PATH 3 - Renal

lunalovegood's version from 2015-11-06 18:05

Section 1

Question Answer
UTS - Upper is ___ and ___. Lower is ___ and ____.kidneys and ureters, urinary bladder and urethra
Apex of medullary pyramid makes a _____ ____ --> minor calyx --> major calyx --> ____ ____ --> ureterrenal papilla, renal pelvis
Glomeruli, proximal convoluted tubules, and distal convoluted tubules are all located in the...cortex (also BEGINNING of collecting ducts)
Collecting ducts, loops of henle, and blood vessels are located in the...medulla
Where are mesangial cells? Bowman's capsule?glomerulus, glomerulus
Glomerulus - epithelial cells have ___ ____. Endothelial cells have ____.foot processes, pores (pores are 70-100nm gaps allowing filtration through basement membrane)
Glomerular barrier is HIGHLY permeable to...water, solutes
Glomerular barrier is IMPERMEABLE to...larger size things like albumin or cells
T/F - the kidney regulates blood pH via regulating plasma bicarb and H+.True
Name 3 hormones the kidney makes or transforms.Vitamin D, Renin, Erythropoietin
Stimulates rate of production, maturation, and release of RBCs from bone marrow.erythropoietin
Begins as a 10-20% decline in GFRDiminished Kidney Reserve
Decline of 20-50% of GFRRenal Insufficiency
Nitrogenous compounds begin to build up in bloodRenal Insufficiency
Kidney can no longer maintain excretory, metabolic, and endocrine fxns beyond normal compensatory mechanismsRenal failure
Elevated blood urea nitrogenous compounds (BUN) like in ARF.azotemia
Ischemia, uncontrolled or malignant HTN, and glomerular disease or cytotoxicity can all cause...ARF
Your patient may have uremic bleeding problems. What do you do before surgery?local hemostatic measures, uremia corrected with dialysis
Your patient has WBC suppression. What do you do before surgery?antibiotic prophylaxis
Name 4 diseases that cause secondary HTN.renal disease (most common), endocrine disease, cardiovascular, neurologic
T/F - Only secondary HTN can be benign.FALSE (both PRIMARY and SECONDARY HTN may be either BENIGN or MALIGNANT)
Hyaline arteriolosclerosis is ____ nephrosclerosis.benign (intimal thickening, subendothelial hyaline deposition)
Hyperplastic ateriolosclerosis is ____ nephrosclerosis.malignant
____ --> renal artery --> _____ artery --> glomerulusaorta - renal artery - interlobular artery - glomerulus
Glomerulus --> _______ arterioles --> _______ capillaries --> ultimately to venous system.efferent arterioles - peritubular capillaries (accompany the collecting tubules - re-absorption and secretion)
____ and ____ epithelial cells form the walls of the glomerulus.Parietal and visceral (visceral lines outside of capillaries - contains podocytes - 20-30nm gaps to allow filtration, parietal lines Bowman's space)
Matrix that holds capillary tufts together.mesangial cells
Urine is first collected in...Bowman's capsule
Glomerular disease is mostly caused by ___ mechanisms.immune
Glomerular deposition of immunoglobulins +/- components of complement system ---> kidney injuryGlomerular disease
Describe the 2 forms of antibody injury in Glomerular disease.1) antigen-antibody complexes are deposited in the glomeruli injuring them and 2) antibodies to an epithelial antigen within glomeruli (or toxins and cytokines)
T/F - Glomerular Disease will cause proteinuria.True


Question Answer
Human kidney has _________-___ pyramidal lobes.7-8
Chronic RF caused by DM.34%
Chronic RF caused by HTN.25%
Chronic RF caused by glomerulonephritis.16%
State the Blood Pressure equation.BP = Cardiac output X Peripheral Resistance
Essential (primary) HTN is _________% of cases.95%
Secondary HTN is _________% of cases.5%
_________% of HTNive Renal Disease remain stable and controlled by meds, diet, exercise with normal life expectancy.90%
_________% of HTNive Renal Disease will rapidly progress and left untreated may cause death in 1-2 years.5%
Renal Artery Stenosis is the cause of HTN _________-_________% of the time.2-5%
Renal Artery Stenosis is _________-_________% curable.70-80%


Peripheral Resistance Factors
Question Answer
Angiotensin IIconstrictor
Na+blood volume
Mineralcorticoidsblood volume
alpha-adrenergicneural factor (constrictor)
B-adrenergicneural factor (dilator)


Renal Failure Risks in Medicine
Question Answer
___ abnormalities.platelet (bleeding)
Defects in platelet to ____ ___ interaction.vessel wall (bleeding)
____ toxins in blood.uremic (bleeding problems)
Production of _________ in blood.NO (bleeding)
___ suppression.WBC (infection)
____ transplant.kidney (immunosuppression meds)
T/F - Drug doses and interactions may lead to metabolite accumulation and toxicity.True


Benign Nephrosclerosis, Malignant Nephrosclerosis, Renal Artery Stenosis
Question Answer
Hyaline arteriosclerosisBenign
Narrowed lumens, hypoperfusion of kidneyBenign, Malignant
Renin usually NOT triggered, easily controlledBenign
Seen with aging, worse with HTN and diabetesBenign
Ischemic atrophy which reduces GFR with mild proteinuriaBenign
Managed with salt-free dietBenign
Both kidneys affectedBenign, Malignant
Kidney has granular surfaceBenign
Rapidly progressive course, may cause death in 1-2 years if left untreatedMalignant
Injury to arteriolar walls - fibrinoid necrosis - hyperplastic arteriolosclerosisMalignant
Hyperplasic arteriolosclerosisMalignant
Renin system triggeredMalignant, Goldblatt Kidney
Diastolic >120 - cerebral edema - visual impairment - CV abnormalities, ARF, deathMalignant
Necrosis of arteriolesMalignant
Unilateral Kidney involvementGoldblatt Kidney (Renal Artery Stenosis)
Renovascular HTN aka HTN secondary to kidney diseaseGoldblatt Kidney
Kidney disease secondary to HTNBenign, Malignant
Atherosclerosis of renal artery or fibromuscular dysplasiaGoldblatt Kidney
Constriction of renal artery, renal ischemia, renin, HTNGoldblatt Kidney
Not systemic HTN???Goldblatt Artery (no comprende)
Treated with renal artery angioplasty, bypass, or nephrectomyGoldblatt Kidney
Tunica media hyperplasia, smooth muscle cells replicateMalignant


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