patho exam4

What are the kidneys responsible for?

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

What two important endocrine functions can the kidneys perform?

Production of erythropoietin: regulator of red blood cell quantity 2. 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?

Transports 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 combination with phosphate and ammonia buffer

How do 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 do?

Block Na+ reabsorption

What do kidneys normally secrete?

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

Where do intrarenal disorders occur?

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 and Hypoplasia: some fetal kidney development but they are smaller than normal

What are the 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 (and 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 infection 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 are renal stones defined as?

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

What does glomerulonephritis produce?

Produce inflammation in glomeruli.

What are the layers of membranes of glomerular capillaries?

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

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 the signs/symptoms of CKD 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 erythropoietin production by the kidney

What are some risk factors for developing advanced CKD?

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

What is the pathophysiology of Acute Kidney Injury (AKI)?

Abrupt reduction in renal function producing an accumulation of waste materials 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 disorders?

Urinalysis

What are the three types of urinary incontinence?

Urgency, stress, and mixed

When does stress urinary incontinence occur?

Occurs when urine is involuntarily lost with increases 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?

Can lead to urinary incontinence and frequency

Define cystitis.

Inflammation of the bladder lining

Urolithiasis is most often caused by?

Most often caused by stones traveling to the ureters, bladder, or urethra from the kidney