Term
| What provides a smooth surface for blood to flow against? |
|
Definition
|
|
Term
| What is the BV endothelium called? |
|
Definition
|
|
Term
| What is in the adventitia around the arteries? |
|
Definition
| CT, Nerves, small arterioles |
|
|
Term
| Do BV get all of their nutrients from the blood they carry? |
|
Definition
| No, they need additional capillaries to provide their own blood supply |
|
|
Term
| What are the elastic arteries often called? |
|
Definition
|
|
Term
| What are two examples of medium BV? |
|
Definition
| Coronary and renal arteries |
|
|
Term
| Can different types of arteries be susceptible to different types of dx? |
|
Definition
|
|
Term
| Compare arteries to veins |
|
Definition
| Veins have greater diameter, larger lumens, thinner walls. Only some veins have smooth muscle |
|
|
Term
| If the CV system is in a hypertensive state, what will present first? |
|
Definition
| enlarged veins before enlarged arteries |
|
|
Term
| What does the weaker nature of veins leave them prone to? |
|
Definition
| irregular dilation compression and inflammation |
|
|
Term
| What do venous valves do? |
|
Definition
| Fxn as check valves to prevent backflow of blood |
|
|
Term
| What is the diameter of a normal capillary? |
|
Definition
|
|
Term
| How thick are capillaries? |
|
Definition
|
|
Term
| How much capillary surface area is there in 1 cubic inch of tissue? |
|
Definition
|
|
Term
| Are capillaries how pressure or low? Fast or slow blood flow? |
|
Definition
| low pressure; slow blood flow |
|
|
Term
| What are fxn's of the endothelium? |
|
Definition
| permeability, vessel repair, coagulation/clotting, regulates inflammation/cell growth, oxidizes LDL, modulates blood flow |
|
|
Term
| Where is the BV endothelium found? |
|
Definition
| Throughout the entire vascular system |
|
|
Term
| What role do cytokines play with BV endothelium? |
|
Definition
|
|
Term
| What role do growth factors play with BV endothelium? |
|
Definition
|
|
Term
| What is the only vein that has oxygenated blood? |
|
Definition
|
|
Term
| Where is the tricuspid valve? |
|
Definition
| Right atrium --> Right ventricle |
|
|
Term
| Where is the mitral valve? |
|
Definition
| Left atrium --> Left ventricle |
|
|
Term
| What is the sinus rhythm? |
|
Definition
| the rhythm of a normal heart |
|
|
Term
|
Definition
|
|
Term
|
Definition
| <100 BPM, rare compared to tachycardia |
|
|
Term
| What is the coronary artery most commonly affected in MI? |
|
Definition
| left anterior descending artery |
|
|
Term
| What does the SA node control? |
|
Definition
| electrical impulse that coordinates contraction of the heart |
|
|
Term
| What can cause tachycardia? |
|
Definition
| fever, sickness, weakness |
|
|
Term
| What is the cutoff for reduced risk of MI with regards to resting heart rate? |
|
Definition
|
|
Term
|
Definition
| contraction/emptying blood form the heart |
|
|
Term
| Do the left and right sides of the heart contract simultaneously? |
|
Definition
|
|
Term
| What two structures receive blood from the heart? |
|
Definition
|
|
Term
| What is the first heart sound? |
|
Definition
| when the tricuspid and mitral valves close at the beginning of heart contraction cycle |
|
|
Term
| What valves are closed as blood is exiting the heart? |
|
Definition
| mitral and tricuspid valve "MT" |
|
|
Term
| What is the first heart sounds also called? |
|
Definition
|
|
Term
|
Definition
| relaxation/filling of heart with blood |
|
|
Term
| What valves are closed during diastole? |
|
Definition
| pulmonary and aortic valves |
|
|
Term
| What causes the second heart sound? |
|
Definition
| Closing of pulmonary and aortic valves |
|
|
Term
| What is the second heart sound also called? |
|
Definition
|
|
Term
|
Definition
| How much blood is present in the ventricle at the end of diastole (how 'full' the heart is) |
|
|
Term
| What is the Frank-Starling relationship? |
|
Definition
| the elastic stretching of the ventricle due to blood filling it |
|
|
Term
|
Definition
| The force that resists blood flow through the body |
|
|
Term
| What is the main cause of afterload? |
|
Definition
|
|
Term
| What is a high afterload? |
|
Definition
| A less elastic arterial system, greater resistance to blood flow |
|
|
Term
| What is contractility also called? |
|
Definition
|
|
Term
|
Definition
| The ability of the heart muscle to change shape independent of preload/afterload |
|
|
Term
| What can decrease contractility? |
|
Definition
|
|
Term
| What controls contractility? |
|
Definition
| calcium levels and Beta-1 sympathetic system |
|
|
Term
| How much blood per minute can a normal heart move? |
|
Definition
|
|
Term
| What do calcium channel blockers do in the heart? |
|
Definition
| Works on the inner walls of cells, decreases contractility by keeping Ca++ in the cell |
|
|
Term
|
Definition
| cardiac output divided by body surface area |
|
|
Term
| What is a normal cardiac index? |
|
Definition
|
|
Term
| What is a sinus (general definition) |
|
Definition
| Any opening/hollowing/cavity |
|
|
Term
| Can the sinoatrial (SA) node regulate the heart beat? |
|
Definition
|
|
Term
| Can the AV node regulate heart beat? |
|
Definition
| Yes, it tends to only 40-60 bpm, tends to be overruled by faster beating SA node |
|
|
Term
|
Definition
| irregular contraction of heart muscle |
|
|
Term
| Where does the contraction impulse go from the AV node? |
|
Definition
| into the bundle of His --> divides into R and L branches --> purkinje fibers in ventricle wall |
|
|
Term
| What does the sympathetic system innervate in the heart? |
|
Definition
|
|
Term
| How does the sympathetic system affect cardiac output? |
|
Definition
| increases calcium, which increases contractility --> greater output |
|
|
Term
| What does the parasympathetic system innervate? |
|
Definition
| atria via the vagus nerve, little effect on ventricles |
|
|
Term
| What does parasympathetic system do to cardiac output? |
|
Definition
|
|
Term
| What maintains the resting membrane potential of nerve fibers? |
|
Definition
| Na/K ATP pump maintains depolarized (more negative) intracellular state |
|
|
Term
| What leaks faster, Na or K? |
|
Definition
| K leaks out faster than Na leaks in, so it will always be negative inside of cell |
|
|
Term
| What is open when a cell is depolarizing? |
|
Definition
|
|
Term
| What is open when a cell is repolarizing? |
|
Definition
|
|
Term
| What is faster, cardiac or regular neural AP's? |
|
Definition
|
|
Term
| Does the SA node spontaneously depolarize? |
|
Definition
|
|
Term
| What causes the SA node to spontaneously depolarize? |
|
Definition
| natural leakiness to Na+ and Ca++ |
|
|
Term
| What are the types of Ca++ channels in the heart? |
|
Definition
|
|
Term
| What Ca++ channel type is affected stronger by cardiac drugs? |
|
Definition
|
|
Term
| What stays depolarized longer, SA node or cardiac muscle? |
|
Definition
|
|
Term
| What causes slow repolarization of cardiac muscle? |
|
Definition
| Ca++ channels that are slow to close |
|
|
Term
| When can cardiac muscle repolarize? |
|
Definition
| once K+ and Ca++ channels are closed |
|
|
Term
| What opens first in cardiac muscle depolarization? |
|
Definition
| Na+ gates first, Ca++ second |
|
|
Term
| Compare cardiac and skeletal muscle |
|
Definition
| cardiac cells are smaller than skeletal, cardiac cells are connected via gap jxn's, all cardiac muscle cells share neural stimulation --> firing at the same time |
|
|
Term
