indicators are used for AKI?

Study These Flashcards
A
  • Ratios of BUN to plasma creatinine concentration
  • Fractional excretion of Na+
  • Cystatin C
22
Q

What dietary changes are recommended for managing hyperkalemia?

Study These Flashcards
A
  • Restrict dietary sources of potassium
  • Use non-potassium-sparing diuretics
23
Q

What characterizes chronic kidney disease (CKD)?

Study These Flashcards
A

Progressive loss of renal function associated with systemic or intrinsic kidney diseases

24
Q

What are the common systemic diseases that can lead to CKD?

Study These Flashcards
A
  • Hypertension
  • Diabetes mellitus
  • Systemic lupus erythematosus
25
What is the intact nephron hypothesis?
Loss of nephron mass leads surviving nephrons to maintain kidney function through compensatory mechanisms
26
What contributes to the progression of CKD?
* Proteinuria * Angiotensin II
27
What are common clinical manifestations of CKD?
* Hypertension * Anorexia * Nausea * Vomiting * Edema * Anemia
28
What is the effect of CKD on sodium and water balance?
Increased sodium delivery to nephrons leads to less reabsorption and potential volume depletion
29
How does CKD affect potassium balance?
Tubular secretion of K+ increases until oliguria develops, leading to potentially dangerous serum levels
30
What happens to acid-base balance in early renal insufficiency?
Acid excretion and bicarbonate reabsorption increase to maintain normal pH
31
What happens to serum creatinine (SCr) as GFR decreases?
Serum creatinine increases ## Footnote SCr is a good marker of changing glomerular function but is affected by muscle mass and fluid overload.
32
What is the effect of potassium-sparing diuretics like spironolactone on serum potassium levels?
They may precipitate increased serum potassium levels ## Footnote This occurs as the disease progresses and total body potassium increases.
33
At what GFR level does metabolic acidosis develop?
When GFR decreases to 30%-40% of normal ## Footnote In end-stage kidney disease (ESKD), metabolic acidosis may be severe enough to require dialysis.
34
What are the consequences of impaired renal synthesis of calcitriol?
Accelerates hypocalcemia ## Footnote This is due to decreased intestinal absorption of calcium.
35
What are the effects of acidosis on calcium balance?
Leads to negative calcium balance ## Footnote Hypocalcemia can cause secondary hyperparathyroidism and vitamin D deficiency.
36
What is the relationship between GFR and plasma urea levels?
As GFR decreases, plasma urea levels increase ## Footnote Urea clearance varies with hydration status, making it a poor index for GFR.
37
What are the indicators of a catabolic state in kidney disease?
Proteinuria and negative nitrogen balance ## Footnote Levels of serum proteins, including albumin, decrease, and there is loss of muscle mass.
38
What is the most common hematologic alteration in kidney disease?
Normochromic normocytic anemia ## Footnote This is due to a lack of erythropoietin.
39
What are the major causes of morbidity and mortality in patients with chronic kidney disease?
Cardiovascular disease and dyslipidemia ## Footnote Hypertension and anemia are also significant concerns.
40
What are common gastrointestinal symptoms associated with uremia?
Anorexia, nausea, vomiting, and mouth ulcers ## Footnote Uremic fetor is bad breath caused by the breakdown of urea by salivary enzymes.
41
What is the primary treatment for uremic gastroenteritis?
Protein-restricted diet and sodium-based alkali ## Footnote This helps relieve nausea and vomiting.
42
What is the function of erythropoiesis-stimulating agents (ESA) like epoetin alfa?
Stimulates erythropoiesis to reduce anemia ## Footnote They interact with receptors on hematopoietic stem cells in the bone marrow.
43
What adverse effect is most common with erythropoiesis-stimulating agents?
Hypertension ## Footnote There is also a risk of thromboembolic disease, TIA, and stroke.
44
What is the mechanism of action of loop diuretics like furosemide?
Inhibits reabsorption of sodium and chloride in the ascending loop of Henle ## Footnote This leads to the excretion of Na+, Cl-, and water.
45
What is the desired effect of calcium carbonate in CKD patients?
Normalizes phosphate levels and neutralizes gastric acidity ## Footnote It acts like intrinsic calcium.
46
What is the main indication for using cation exchange resins like polystyrene sulfonate?
Treatment of hyperkalemia ## Footnote This is used in conjunction with other measures.
47
What are the major adverse effects of cation exchange resins?
Hypocalcemia, hypokalemia, and sodium retention ## Footnote Monitoring for confusion and dyspnea is important.
48
Fill in the blank: As GFR decreases, the ability to concentrate and dilute urine _____
decreases
49
True or False: Fluid overload can lead to pulmonary edema in kidney disease.
True
50
What is the treatment for secondary hyperparathyroidism in CKD?
Dialysis and control of serum calcium and phosphate levels ## Footnote This helps manage complications associated with renal disease.

PAT202 (3 decks)

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