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Phys III-III
Mr. Good Case Study
21
Other
Not Applicable
04/08/2004

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Term
____ blocks synthesis of vasodialtor prostaglandins (PGE2, PGI2) which will block afferent constriction/dilatation and reduce/increase blood flow and GFR
Definition
Indomethacin; dilatation; reduce
Term
What can cause filtration to fall? (3)
Definition
low blood pressure; low blood volume; change in vascular resistance
Term
Some leakiness at filtration barrier leads to ...
Definition
mild proteinuria (2+)
Term
high plasma digoxin levels leads to ...
Definition
affected heart conduction, bradycardia, low cardiac output
Term
Does creatinine clearance = GFR?
Definition
No, but it's a good approximation
Term
Pre-renal failure: (prerenal azotemia or elevated BUN) is when normal __:__ (BUN:Cr) may be __:__ or higher b/c, in addition to the GFR effect on BUN, increased urea reabsorption (appropriate response to dehydration) elevates BUN even further.
Definition
10:1; 20:1
Term
Pre-renal failure: U osm > ___, U cr/P cr > __, U na < __, Na reabsorb % is < __.
Definition
500; 40; 20; 1.0
Term
Acute Tubular Necrosis (ATN): Trap urea well/ not well, conc/fail to conc urine, Fractional Excretion of Na reaches/does not reach low enough levels.
Definition
not well; fail to conc; does not reach low enough levels (>1%)
Term
Can prerenal failure cause ATN?
Definition
yes, renal ischemia --> tubular damage
Term
Identify 4 messengers working to replenish Mr. Goods's volume/pressure status...
Definition
renin, aldosterone, ADH, catecholamines
Term
Amount of K reabsorbed before the macula densa = __ %.
Definition
92%
Term
Normal urine conc = ___ mOsm/L is needed to properly conserve ___.
Definition
1200; water
Term
inability to concentrate urine is...
Definition
isosthenuria
Term
Which part of conc mechanism has failed for Mr. Good? ____ ; Which hormone regulates urine conc? ___
Definition
Na pumping in thick ascending loop of Henle is compromised; ADH
Term
low bicarb indicates low/high pH...
Definition
low (acidotic)
Term
To measure acid excretion...
Definition
titratable acid + ammonia - bicarb
Term
what will drive higher resp rate?
Definition
metabolic acidosis
Term
___% of cardiac ouput flows to kidneys
Definition
20-25
Term
___% of renal blood lfow perfuses to the cortex.
Definition
85-90
Term
___% of filtered inulin that is excreted in urine.
Definition
100
Term
___% of PAH cleared from renal plasma in single passage through kidneys.
Definition
85-90
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