| How many syncytia are found in the heart? |
|
Definition
|
|
Term
| Where are the syncytia found in the heart? |
|
Definition
|
|
Term
| What is the term for blocks of cardiac cells that fire together due to gap jxn's? |
|
Definition
|
|
Term
| Do ions move easier in cardiac or skeletal muscle? |
|
Definition
|
|
Term
| What can induce Ca++ release in a cardiac muscle cell? |
|
Definition
| Initial Ca++ entering cell causes sarcoplasmic reticulum and mitochondria to release Ca++ |
|
|
Term
| If Ca++ cannot leave cardiac muscle, what happens? |
|
Definition
|
|
Term
| What is seen in the unbound [Ca++] when contractility is increased? |
|
Definition
|
|
Term
| Do Ca++ channel blockers completely stop Ca++ flow? |
|
Definition
|
|
Term
| How is Ca++ removed from the cell? |
|
Definition
| Sodium/Calcium exchange, calcium is taken up by the sarcoplasmic reticulum and mitochondria |
|
|
Term
| What is the prevalence of CVD death in the US? |
|
Definition
|
|
Term
| How much does CVD depress life expectancy? |
|
Definition
|
|
Term
| At what ages does cancer overtake CVD for #1 cause of death? |
|
Definition
|
|
Term
| What ratio of pt's wil present with some form of CVD? |
|
Definition
|
|
Term
| Are males or females more likely to die from CVD? |
|
Definition
| Both are equally likely, CVD is the # killer of both sexes |
|
|
Term
| Where do women present with heart dx s/sx? |
|
Definition
|
|
Term
| Which arm is more likely to present pain during a cardiac event? |
|
Definition
| left arm, but both can present it |
|
|
Term
|
Definition
| a short term loss of consciousness |
|
|
Term
| What are the most important s/sx of heart dx? |
|
Definition
| jaw, back, dyspnea, nausea and vomiting (n&V) |
|
|
Term
| What ocular findings increase risk of CVD? |
|
Definition
| ARMD, retinopathy (diabetic or non) |
|
|
Term
| What is the increased prevalence of CVD in ARMD? |
|
Definition
| 2x higher death rate from CVD |
|
|
Term
| What is the increased prevalence of CVD in retinopathy? |
|
Definition
| 2-6x higher chance of heart dx |
|
|
Term
| What can CVD cause in the eye? |
|
Definition
| TIA, central retinal vein occlusion (CRVO), ocular ischemic syndrome (carotid blockage) |
|
|
Term
| Name two CV meds than can cause adverse ocular rxns |
|
Definition
|
|
Term
| What ocular med can cause stroke? |
|
Definition
|
|
Term
| What can require AB prophylaxis? |
|
Definition
| some optometric procedures if the pt also has CVD |
|
|
Term
| What is a typical biochemical sign of MI |
|
Definition
| serum enzyme levels increase |
|
|
Term
| What three enzymes can indicated MI? |
|
Definition
creatine phosphokinase
Lactate dehydrogenase
troponin I |
|
|
Term
|
Definition
| creatine phosphokinase - myocardial band |
|
|
Term
| What is the onset of increased CK-MB? |
|
Definition
|
|
Term
| What can cause LDH-1 serum levels to increase? |
|
Definition
|
|
Term
| What is the peak of CK-MB serum levels |
|
Definition
|
|
Term
| When is CK-MB back to normal after MI |
|
Definition
|
|
Term
| What is the onset of increased LDH-1 after MI? |
|
Definition
|
|
Term
| When I the peak of LDH-1 levels after MI? |
|
Definition
|
|
Term
| When does LDH-1 drop back to normal after a MI? |
|
Definition
|
|
Term
| When does troponin I increase after MI? |
|
Definition
|
|
Term
| What is the peak of troponin I levels after MI? |
|
Definition
|
|
Term
| When does troponin I levels return to normal after a MI? |
|
Definition
|
|
Term
| How many waves are in a normal ECG |
|
Definition
|
|
Term
| What is the 'P' wave in an ECG? |
|
Definition
| atrial cell depolarization |
|
|
Term
| What is the 'QRS' wave in an ECG? |
|
Definition
|
|
Term
| What is the 'T' wave in an ECG? |
|
Definition
| ventricular repolarization |
|
|
Term
|
Definition
| measure of AV conduction time |
|
|
Term
| What is cardiac catheterization? |
|
Definition
| insertion of a thin flexible tube into a vein (often femoral) or artery, which is guided into the heart |
|
|
Term
| What can cardiac catheterization detect? |
|
Definition
| BP and patterns of blood flow; cardiac output in general |
|
|
Term
| How is angiography contrast introduced? |
|
Definition
|
|
Term
| What image is taken in contrast angiography? |
|
Definition
|
|
Term
| What is monitored in a cardiac stress test? |
|
Definition
|
|
Term
| What changes during cardiac ischemia during a stress test? |
|
Definition
|
|
Term
| What is echocardiography? |
|
Definition
| ultrasound scan of the heart, measures structure and movement of heart |
|
|
Term
|
Definition
| Multiple gated acquisition scan |
|
|
Term
| What is measured in a MUGA scan? |
|
Definition
| left ventricular wall motion and ventricle ability to eject blood |
|
|
Term
| What is the stress thallium test commonly known as? |
|
Definition
|
|
Term
| What is administered in the DIP-thal test |
|
Definition
| Thallium 201 is injected into the vein |
|
|
Term
| What does the DIP-thal test measure? |
|
Definition
| How much thallium is taken up by myocardial tissues, dead tissues absorbs it poorly |
|
|
Term
|
Definition
| a region of dead or scarred heart tissue of compromised fxn |
|
|
Term
| What does Na/K pump inhibition cause? |
|
Definition
slower conduction through AV node
increased contractility due to increased intracellular [Ca++] |
|
|
Term
| What are the visual side effects of Na/K pump inhibition? |
|
Definition
| blurred vision, altered color perception (blue tinged), haloes on dark objects |
|
|
Term
| When are visual side effects of Na/K pump inhibition most common? |
|
Definition
| overdose of related drugs |
|
|
Term
|
Definition
Decreases contractility through decreased influx of Ca++ into cardiac muscle
Delays removal of Ca++ from pacemaker cells |
|
|
Term
| What is the mechanism of Verapamil? |
|
Definition
| slows heart rate by interfering with SA and AV repolarization |
|
|
Term
| What cardiac meds interfere with the ANS? |
|
Definition
|
|
Term
| What do Beta blockers inhibit? |
|
Definition
|
|
Term
| What drug can slow conduction time and should not be used in severe heart block pt's? |
|
Definition
|
|
Term
| What do beta blockers do to heart activity? |
|
Definition
| decrease heart rate, decrease contractility |
|
|
Term
| What is the cause of primary HTN? |
|
Definition
|
|
Term
| What % of HTN is primary? |
|
Definition
|
|
Term
| What are the physiologic abnormalities in primary HTN? |
|
Definition
persisten elevated cardiac output
abnormal peripheral resistance |
|
|
Term
| What is impaired natriuresis? |
|
Definition
| elevated BP --> does not cause natriuresis as it does in normals --> BP does not lower properly |
|
|
Term
| What is baroreceptor resetting? |
|
Definition
| In HTN, the baroreceptors maintain a set point that is too high, so the feedback loop does not damp BP properly |
|
|
Term
| Can renin-angiotensin-aldosterone system abnormalities cause HTN? |
|
Definition
|
|
Term
|
Definition
| HTN that presents as a s/sx of another dx |
|
|
Term
| What can renal dx do to BP? |
|
Definition
| raise it due to reduced salt excretion, altered renin-angiotensin-aldosterone activity |
|
|
Term
| What can an adrenal or pituitary tumor do to BP? |
|
Definition
|
|
Term
| What can thyroid dx do to BP? |
|
Definition
|
|
Term
| What can sleep apnea and sleep deprivation do to BP? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What are considerations for how to treat HTN? |
|
Definition
level of BP elevation
What risk factors are present
Any comorbities? (diabetes, renal dx)
Any organ or CV dx?
