Term
| What part of the kidney contains all the glomeruli and 85% of the nephron tubules? |
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Definition
| Cortex (the outer rim of the kidney) |
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|
Term
| At what percentage of nephron damage does serious renal impairment occur? |
|
Definition
|
|
Term
| What part of the kidney is the 'functional unit' of the kidney? |
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Definition
|
|
Term
| What is the rate of glomerular filtration? |
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Definition
|
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Term
| What part of the glomerulus is selectively permeable and prevents plasma proteins, RBCs, WBCs and platelets from going through? |
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Definition
|
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Term
| What are the actions of the Proximal Convoluted Tubule dependent on? |
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Definition
|
|
Term
| What part of the PCT reabsorbs Cl? |
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Definition
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Term
| What part of the loop of henle is permeable to water? |
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Definition
|
|
Term
| Which cells in the collecting duct respond to ADH? |
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Definition
|
|
Term
| Which cells in the Collecting duct regulate acid secretion? |
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Definition
|
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Term
| In the DCT which hormones control the reabsorption of sodium and water? |
|
Definition
| Aldosterone and angiotensin |
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|
Term
| In the DCT which hormones inhibit reabsorption? |
|
Definition
| Atrial Natriuretic Peptide and urodilatin |
|
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Term
| Which chromosome is affected with Autosomal Recessive Polycystic Kidney Disease in young children? When does this defect appear? What is the prognosis? |
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Definition
Defect on Chromosome 6
Appears in utero
High fatality rate |
|
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Term
| Which type of polycystic kidney disease is diagnosed in adulthood? |
|
Definition
| Autosomal Dominant Polycystic Kidney Disease (ADPKD) |
|
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Term
| Which nerves will be affected with ADPKD (Autosomal Dominant Polycystic Kidney Disease)? |
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Definition
|
|
Term
| Which chromosome is affected with Autosomal Dominant Polycystic Kidney Disease in adults? |
|
Definition
95% of the cases affect chromosome 16
5% affect a gene on chromosome 4 |
|
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Term
| Which disease causes multiple dilation of collecting ducts that appear like fluid filled cysts? |
|
Definition
| Polycystic Kidney Disease |
|
|
Term
| How does polycystic kidney disease affect the kidneys? |
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Definition
| PKD always activates the RAAS system which causes an increase in BP |
|
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Term
| If the patient presents with HTN, a history of UTIs, back & flank pain, Hematuria, and scans showing bilaterally enlarged kidneys on scans, what condition do you suspect? |
|
Definition
| Polycystic Kidney Disease |
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Term
| What are the infectious triggers of acute glomerulonephritis? (2) |
|
Definition
Poststreptococcal
Non-strep/Post-infection |
|
|
Term
| What are the bacterial triggers of acute glomerulonephritis? (4) |
|
Definition
Infective Endocarditis
Meningococcemia
Pneumococcal Pneumonia
Sepsis |
|
|
Term
| What are the viral triggers of acute glomerulonephritis? (3) |
|
Definition
Hep B or C
Mononucleosis
Varicella |
|
|
Term
| What are the signs of abrupt onset acute glomerulonephritis? (esp urinalysis finding) |
