Exam 4

25. True or False: Normal cellular metabolism continually releases acids

True

What does the pH of a fluid reflect?

Its 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 the three major mechanisms to regulate the acid-base status?

Buffers, respiratory system, and renal system

Bicarbonate ion is an indicator of?

Bicarbonate ion is an indicator of the renal (metabolic) component of the acidbase balance

True or False: Buffers take awhile to defend against any pH changes in all body fluids

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 a 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 disorders?

Kidneys

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

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?

Is the presence of factor that increases 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 kidney

26. . 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.

27. 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 are the layers of membranes of glomerular capillaries?

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

What does glomerulonephritis produce?

Produce inflammation in glomeruli.

What does proteinuria lead to?

Hypoalbuminemia

28. 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

29. 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