Ethnicity |
|
|
Term
| What is the goal of HTN treatment? |
|
Definition
| Reduce CVD, morbidity and mortality |
|
|
Term
| What is the target BP for HTN tx? |
|
Definition
<140/90 mmHg
If diabetic/renal dx is present, target is <130/80 |
|
|
Term
| What reduction in stroke can be realized due to HTN tx? |
|
Definition
|
|
Term
| What reduction in MI can be realized due to HTN tx? |
|
Definition
|
|
Term
| What reduction in heart failure can be realized due to HTN tx? |
|
Definition
|
|
Term
| What are nonpharmacological measures to reduce HTN? |
|
Definition
pt education
cease smoking
Na intake <2.3 g/d (6g NaCl)
Maintain 90 mmol/d of K+
Maintain proper Ca++, Mg+, and Vit D
weight reduction and exercise
limit EtOH |
|
|
Term
| What does reducing EtOH cause endocrine wise? |
|
Definition
| reduced catecholamine release |
|
|
Term
| What is very bad habit for maintaining proper BP? |
|
Definition
|
|
Term
| What is the level of BP reduction that can bee seen through 'dark chocolate tx'? |
|
Definition
5.2 mmHg systolic
1.8 mmHg diastolic |
|
|
Term
| ACE inhibitors and CCB are being studied for what purpose? |
|
Definition
| HTN tx, reducing morbidity and mortality |
|
|
Term
| What is the mechanism of diuretics? |
|
Definition
| decreased Na+ reabsorption in kidneys |
|
|
Term
| What is the result of diuretic use? |
|
Definition
| increased urine output --> decreased blood volume |
|
|
Term
| How does the body resist diuretic effectiveness? |
|
Definition
| it can reset the feedback loop to maintain the higher HTN |
|
|
Term
| Can diuretics reduce peripheral resistance? |
|
Definition
| yes, via relaxing arteriolar smooth muscle |
|
|
Term
| What is a good drug to pair with a diuretic for HTN tx? |
|
Definition
|
|
Term
| What ethnicity responds very well to diuretics for HTN tx? |
|
Definition
|
|
Term
| What are thiazide diuretics? |
|
Definition
decrease Na+ reabsorption in the short term
increased vasodilation in the long term |
|
|
Term
| What is the time course for maximum effect in thiazide diuretics? |
|
Definition
|
|
Term
| What are the adverse effects of diuretics? |
|
Definition
hypokalemia --> arrythmia
hyperuricemia (70%)
volume depletion
hypercalcemia
hyperglycemia (10%) |
|
|
Term
| What is the CI for thiazide diuretics? |
|
Definition
|
|
Term
| What is the mechanism of loop diuretics? |
|
Definition
| inhibit re abosorption of ions in the loop of Henle |
|
|
Term
| What is the most efficacious of all diuretics? |
|
Definition
|
|
Term
| Are loop diuretics long or short acting? |
|
Definition
| Short, must be taken 2x /day |
|
|
Term
| What is more potent, bumetanide or furosemide? |
|
Definition
| bemtanide, though furosemide more commonly prescribed. Loop diuretic. |
|
|
Term
| What are the adverse effects of loop diuretics? |
|
Definition
Permanent ototoxicity
hyperuricemia
acute hypovolemia --> shock, arrythmia
K+ depletion |
|
|
Term
| What are K+ sparing diuretics? |
|
Definition
inhibit Na reabsorption and K+ secretion
prevent aldosterone from binding and working |
|
|
Term
| Name a K+ sparing diuretic |
|
Definition
|
|
Term
| What are adverse side effects of K+ sparing diuretics? |
|
Definition
| gynecomastia in males, menstrual irregularity in females, therefore better as only a short term tx. |
|
|
Term
| Where are Beta blockers most effective? |
|
Definition
| In young and/or caucasian pt |
|
|
Term
| How do Beta blockers reduce HTN? |
|
Definition
decrease cardiac output
decrease sympathetic outflow to decrease renin release |
|
|
Term
| What is the time course of beta blockers for treating HTN? |
|
Definition
| may take several weeks for maximum effect |
|
|
Term
| What are Beta blocker CI's? |
|
Definition
sinus bradycardia
asthma
greater than 1st degree heart block
PAD ( non selective blockers
Diabetics that use insulin (non-selective blockers) --> masks s/sx of low insulin |
|
|
Term
|
Definition
|
|
Term
| Name 3 non-selective beta blockers |
|
Definition
| propranolol, timolol nadolol |
|
|
Term
| Name 3 Beta 1 selective beta blockers |
|
Definition
| atenolol, metoprolol, nebivolol |
|
|
Term
| Name an alpha and beta blocker |
|
Definition
|
|
Term
|
Definition
block angiotensin 1 --> angiotensin 2 pathway
reduce aldosterone
prevent bradykinin inactivation --> vasodilation |
|
|
Term
| What are adverse side effects of ACE inhibitors? |
|
Definition
dry cough
rashes, fever
hyperkalemia
altered taste |
|
|
Term
| What is a CI for ACE inhibitors? |
|
Definition
|
|
Term
| What is the suffix for ACE inhibitors? |
|
Definition
|
|
Term
| What is the DOC for DM htn? |
|
Definition
|
|
Term
| What drug is administered by MD for close observation? |
|
Definition
| ACE inhibitors, may cause syncope or angioedema |
|
|
Term
|
Definition
| angiotensin II antagonists |
|
|
Term
|
Definition
| inhibit angiotensin II from binding to receptor, blocks aldosterone secretion |
|
|
Term
| Do ARB's influence bradykinins? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What are adverse effects of ARB's? |
|
Definition
|
|
Term
| Redo slide 45, ask about what drug she highlighted |
|
Definition
|
|
Term
| What is the mechanism of Ca++ channel blockers? |
|
Definition
| modulates smooth muscle Ca++ release --> reduces muscle tone, vasodilation |
|
|
Term
| Can Ca++ channel blockers reduce PR? |
|
Definition
|
|
Term
| What is the time course for Ca++ channel blockers? |
|
Definition
| short duration, must be used tid for good control |
|
|
Term
| What are adverse effects of Ca++ channel blockers? |
|
Definition
constipation
dizziness
HA
fatigue |
|
|
Term
| What are CI for Ca++ channel blockers? |
|
Definition
heart failure,
topical Beta blockers --> hypotension, bradycardia, AV block |
|
|
Term
| Why are 2nd gen Ca++ channel blockers more effective? |
|
Definition
|
|
Term
| What are renin inhibitors? |
|
Definition
| 1st new class of HTN drugs in 10 yrs |
|
|
Term
| How do renin inhibitors work? |
|
Definition
| inhibits renin from producing angiotensin II |
|
|
Term
| What are the advantage of renin inhibitors? |
|
Definition
|
|
Term
| What are the SE of renin inhibitors? |
|
Definition
| diarrhea, HA, cold symptoms |
|
|
Term
|
Definition
|
|
Term
| What are the disadvantages of combo drugs? |
|
Definition
|
|
Term
| What drugs were abandoned due to major CVD risk? |
|
Definition
| alpha blockers for HTN tx |
|
|
Term
|
Definition
| a CNS drug that treats HTN |
|
|
Term
| What is Clonidine's mechanism for HTN? |