|
Definition
Hematuria
Proteinuria
Azotemia (NO3 waste)
Renal sodium and water retention |
|
|
Term
| What is a key finding in the Bowman's space with Acute Glomerulonephritis? |
|
Definition
| damaged by fibrin deposition and crescent formation and a decrease in GFR |
|
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Term
| If a patient presents with abrupt onset "coffee or smoky" urine, RBC and WBC casts in the urine, proteinuria, ascites, periorbital edema and lower extremity edema and a hx of streptococcal infection, what condition does this patient have? |
|
Definition
|
|
Term
| How is acute glomerulonephritis definitively diagnosed? |
|
Definition
|
|
Term
| Which renal condition is caused by activated inflammatory cells which create antibody-antigen complexes, deposition of complement and neutrophil & monocyte attraction causing lysosomal enzyme damage creating a more permeable membrane? |
|
Definition
|
|
Term
| If a patient presents with viral sx, nausea, vomiting, HTN, edema, hematuria, proteinuria, and rising creatinine levels what condition do you suspect? |
|
Definition
| Rapidly Progressing Glomerulonephritis |
|
|
Term
| How is Rapidly Progressing Glomerulonephritis treated? |
|
Definition
50% of pts require immediate dialysis, and 50% will need dialysis within the next weeks to months
sodium and fluid restriction
diuretics
methylprednisone- helps 75% of patients |
|
|
Term
| Which disorder is characterized by slowly progressing deterioration in renal function characterized by persistent hematuria & proteinuria? |
|
Definition
| Chronic Glomerulonephritis |
|
|
Term
| Which condition is characterized by contracted, scarred kidneys, tubular atrophy and dilation and formation of antigen-antibody complexes? |
|
Definition
| Chronic Glomerulonephritis |
|
|
Term
| If a patient presents with edema, HTN, decreased renal function, scarring of the kidneys, hematuria, and proteinuria? |
|
Definition
| Chronic Glomerulonephritis |
|
|
Term
| What is the most likely cause of Chronic Glomerulonephritis? |
|
Definition
|
|
Term
| What is the treatment for chronic glomerulonephritis? |
|
Definition
long term dialysis
renal transplantation |
|
|
Term
| With signs and symptoms including edema, altered immunity, hypercoagubility, hyperlipidemia, hypoalbuminemia and lipiuria, what condition would you suspect? |
|
Definition
|
|
Term
| What diseases are related to the formation of Nephrotic Syndrome? How do they cause nephrotic syndrome? |
|
Definition
Diabetic Nephropathy
Amyloidosis
They increase the permeability of the glomerular wall |
|
|
Term
| Why does hyperlipidemia occur with nephrotic syndrome? |
|
Definition
| The decrease in plasma albumin levels causes the liver to increase the synthesis of cholesterol, TGs and lipoprotein. |
|
|
Term
| What is the hypercoagublity associated with Nephrotic syndrome caused by? |
|
Definition
Due to altered levels of clotting factors
Increased aggregation of platelets
Antithrombin III is secreted in the urine
Hyperfibrinogenemia
Impaired Fibrinolysis |
|
|
Term
| What can the loss of cholecalciferol in Nephrotic syndrome lead to? |
|
Definition
vitamin D Deficiency
Secondary Hyperparathyroidism
hypocalcemia |
|
|
Term
| Which condition is characterized by sudden severe renal function with a decrease in GFR and a marked decrease in renal output over hours or days with azotemia? What is oliguric classified as, what is non-oliguric classified as? |
|
Definition
Acute Renal Failure
Oliguric - < 500ml/day
Non-Oliguric > 7800ml/day |
|
|
Term
| What are the chronic factors that increase your risk for Acute Glomerulonephritis? |
|
Definition
Pre-existing renal impairment
Atherosclerosis
HTN
Diabetes Mellitus
Heart Failure
Chronic Liver impairment/failure
Advanced age |
|
|
Term
| What are some of the conditions that cause PRERENAL acute renal failure? |
|
Definition
Hypovolemia
Hemorrhage
Shock
Ascites (Third Spacing)
Burns
Dehydration
Decreased Cardiac Output
Cardiogenic Shock
Dysrhythmias
Cardiac Tamponade
CHF
MI
Thromboembolus of Renal Vasculature |
|
|
Term
