Patho exam 4

good luck :))

True or False: Normal cellular metabolism continually release acids.

True

What does the pH of fluid reflect?

Degree of acidity or alkalinity

What type of ions do acids release?

Hydrogen ions (H+)

Death can occur if?

pH falls below 6.9 and pH rises above 7.8

What are three major mechanisms to regulate the acid-base status?

Buffers, respiratory system, and renal system

Bicarbonate ion is an indicator of?

The renal (metabolic) component of the acid-base balance

True or False: Buffers take a while to defend against any pH changes in all body fluid.

False, buffers are the first line of defense against pH changes in all body fluids

True or False: Each buffer can be defined as a "buffer system"

True

What is the process that bicarbonate ions undergo when there is too little acid in the body?

Bicarbonate buffer system releases hydrogen ions from the weak acid to decrease the pH

True or False: 20:1 ratio of bicarbonate ions to carbonic acid necessary for normal pH.

True

What makes up carbonic acid?

CO2 and Water

Which organ excretes carbonic acid?

Lungs

Hyperventilation results in?

Decreased carbon dioxide in the blood, and thus reducing carbonic acid

What is the third line of defense against acid-base disorder?

Kidney

True or False: Lungs compensate for acid-base imbalances resulting from altered levels of metabolic acid.

True

How do the kidneys compensate for imbalances?

The kidneys compensate for acid base imbalances resulting from altered levels of carbonic acid

What is alkalosis?

Presence of factors that increase pH of blood above normal, making it more alkaline

True or False: Metabolic acidosis is relative excess of any acid except carbonic acid.

True

Keto Acids accumulate where?

in the blood

What is the compensatory response to metabolic acidosis?

Hyperventilation

What is the compensatory response to respiratory acidosis?

Increased excretion of metabolic acids by the kidneys

What is the compensatory response to metabolic alkalosis?

Hypoventilation

What is the compensatory response to respiratory alkalosis?

Decreased excretion of metabolic acids by the kidneys

What are the kidneys responsible for?

Maintaining fluid and electrolyte homeostasis and ridding the body of water-soluble wastes

What are two important endocrine functions can the kidneys preform?

Production of erythropoietin: regulator if red blood cell quantity and activation of vitamin D: cofactor for intestinal calcium absorption

True or False: The pelvis is composed of urinary collecting structures.

True

True or False: The interlobular arteries branch multiple times to form afferent arterioles for each of the millions of kidney glomeruli.

True

What is the function of the descending loop of Henle?

Transport water; delivers a concentrated filtrate to ascending loop of Henle

True or False: Kidney health is primarily assessed by measurements of its function.

True

Which waste product is used to estimate GFR?

creatinine

What are the products that urine should NOT contain?

Glucose, blood proteins, blood cells, and any molecule greater than 70,000 Daltons

What are the factors regulating filtration pressures?

Blood volume, autoregulation, and plasma oncotic pressure

True or False: Nephrons cannot regulate their own GFR.

False, they can

True or False: Glucose is filtered freely across the glomerular membrane.

True

What happens to the excess hydrogen ions?

Excess H+ ions are excreted in the urine in combina�on with phosphate and ammonia buffer.

How do the kidneys regulate blood volume and osmolality?

By Altering glomerular filtration rate (GFR) and reabsorption of the urinary filtrate

True or False: Aldosterone and Angiotensin II increase both sodium and water reabsorption.

True

What do thiazide-like diuretics'?

Block Na+ reabsorption

What do kidneys normally secrete?

Erythropoietin, a growth factor for red blood cells and Active vitamin D, a necessary cofactor for calcium absorption from the intestine.

Where do intrarenal disorders occur?

Primarily within the kidney and have the potential to result in renal insufficiency or failure

What is the term for kidney and renal pain?

nephralgia

What are some renal congenital abnormalities?

Agenesis: kidneys do not develop in the fetus & Hypoplasia; some fetal kidney development but they are smaller than normal

What are two most common cystic kidney disease forms?

Autosomal recessive and dominant forms

True or False: Wilms Tumor is the most common kidney cancer in adults.

False, in children (identified by palpable abdominal mass)

Infection of the kidney is known as?

Pyelonephritis

What is the most common cause of infection of the kidney?

Ascending infections from the lower urinary tract

What is the pathogenesis of acute pyelonephritis?

Occurs when there is an obstruction or ureteral reflux that allows contaminated urine to get into the kidney

How is renal stones defined?

Crystal aggregates composed of organic and inorganic materials located within the urinary tract

What are the layers of membranes of glomerular capillaries?

Endothelium, basement membrane, and epithelial cells with foot-like projections (podocytes)

What does glomerulonephritis produce?

inflammation in glomeruli

What does proteinuria lead to?

hypoalbuminemia

True or False: Chronic kidney disease (CKD) is a progressive and irreversible.

True

True or False: Medicare spending for patients with CKD ages 65 and older exceeded $50 billion in 2013 and represented 20% of all Medicare spending in this age group.

True

True or False: Beginning with stage 3, patients are classified as having CKD, according to GFR, regardless of the existence of kidney damage.

True

Describe signs/symptoms of CKD of the stages?

Stages 1-3: usually without symptoms, and Stages 4-5: disturbances in water/electrolyte balance; metabolic and endocrine changes become clinically manifest

What are the clinical manifestations of abnormal salt and water?

Generalized edema, Fluid in the lungs, High blood pressure, Palpitations, Muscle pain

Why would polyuria occur?

Kidney is unable to concentrate the filtrate

True or False: Cardiovascular disease is both a risk factor and a complication of CKD

True

What are some urea effects on the CNS?

Headache, confusion, coma

What are CKD associated bone disorders?

Hyperphosphatemia, Hypocalcemia, Secondary Hyperparathyroidism

What would be most significant when assuming CKD associated anemia?

Lack of erythropotien production by the kidney

What are risk factors for developing advanced CKD?

Obesity, SES, smoking, diabetes mellitus, high BP, periodontal disease, sleep apnea

What is the pathophysiology Acute Kidney Injury (AKI)?

Abrupt reduction in renal function producing an accumulation of waste material in the blood

What is the function of the lower urinary tract (LUT)?

Responsible for the transport, storage, and elimination of urine from the body

Describe micturition?

Voiding, involves both reflex and voluntary mechanisms, mediated by the micturition center in the pons

Injury or disease to this can affect LUT function?

Injury or disease to the spinal cord

What is used to diagnose infection of LUT disorder?

Urinalysis

What are three types of urinary incontinences?

Urgency, stress, and mixed

When does stress urinary insentience occur?

Urine is involuntarily lost with increase in intra-abdominal pressure

True or False: Enuresis is intermittent incontinence while awake.

False, it is when asleep

What is the most common type of enuresis?

Primary nocturnal enuresis: child who has never achieved continence

Deficiency in which hormone can cause enuresis?

ADH (vasopressin)

Neurogenic bladder can lead to?

Urinary incontinence and frequency

Define cystitis

Inflammation of the bladder lining

Urolithiasis is most often caused by?

mostly cause by stones traveling to the ureters, bladder, or urethra from the kidney