|
Definition
| sympathetic vasomotor center |
|
|
Term
| What is a good drug for treating HTN if kidney ex is present? |
|
Definition
| clonidine, it acts on the CNS instead of the kidneys |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What are the kidneys fxn's? |
|
Definition
1. Remove waste
2. Regulate blood composition
3. Excrete foreign substances |
|
|
Term
| What is regulated in the blood by the kidneys? |
|
Definition
1. Amount of water
2. Quantity and concentration of ions
3. Acid-base balance |
|
|
Term
| What are some systems affected by kidney fxn? |
|
Definition
| GI, neurologic, muscle, heart, pretty much all systems |
|
|
Term
| What shape is the kidney? |
|
Definition
bean shaped, in back of abdomen at level of the lower ribs.
Each weighs 1/4 lb.
Dimensions: 4 x 2.5 x1.5 inches |
|
|
Term
| What is the major renal vein? |
|
Definition
| blood returns to heart through inferior vena cava |
|
|
Term
| What is the major renel artery? |
|
Definition
| major branch from aorta; 20% of systemic blood flow goes to kidney |
|
|
Term
| What is the blood flow through the kidney? |
|
Definition
|
|
Term
| What is the kidney medulla? |
|
Definition
| containts light colored pyramids |
|
|
Term
| What is the kidney pelvis? |
|
Definition
| flat funnel shaped cavity that collects the urine into the ureters |
|
|
Term
| what is the kidney cortex? |
|
Definition
| Outer 1/3 of kidney, contains most of the filtration units |
|
|
Term
| What does 'pilo' refer to? |
|
Definition
|
|
Term
|
Definition
| cortex and medulla, perpendicular to surface of kidney |
|
|
Term
| How many nephrons per kidney? |
|
Definition
|
|
Term
| What doe each nephron do? |
|
Definition
| produce urine, clean the blood |
|
|
Term
| What has vasculature similar to the eye? |
|
Definition
| The kidney, so DM and SLE have similar effects on these structures |
|
|
Term
|
Definition
| ball of capillaries, long thin tube with a hair pin loop, closed at one end |
|
|
Term
| Where are peritubular capillaries? |
|
Definition
|
|
Term
| Who do peritubular capillaries absorb? |
|
Definition
| water, solutes, which leave renal tubules |
|
|
Term
| What provides blood to renal tissue? |
|
Definition
|
|
Term
|
Definition
| pinhead sized filtration capsule 1million per kindey |
|
|
Term
| What is Bowman's Capsule? |
|
Definition
| hollow sphere around glomeruli that drain into the tubules |
|
|
Term
|
Definition
| where the urine drains from the glomeruli |
|
|
Term
| Where is the vascular pole? |
|
Definition
| where blood enters the glomeruli |
|
|
Term
| What are juxtaglomerular cells? |
|
Definition
| baroreceptors that sense pressure change that produce, store and excrete renin |
|
|
Term
| Where are enlarged smooth muscle cells of afferent arterioles found in the kidneys? |
|
Definition
|
|
Term
| Where are Bowman's capsules located? |
|
Definition
|
|
Term
| What are glomelular capillaries |
|
Definition
| ball of capillaries with fenestrated endothelium and incomplete basement membrane |
|
|
Term
| What are mesangial cells? |
|
Definition
| Cells w/ phagocytic and contractile fxn to control blood flow |
|
|
Term
| What holds the glomelular 'ball' together |
|
Definition
|
|
Term
| What capillary has an incomplete basement membrane? |
|
Definition
|
|
Term
|
Definition
| modified epithelial cells that support glomelular capillaries |
|
|
Term
| What are podocytes similar to? |
|
Definition
| choriocapillaris and RPE cells |
|
|
Term
| What gets through fenestrated structures more readily? |
|
Definition
| positively charged ions, substances found in high conc. Systemically, smaller size all facilitate movement across membrane |
|
|
Term
| Why should protein NOT be able to get into the glomerulus? |
|
Definition
| proteins are large molecules, SHOULD be too large to get through |
|
|
Term
| Is the glomelular capillary system high pressure? |
|
Definition
| yes, and it is leaky so exudates are forced through |
|
|
Term
| What are the two important factors that control glomelular filtration rates? |
|
Definition
|
|
Term
| Is there parasympathetic innervation in the afferent tubule? |
|
Definition
|
|
Term
| What does sympathetic stimulation of the kidney do? |
|
Definition
| constricts arteriole and releases rein from juxtaglomelular cells |
|
|
Term
| What does constriction of renal blood flow do? |
|
Definition
| slows blood flow and reduces filtration pressure |
|
|
Term
| What does angiotensin II do under sympathetic stimulus? |
|
Definition
| constriction of efferent ateriole |
|
|
Term
| What triggers angiotensin II? |
|
Definition
|
|
Term
| What do PG's, nitric oxide, and endothelin do? |
|
Definition
| chemical mediators that influence renal blood vessels |
|
|
Term
| Where is the afferent arteriole of the glomerulus? |
|
Definition
|
|
Term
| Where is the efferent arteriole of the glomerulus? |
|
Definition
| downstream of glomerulus 'Efferent is the Exit' |
|
|
Term
| Does the kidney try to maintain constant filtration? |
|
Definition
|
|
Term
| What is the mechanism of initial filtration? |
|
Definition
| 2-3x higher pressure than any other capillary bed is found in glomeruli; this forces substances through capillaries |
|
|
Term
| What is the glomerulus selective for? |
|
Definition
| smaller substances, positive substances, configuration of the the substance |
|
|
Term
|
Definition
| water, ions, glucose, AA, bicarbonate |
|
|
Term
|
Definition
| substance filtered by glomeruli are brought back into the body |
|
|
Term
|
Definition
| ions, glucose, amino acids from the lumen of nephron |
|
|
Term
| What facilitates reabsorption? |
|
Definition
| specialized transporters on epithelial cells of nephrons |
|
|
Term
| Are transporters active or passive? |
|
Definition
|
|
Term
| How is Na+ related to reabsorption? |
|
Definition
| Na+ is sometimes exchanged with substances, enters together via shared transporters or can undergo solvent drag with reabsorbed substances |
|
|
Term
| What are the two major modifers of absorption? |
|
Definition
| concentration, rate of filtrate flow |
|
|
Term
| What does a higher flow of filtrate cause? |
|
Definition
| Less time for transporters to glean their targeted substance |
|
|
Term
| Where does reabsorption of water occur? |
|
Definition
| alon tubules in a passive mechanism |
|
|
Term
| What % of total filtrate volume becomes urine? |
|
Definition
|
|
Term
| What is reabsorbed in the proximal tubule? |
|