| What are some of the conditions that cause POSTRENAL acute renal failure? |
|
Definition
BPH
Calculi
UTI
Tumors
Strictures
Neurogenic Bladder |
|
|
Term
| What are some of the conditions that cause INTRARENAL acute renal failure? |
|
Definition
Antibiotics
Contrast Media
Heavy Metals (lead)
Cytotoxic Drugs
Ischemic ATN (Acute Tubular Necrosis)
Prolonged Prerenal ARF
Transfusion Rxn
Rhabdomyolysis
Nephrotoxic ATN (Acute Tubular Necrosis)
Prolonged Postrenal ARF
Carbon tetrachloride
HUS - Hemolytic Urinic Syndrome |
|
|
Term
| Which type of ARF is caused by decreased perfusion to the kidneys, results in reversible oliguria, increased production of renin, angiotensin II and aldosterone leading to increased fluid retention? |
|
Definition
|
|
Term
| Which type of ARF has oliguria, anuria, produces an increase in retrograde pressure within the kidney, bowman's capsule & glomerulus that can be reversed if obstruction is removed? |
|
Definition
|
|
Term
| What type of ARF causes more derangement in the kidneys caused more commonly by Acute Tubular Necrosis (ATN), nephron damage that can take weeks to months to recover (may also progress into CRF)? |
|
Definition
|
|
Term
| What are the stages of ARF? |
|
Definition
Oliguric Phase
Diuretic Phase
Convalescent Phase |
|
|
Term
| How long does the Oliguric Phase of ARF last? What is the amount of urine output? What does this stage signify? |
|
Definition
Lasts 1 - 2 wks
Urine Output < 500 ml (Anuria occasionally results in < 50mL/24hr)
Signifies extensive, severe tubular damage |
|
|
Term
| How long does the Diuretic Phase of ARF last? What is the amount of urine produced? What does this stage signify? |
|
Definition
Last 2 days - 2 weeks
Large amounts of dilute urine are produced
Signifies restored tubular patency |
|
|
Term
| How long does the convalescent stage of ARF last? What does it signify? |
|
Definition
Lasts 8 days to 1 yr
Signifies full or partial recovery |
|
|
Term
| What are some lab findings that would signify ARF? |
|
Definition
Urine (Casts, WBCs, Proteinuria, decreased osmolality)
Increased serum electrolytes, PO4, decreased serum calcium, increased BUN/Cr
Hyperkalemia
Decreased Erythropoietin Production |
|
|
Term
| What condition is defined as GFR < 60mL/min for 3 months or more? |
|
Definition
|
|
Term
| What is the treatment for ESRD (End Stage Renal Disease)? |
|
Definition
|
|
Term
| What determines the amount of impaired renal function in chronic renal failure? |
|
Definition
| Degree of interstitial fibrosis determines the amount of impaired renal function |
|
|
Term
| What are the stages of CRF? |
|
Definition
Decreased renal reserve
Renal Insufficiency
ESRD (End Stage Renal Disease) |
|
|
Term
| What stage of CRF has <75% nephron loss, normal BUN/Cr and is asymptomatic? |
|
Definition
|
|
Term
| What stage of CRF has 75 - 90% nephron loss, polyuria, nocturia, and mild elevation in BUN/Cr? |
|
Definition
|
|
Term
| Which stage of CRF has >90% nephron loss, azotemia, uremia, fluid and lyte abnormalities, as well as renal osteodystrophy? |
|
Definition
|
|
Term
| In terms of GFR, what does a doubling of serum creatinine imply? |
|
Definition
|
|
Term
| What state are pts who have CRF always in? |
|
Definition
|
|
Term
| What is a danger of CRF particularly in DM pts? |
|
Definition
| Increased glucose level from carbohydrate intolerance |
|
|
Term
| What 2 bone conditions are caused by chronic renal failure? What is it caused by? What are the signs and symptoms of this bone condition? |
|
Definition
Osteodystrophies include Osteitis fibrosa and osteomalacia; Osteitis fibrosa - hypocalcemia and hyperparathyroid state/ Osteomalacia - from impaired ability to form new bone tissue
Bone Pain, Fractures, Vertebral Compression |
|
|
Term
| What are the 2 compartments in dialysis? By what process is dialysis accomplished by? |
|
Definition
Bloodstream
Dialysate Fluid
Accomplished by osmosis and difusion |
|
|
Term
| What is the semipermeable membrane in peritoneal dialysis? What is a major complication of peritoneal dialysis? |
|
Definition
The pts peritoneum
Peritonitis |
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