Definition
| 80% of glomelular filtrate |
|
|
Term
| What is reabsorbed in the Loop of Henle? |
|
Definition
| water and salt, 6% of filtrate reabsorbed here |
|
|
Term
| What is reabsorbed in the distal tubule? |
|
Definition
| 9% of filtrate. Variable reabsorption and active secretion occurs |
|
|
Term
| What is reabsorbed in the collecting tubule? |
|
Definition
|
|
Term
| What is excretion sometimes called? |
|
Definition
|
|
Term
| What is the distal tubule sometimes called? |
|
Definition
| Distal convoluated tubule |
|
|
Term
| What is excreted in the glomerulus? |
|
Definition
| water, ions, glucose, AA, bicarbonate |
|
|
Term
| What % of Na is reabsorbed? |
|
Definition
|
|
Term
| What does Na reabsorption depend on? |
|
Definition
|
|
Term
| how much water and Cl- is reabsorbed? |
|
Definition
|
|
Term
| How much K+ is reabsorbed? |
|
Definition
|
|
Term
| Where is the filtrate isotonic? |
|
Definition
| entrance to the loope of Henle |
|
|
Term
| What is the only thing reabsorbed in the descending loop of Henle? |
|
Definition
|
|
Term
| What is the osmolarity of the filtrate as it leaves the Loop of Henle? |
|
Definition
|
|
Term
| What reabsorbs water reclaimed in the loop of Henle? |
|
Definition
|
|
Term
| What does ''water flows down hill'' remind? |
|
Definition
| That water flows out (reabsorbed) in the descending loop of Henle |
|
|
Term
| As it enters the Ascending loop of Henle, what is the osmolarity? |
|
Definition
|
|
Term
| Is the ascending loop of Henle permeable to water? |
|
Definition
| No. 'Water can't flow uphill' |
|
|
Term
| What is reabsorbed in the Ascending Loop of Henle? |
|
Definition
|
|
Term
| What does the reabsorption of salt do to the medulla? |
|
Definition
|
|
Term
| What is the osmolarity of exit filtrate from the Acending loop of Henle? |
|
Definition
|
|
Term
| Where are macula densa cells? |
|
Definition
| Specialized epithelial cells that connect the distal convoluated tubule |
|
|
Term
| What do macula densa cells do? |
|
Definition
| Sense the levels sodium and chloride in filtrate. |
|
|
Term
| What do macula dense cells do if NaCl is low in the filtrate? |
|
Definition
| encourage relase of renin from juxtaglomelular cells |
|
|
Term
| What does parathyroid hormone induce in the distal tubule? |
|
Definition
| increased Ca++ absorption |
|
|
Term
| Are early cells of the distal tubule permeable to water? |
|
Definition
|
|
Term
| Is filtrate hypotonic or hypertonic in the distal tubule? |
|
Definition
|
|
Term
| What is Na exchanged for in the distal tubule? |
|
Definition
| K+ is excreted actively, partly in exchange for Na+ |
|
|
Term
| How is Na reabsorbed in the collecting duct? |
|
Definition
|
|
Term
| What does aldosterone increase in the collecting duct? |
|
Definition
| K+ excretion/Na+ reabsorption exchange |
|
|
Term
| What does ADH do to the collecting duct? |
|
Definition
| allows water to pass through walls of collecting ducts |
|
|
Term
| What is the osmolarity of urine in the collecting duct? |
|
Definition
|
|
Term
| What is passively reabsorbed in the collecting duct? |
|
Definition
|
|
Term
| What is the major stimulus for ADH secretion? |
|
Definition
|
|
Term
| What measures blood volume? |
|
Definition
| baroreceptors found in a multitude of places like Aorta, pulmonary vessels, carotid artery |
|
|
Term
| What mechanism do baroreceptors use to measure pressure? |
|
Definition
| measure stretch of BV walls |
|
|
Term
| What does decreased blood volume cause? |
|
Definition
| low BP and increased osmolarity |
|
|
Term
| Where are osmoreceptors found? |
|
Definition
|
|
Term
| What are osmoreceptors most sensitive to? |
|
Definition
| Na+ and mannitol, glucose to a lesser effect |
|
|
Term
| What does ADH cause in the kidney? |
|
Definition
| increased water reabsorption |
|
|
Term
| What is the autocrine system? |
|
Definition
| hormones that bind to receptors and affect the fxn of the cell type that produced it. |
|
|
Term
| What is a vasoactive peptide? |
|
Definition
|
|
Term
| What are the type of endothelins? |
|
Definition
|
|
Term
| What do endothelins cause? |
|
Definition
increased BP through vasoconstriction
can cause vasodilation in a minority of instances
Tends to cause salt and water retention |
|
|
Term
|
Definition
| A molecular gas that has three forms that act on the kidney |
|
|
Term
| What does nitric oxide cause in the kidney? |
|
Definition
more water to be excreted
helps macula densa cells to provide feedback |
|
|
Term
| What may normotensive glaucoma be related to? |
|
Definition
|
|
Term
|
Definition
| increase blood flow to kidney; prevent vasoconstriction |
|
|
Term
| What can impair water reabsorption through blocking ADH in the collecting duct? |
|
Definition
|
|
Term
| What can prescribing PG's as an optometric drug cause systemically? |
|
Definition
|
|
Term
| What prevents water and sodium reabsorption and prevents K excretion? |
|
Definition
|
|
Term
| How is angiotensin II formed? |
|
Definition
| renin combines w/ angiotensinogen --> angiotensin I --> AG II |
|
|
Term
|
Definition
| A potent vasoconstrictor that increases ADH release |
|
|
Term
|
Definition
|
|
Term
| What is the general effect of increased angiotensin II? |
|
Definition
|
|
Term
| Where is ADH released from? |
|
Definition
|
|
Term
| What increases aldosterone release from adrenal cortex? |
|
Definition
|
|
Term
| What is released in response to hypoxia by the kidney? |
|
Definition
|
|
Term
|
Definition
| stimulate bone marrow to produce RBC's |
|
|
Term
|
Definition
| Stimulates absorption of calcium in intestine |
|
|
Term
| What is the pH target for blood? |
|
Definition
|
|
Term
|
Definition
| neutralized by bicarbonates |
|
|
Term
| What regulates bicarbonate regeneration? |
|
Definition
|
|
Term
| How does the kidney influence blood pH? |
|
Definition
| excretes H+ or Bicarbonate |
|
|
Term
| What is a sign of kidney disease? |
|
Definition
|
|
Term
| What is a common problem with kidney dx? |
|
Definition
|
|
Term
| What is the glomelular filtration rate? |
|
Definition
| Amt of filtrate formed in all nephrons |
|
|
Term
| What % of renal plasma flow is filtered? |
|
Definition
|
|
Term
| what is the normal glomelular filtration rate? |
|
Definition
|
|
Term
| What is glomelular filtration rate use to assess? |
|
Definition
|
|
Term
| How is a glomelular filtration rate measured? |
|
Definition
| collected blood is timed to see how fast substances are removed from the body |
|
|
Term
| What test requires the pt to be in a clinic for hours to perform the test? |
|
Definition
| glomelular filtration rate |
|
|
Term
|
Definition
| byproduct of muscle metabolism |
|
|
Term
| What does the kidney do to creatinine? |
|
Definition
| filters it out, but does not reabsorb it out of the tubules |
|
|
Term
| What is the normal value for a creatinine clearance test? |
|
Definition
|
|
Term
| What is an abnormal value for creatinine clearance? |
|
Definition
| <60 = significant indicator of kidney dx |
|
|
Term
| How is the creatinine clearance test performed? |
|
Definition
| urine is collected for 24 hrs w/ a blood draw at the end |
|
|
Term
| What is the normal serum level of creatinine? |
|
Definition
|
|
Term
| What can influence normal creatinine serum levels? |
|
Definition
| gender and size of individual |
|
|
Term
| If creatinine serum level is doubled, what does this mean? |
|
Definition
| kidney fxn has fallen to half of normal rate |
|
|
Term
| If creatinine serum level is triple, what does this mean? |
|
Definition
| kidney fxn has fallen to 25% of normal rate |
|
|
Term
|
Definition
| tests urea as an indicator of kidney fxn |
|
|
Term
|
Definition
| end product of protein metabolism |
|
|
Term
| What is the rate of urea excretion? |
|
Definition
| roughly 50% excreted, 50% reabsorbede |
|
|
Term
| What is a normal value for urea in the BUN test? |
|
Definition
|
|
Term
| What increases in the BUN test with decreasing kidney fxn? |
|
Definition
|
|
Term
|
Definition
| an asymptomatic malfunction that is indicative of poor urea release in kidney |
|
|
Term
| What is abnormally seen in urinalysis? |
|
Definition
| protein, blood or glucose |
|
|
Term
| What is the first sign of kidney involvement in DM? |
|
Definition
|
|
Term
|
Definition
| neutrophil gelatinase associated lipocalin |
|
|
Term
|
Definition
acute damage to the kidney
indicator of necessity for dialysis to allow kidney to heal/recover |
|
|
Term
| What does increased potassium and phosphate levels indicate? |
|
Definition
|
|
Term
| What does decreased calcium, pH and bicarbonate levels indicate? |
|
Definition
|
|
Term
|
Definition
flourescine imaging of the urethra, bladder, and ureteral orifices
allows for biopsy |
|
|
Term
| What can ultrasound evaluate in the kidney? |
|
Definition
| structure, tumors, abnormalities |
|
|
Term
| What % of US adults have chronic kidney dx? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| How many die per year due to renal problems? |
|
Definition
|
|
Term
| How many americans require dialysis or kidney transplantation to live? |
|
Definition
|
|
Term
| How many people are waiting for a kidney? |
|
Definition
|
|
Term
| How many people receive kidney transplants each year? |
|
Definition
|
|
Term
| Is CKD increasing or decreasing in the US? |
|
Definition
|
|
Term
| What does CKD increase the risk for? |
|
Definition
| ARMD 3-5x greater, dry eye 15x greater |
|
|
Term
| What can optometric prescribed medications cause? |
|
Definition
|
|
Term
| What may be adjusted if CKD is suspected in a pt? |
|
Definition
| decreased dosage of meds may be required to protect kidneys |
|
|
Term
| What is the most common cause of kidney failure? |
|
Definition
|
|
Term
| What is a second most common cause of kidney failure? |
|
Definition
|
|
Term
| How much kindey fxn can be lost before sx develop? |
|
Definition
|
|
Term
| When is pain felt during kidney failure/dx? |
|
Definition
| Only if stretching of renal fascia or muscular contraction of ureters |
|
|
Term
| What % of pt's have a GFR of 50-60 mL/min that are diagnosed by primary care physician? |
|
Definition
|
|
Term
| What is the threshold for kindey dx to be considered chronic? |
|
Definition
|
|
Term
| What are the three general locations for kidney failure to act? |
|
Definition
pre-renal - burns, blood loss, other systemic problem leads to kidney dysfunction
intrinsic - the kidney itself is the cause, perhaps with the medulla or tubules, etc. Even with normal bloodflow, still going to fail
post-renal - kidney stones, fluid backup due to blockage downstream |
|
|
Term
| What are common first s/sx of kidney dx? |
|
Definition
| HTN, pulmonary edema, HA, swelling of legs, nausea and vomiting, Weight loss, itching, cognitive impairment, tendency to bleed, |
|
|
Term
| What kidney dx s/sx are related to fluid balance problems? |
|
Definition
| HTN, swelling of legs, pulmonary edema |
|
|
Term
| What kidney dx s/sx are due to increased levels of urea, ions, and other waste products? |
|
Definition
| Fatigue, HA, weight loss, nausea and vomiting, cognitive fxn loss |
|
|
Term
| What causes itching in kidney dx? |
|
Definition
| phosphorus levels increase |
|
|
Term
| What are the s/sx of chronic kidney dx (CKD)? |
|
Definition
|
|
Term
| What products are increased in the system with decreased kidney fxn? |
|
Definition
| hormones and nitrogenous wastes |
|
|
Term
| What products are decreased in the system with kidney fxn loss? |
|
Definition
|
|
Term
|
Definition
| if the pt has s/sx of uremia |
|
|
Term
| Which organs are affected by CKD? |
|
Definition
|
|
Term
| What does CKD do to the skin? |
|
Definition
| increased pigmentation due to hormonal changes, and pruritis |
|
|
Term
| What does renal osteodystrophy cause systemically? |
|
Definition
| hyperparathyroidism --> calcitrol, osteosclerosis, osteomalacia, muscle weakness |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Ca Sulfate and phosphate precipitate in the sweat, ODIFEROUS, smells like a porta potty, yellow discoloration of skin |
|
|
Term
|
Definition
|
|
Term
| Who is most prone to kidney dx? |
|
Definition
|
|
Term
| What is the threshold for ESRD? |
|
Definition
|
|
Term
| What is the main cause of death with impaired kidney fxn? |
|
Definition
| cardiovascular death, stroke |
|
|
Term
| How many people are affected by ESRD per yr in the US? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| what are some causes of ARF? |
|
Definition
| hemorrhaging, shock, infections, autoimmune dx, meds |
|
|
Term
|
Definition
| loss of regulatory, excretatory, and endocrine fxn of kidney |
|
|
Term
| What % of pt's will fully recover from ARF if properly treated? |
|
Definition
|
|
Term
| What can pregnancy sometimes cause in the kidney? |
|
Definition
|
|
Term
| What is the most common cause of ARF? |
|
Definition
|
|
Term
| What is the onset of declined GFR in ATN? |
|
Definition
|
|
Term
|
Definition
| acute ischemic or nephrotoxic insult |
|
|
Term
| What tissue is destroyed in ATN? |
|
Definition
| tubular epithelial cells --> decreased ion transport |
|
|
Term
| Where do the destroyed epithelial cells go in ATN? |
|
Definition
| clog the tubules causing damaged vasculature from increased pressure |
|
|
Term
| What is the result of damaged vasculature in the kidney? |
|
Definition
| vasoconstriction, reduced urine volume, increased waste products in the blood |
|
|
Term
| What happens to endothelin, nitric oxide and PG levels in ATN? |
|
Definition
| increased endothelin, decreased PG and nitric oxide --> vasoconstriction |
|
|
Term
| What feedback loop causes reduced urine in ATN? |
|
Definition
| renin production increases --> less urine |
|
|
Term
| What is malignant hypertension? |
|
Definition
| uncommon form of HTN, medical emergency |
|
|
Term
| What is the tx of malignant hypertension? |
|
Definition
| immediate and aggressive anti-HTN therapy |
|
|
Term
| What are the s/sx of malignant hypertension? |
|
Definition
| BP > 120 mmHg, ONH edema, scotoma, encephalopathy, renal failure, CV (cardiovascular) abnormalities |
|
|
Term
| What is the pathophysiology of malignant hypertension? |
|
Definition
| vascular damage to kidney --> increased permeability of small vessels --> fibrosis of vessels --> narrowing of vessel lumun --> ischemia of kidney --> renin release --> even further vasoconstriction |
|
|
Term
| What are specific mechanism for meds to cause ARF? |
|
Definition
| Type 1 and Type IV hypersensitivity (hapten), med causes toxicity |
|
|
Term
| What can cause ARF through medication toxicity? |
|
Definition
| aminoglycosides cause 10% of pt's to have nephrotoxicity |
|
|
Term
| What is the timing of ARF onset after aminoglycoside regimens are started? |
|
Definition
|
|
Term
| What is the prognosis for ARF due to aminoglycoside nephrotoxicity? |
|
Definition
| very good change for recovery |
|
|
Term
| What cause of ARF is NOT dose related? |
|
Definition
| Type 1 and Type IV hypersensitivity |
|
|
Term
| What cause of ARF IS dose related? |
|
Definition
|
|
Term
| What can NSAID's cause in the kidney? |
|
Definition
| decreased PG --> vasoconstriction --> ARF |
|
|
Term
| What can radiographic contrast agents cause in the kidney? |
|
Definition
| ARF in up to 76% of pt's who take it |
|
|
Term
| What are risks for taking radiographic contrast agents? |
|
Definition
| pt's with pre-existing renal insufficiency |
|
|
Term
| What is a common precaution taken when using radiographic contrast agents? |
|
Definition
| IV to prevent dehydration |
|
|
Term
| Can radiographic contrast agents cause hypersensitivity rxns? |
|
Definition
|
|
Term
| What dz's are related to glomelular dysfunction? |
|
Definition
| nephrotic syndrome, nephritic syndrome, membranoprolifereative glomerulonephritis |
|
|
Term
| What are s/sx of nephrotic syndrome? |
|
Definition
| massive proteinuria, edema (eyelids first), hypoalbuminemia, hyperlipiduria and hyperlipidemia |
|
|
Term
| What is nepthrotic syndrome? |
|
Definition
| derangement of glomelular capillary walls |
|
|
Term
| What causes the body to produce increased plasma proteins and lipoproteins? |
|
Definition
| hypoalbuminuria due to nephrotic syndrome |
|
|
Term
|
Definition
| If skin is depressed manually, it will remain depressed after removing the source of pressure. |
|
|
Term
| What dx presents deranged capillaries? |
|
Definition
|
|
Term
| Where does the edema start in nephrotic syndrome? |
|
Definition
|
|
Term
| What causes bubbly urine? |
|
Definition
| nephrotic syndrome due to massive proteinuria |
|
|
Term
| What does hypoalbuminemia cause? |
|
Definition
| lipoprotiein and plasma protein synthesis |
|
|
Term
| What causes in increased risk of thromboembolism? |
|
Definition
| hyperlipidemia and hyperlipiduria |
|
|
Term
| What causes nephrotic syndrome? |
|
Definition
| immune mediation, diabetes, NSAID, SLE, membranoproliferative glomerulonephritis, idiopathi c |
|
|
Term
| What tx of nephrotic syndrome is 90% effective? |
|
Definition
|
|
Term
| What is the rate of recurrence for nephrotic syndrome? |
|
Definition
|
|
Term
| What is used for the first six months of nephrotic syndrome tx? |
|
Definition
| thrombo-prophylaxis (warfarin, etc) |
|
|
Term
|
Definition
| decrease glomelular filtration rate, improve charge and size selections. Tx for nephrotic syndrome |
|
|
Term
| What is steroid dependence? |
|
Definition
| Where reduction of corticosteroids causes the dx to relapse, pt becomes dependent on meds |
|
|
Term
| What dx often displays steroid dependence/recurrence during tx? |
|
Definition
|
|
Term
| What is acute glomerulonephritis also called? |
|
Definition
|
|
Term
| What presents abrupt hematuria with lesser amt's of proteinuria and impaired renal function? |
|
Definition
|
|
Term
| Why can blood leak through the glomerulus in acute nephritic syndrome? |
|
Definition
| the blood often cremates into smaller pieces |
|
|
Term
|
Definition
| Decrease in urine production |
|
|
Term
| What causes HTN in acute nephritic syndrome? |
|
Definition
|
|
Term
| In acute nephritic syndrome, where is edema first seen? |
|
Definition
|
|
Term
| What presents worse edema: acute nephritic syndrome or nephrotic syndrome? |
|
Definition
|
|
Term
| What is a common precursor to acute nephritic syndrome? |
|
Definition
| streptococcal infection in previous 10-14 days; Ag-Ab rxn |
|
|
Term
| When is acute nephritic syndrome typically seen? |
|
Definition
| in children, more common in summer and autumn, more common in south |
|
|
Term
| What is a precursor for 5% of acute nephritic syndrome cases? |
|
Definition
|
|
Term
| What dx develops nephritic syndrome up to 50% of the time? |
|
Definition
| post streptococcal pyoderma |
|
|
Term
| If there is no prior strep infection seen with acute nephritic syndrome, what should be considered? |
|
Definition
|
|
Term
| Can acute nephritic syndrome be idiopathic? |
|
Definition
|
|
Term
| Howis acute nephritic syndrome treated? |
|
Definition
| salt restriction, diuretics/anti-hypertensives |
|
|
Term
| What % of acuate nephritic syndrome completely recovers? |
|
Definition
|
|
Term
| How long can acute nephritic syndrome take to clear up? |
|
Definition
|
|
Term
| Does acute nephritic syndrome often progress to chronic renal failure? |
|
Definition
|
|
Term
| What is dense deposit dx also called? |
|
Definition
| membranoproliferative glomerulonephritis |
|
|
Term
| What causes Type I, II, and III hypersensitivity attack of glomerular and mesangium tissues? |
|
Definition
|
|
Term
| What type of dense deposit dx presents with bilateral central drusen? |
|
Definition
|
|
Term
| When is drusen seen in teenagers? |
|
Definition
|
|
Term
|
Definition
| tubulointerstitial nephropathy |
|
|
Term
|
Definition
| glomeruli and renal vessels |
|
|
Term
|
Definition
| bacterial infection of the renal pelvis |
|
|
Term
| What is pyelonephritis often seen? |
|
Definition
|
|
Term
| Is TIN acute or chronice? |
|
Definition
|
|
Term
| What is TIN called if no bacteria are involved? |
|
Definition
| interstitial nephritis, caused by drugs and metabolic disorders, physical injury |
|
|
Term
| What is a common first sign of TIN? |
|
Definition
|
|
Term
| What age does TIN present typically? |
|
Definition
|
|
Term
| What gender is affected more by TIN? |
|
Definition
|
|
Term
| What % of TIN presents with uveitis (TINU)? |
|
Definition
|
|
Term
| What dx presents fever, weight loss and fatigue in 50% of cases? |
|
Definition
|
|
Term
| What % of TINU is recurrent? |
|
Definition
|
|
Term
| What % of TINU presents with ocular symptoms first? |
|
Definition
|
|
Term
| When is iridocyclitis seen? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| inflamed kidney and renal pelvis |
|
|
Term
|
Definition
| bacteria in through urethra --> bladder --> ureters --> kidney |
|
|
Term
|
Definition
| Women due to shape and length of urethra, PREGNANCY |
|
|
Term
| What is usually very responsive to antibiotics? |
|
Definition
|
|
Term
|
Definition
| fever, dysuria, flank/back pain, pyuria |
|
|
Term
| What is chronic pyelonephritis? |
|
Definition
| slowly progressing/insidious dx of kidney |
|
|
Term
| What are the s/sx of chronic pyelonephritis? |
|
Definition
| fatigue, don't feel well; generally vague sx |
|
|
Term
| When is pus seen in urine? |
|
Definition
|
|
Term
| What can lead to renal dialysis? |
|
Definition
|
|
Term
| What presents frequent UTI, vesicoureteric reflux or diabetic nephropathy? |
|
Definition
|
|
Term
| What is the single most important cause of ESRD? |
|
Definition
|
|
Term
| What do ACE inhibitors and angiotensin II treatments protect against? |
|
Definition
|
|
Term
| Where is microalbinurai and proteinuria seen? |
|
Definition
|
|
Term
| Does diabetic nephropathy usually progress? |
|
Definition
| Yes, end stage renal dx 1-5 years after onset generally |
|
|
Term
| What presents nephrotic syndrome and azotemia? |
|
Definition
| diabetic nephropathy 3-5 years after proteinura |
|
|
Term
| What is the classification of diabetic nephropathy? |
|
Definition
|
|
Term
| What can cause capillary basement membrane thickening? |
|
Definition
|
|
Term
|
Definition
| glycosphingolipid metabolism |
|
|
Term
| What enzyme defect causes Fabry dx? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What genetic dx presents symptoms in carriers? |
|
Definition
|
|
Term
| What is the occurrence of Fabry dx? |
|
Definition
|
|
Term
| Is Fabry dx hard to diagnose? |
|
Definition
| Yes, due to s/sx variability |
|
|
Term
| What presents in children with a burning sensation in the hands? |
|
Definition
|
|
Term
| What presents with raised rash on buttocks, groin, thighs? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| where is decreased sweating seen? |
|
Definition
|
|
Term
| What is the most common ocular sign seen in 90% of Fabry dx? |
|
Definition
| corneal whorl or verticillata |
|
|
Term
| What is the best way to see corneal whorl? |
|
Definition
| transillumination in biomicroscopy |
|
|
Term
| What dx causes build up of lipids in tissues? |
|
Definition
|
|
Term
| What causes increased conj vessel tortuosity? |
|
Definition
|
|
Term
| What kind of cataract is caused by Fabrys? |
|
Definition
| spoke like(stellate), anterior subcapsular, follows suture lines, white in appearance |
|
|
Term
| What are the systemic kidney complications from Fabry? |
|
Definition
| renal failure --> proteinuria, azotemia, uremia |
|
|
Term
| What age does 50% of fabry pts present renal failure? |
|
Definition
|
|
Term
| Renal failure, GI dysfunction, cardiovascular and cerebrovascular problems are seen systemically in what dx? |
|
Definition
|
|
Term
|
Definition
| enzyme assay, genetic testing |
|
|
Term
|
Definition
| enzyme replacement, agalsidase beta via IV |
|
|
Term
|
Definition
| Formation of a stone in the collecting system of the kidney |
|
|
Term
| Where are kidney stones usually seen? |
|
Definition
|
|
Term
|
Definition
| Another term for kidney stone |
|
|
Term
| What % of autopsies show a kidney stone? |
|
Definition
|
|
Term
| What are polygenic kidney stones? |
|
Definition
| Stones due to dehydration, medication, gout |
|
|
Term
| What is the composition of a kidney calculus? |
|
Definition
| calcium 75%; Mg 15%; uric acid or cystine 10% |
|
|
Term
| What common ocular drug can cause kidney stones? |
|
Definition
|
|
Term
| What % of people will have a kidney stone at some point in their life? |
|
Definition
|
|
Term
| What is the peak incidence of kidney stones? |
|
Definition
|
|
Term
| What are men more prone to than women? |
|
Definition
| kidney stones, 5-10x greater |
|
|
Term
| What can cause hematuria? |
|
Definition
|
|
Term
| What does kidney stone impingement of ureter cause? |
|
Definition
| severe, suddent pain onset |
|
|
Term
| What is the best way to diagnose a kidney stone? |
|
Definition
|
|
Term
| What % of stones pass sponataneously? |
|
Definition
|
|
Term
| What is the most important tx for kidney stones |
|
Definition
|
|
Term
| What do alpha adrenergic blocks and calcium channel blockers cause for kidney stone pt's? |
|
Definition
|
|
Term
| What are common ways to prevent kidney stones? |
|
Definition
| don't drink too much milk, diet, hydration |
|
|
Term
| What is shockwave lithotripsy? |
|
Definition
| Uses radio waves to break up a kidney stone into small, passable pieces |
|
|
Term
| What is renal cell carcinoma? |
|
Definition
| 80-90% of all malignant kidney tumors |
|
|
Term
| What can cause renal atherosclerosis? |
|
Definition
|
|
Term
| What dx affects both afferent and efferent arterioles of the kidney? |
|
Definition
|
|
Term
|
Definition
| increased susceptibility to renal infection leads to infection of the renal pelvis |
|
|
Term
| What can cause pyelonephritis? |
|
Definition
|
|
