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128 Cards in this Set

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What is the primary function of the kidney?
to maintain a stable environment for optimal cell and tissue metabolism
What does the secretion of renin regulate?
blood pressure
What does the secretion of erythropoietin regulate?
erythrocyte production
What are the 4 main anatomical structures of the renal system?
kidneys, ureters, bladder, urethra
What is the function of the renal capsule?
protection of the kidneys
What is located in the renal cortex?
glomeruli and some tubules
What is located in the renal medulla?
PCT, DCT
What is the functional unit of the kidney?
nephron
What is the pathway of urine flow beginning with the formation in the nephron?
nephron, distal tubules, collecting ducts, renal pelvis, ureters, bladder, urethra
How is urine flow controled?
peristalsis
What is the reflex that communicates the sensation that the bladder is full?
micturition
What structure of the renal system will readily bleed with trauma, surgery or inflammation?
bladder
What type of muscles control excretion of urine through the urethra?
sphincters
What is the length of the female urethra?
3-4 cm
What is the length of the male urethra?
18-20 cm
How much urine must be present in the bladder to feel the micturition reflex?
250-300 mL
GFR (glomerular filtration rate) is directly related to what?
RBF (renal blood flow)
When systemic arterial pressure decreases, what happenes to RBF and GFR?
they are both decreased due to vasoconstriction
Decreased RBF and GFR diminishes excretion of what?
sodium and water
Exercise, body potassium, and hypoxia influence _____.
RBF
What percentage of cardiac output goes to kidney?
20-25%
What percentage of fluid must be lost for the renin-angiotension system to begin?
7%
Angiotension increases the release of ADH secretion by what gland?
posterior pituitary
Angiotension II causes the adrenal gland to release what?
aldosterone
What two transport mechanisms regulate filtrate?
tubular reabsorption, tubular secretion
What mechanism pulls fluid out of filtrate and puts it back into the bloodstream?
tubular reabsorption
What mechanism moves fluid into lumen for excretion?
tubular secretion
True or False: ADH is required in the PCT.
false
What is required in the DCT for fluid reabsorption?
ADH
What hormone controls the FINAL concentration of urine?
ADH
What structure determines the concentration of urine?
Loop of Henle
What vitamin is obtained by diet or sunlight and is converted to an active form in the kidney?
Vitamin D
What stimulates the bone marrow to produce RBCs?
erythropoietin
What are normal BUN ranges?
10-20
What are normal creatinine levels?
0.7-1.2
What happens to BUN and creatinine levels when GFR is decreased?
they are increased
What renal test is increased (falsely) with dehydration?
BUN
What are normal urine pH levels?
5 - 6.5
What are normal specific gravity levels of urine?
1.016 - 1.022
What is the estimate of solute in the urine?
urine specific gravity
What renal effects decrease with aging?
RBF, GFR, nephron function
Urinary Tract Obstructions are also called ______.
obstructive uropathies
What is an interference with the flow of urine at any site along the urinary tract?
urinary tract obstruction
What are some causes of urinary tract obstructions?
tumors, stones, trauma, edema, pregnancy, BPH (benign prostatic hypertropy), carcinoma, inflammation of GI tract, loss of ureteral peristaltic activity, loss of bladder muscle function
What increases hydrostatic pressure and dilation of structures behind the site of occlusion?
obstruction of urine flow
Complete obstruction of the urinary tract leads to what?
renal failure
______ obstruction reduces RBF and GFR and is reflected by an increased plasma creatinine level.
Unilateral
Accumulation of urine is excellent medium for what kind of growth?
bacterial growth
What are masses of crystals and protein that are a common cause of UTO in adults?
kidney stones
What kind of stone can a decreased pH level cause?
uric acid stones
Who is predisposed to uric acid stones?
alcoholics, red meat eaters and those with gout
What are the 3 major kinds of kidney stones?
calcium, struvite and uric acid stones
What percentage of kidney stones are calcium stones?
75-80%
What kind of diet is associated with uric acid stones?
high purine diet
What is the hallmark symptom of kidney stones?
pain
What procedure uses dye and x-ray to locate the stone?
IV Pyelogram
What type of stones are treated with diuretics and allopurinol?
calcium stones
What does a lithotripsy do?
breaks up the stones
A functional UTO that is caused by an interuption of the nerve supply to the bladder caused by motor neuron lesions.
neurogenic bladder
What does upper motor neuron damage (above the sacrum) do to volume control?
interupts volume control
What does lower motor neuron damage (below the sacrum) do to volume control?
causes a complete loss of volume control
A burning sensation, fever, chills and shivering are clinical manifestations of what?
neurogenic bladder
How is neurogenic bladder treated?
antibiotics
What are benign, small tumors that are solid and can be surgically removed if found?
renal adenomas
What are the most common renal tumors?
renal cell carcinoma
What is the five year survival rate of renal cell carcinoma?
less than 50%
What type of carcinomas are associated with tobacco use, obesity, and analgesic use?
renal cell carcinomas
Hematuria, flank pain, weight loss, fatigue, anemia, and hypertension are clinical manifestations of what?
renal tumors
What type of tumors are greatest in men who smoke or work in chemical, rubber, or textile industry?
bladder tumors
Bladder tumors are associated in mutations in what tumor-suppressor gene?
p53
What kind of tumors are often reoccuring? (Should be screened for every 3-5 years)
bladder tumors
Hematuria, frequent urination, and pelvic pain are manifestations of what?
bladder tumors
What is the visual exam of the urinary tract used to diagnose bladder tumors?
cystoscopy
What is the treatment for bladder tumors?
surgery, laser, chemo
What is the most common cause of a urinary tract infection?
bacteria
What is inflammation of the bladder?
cystitis
What are the most common infecting organisms of cystitis?
e.coli, staff, pseudomonas
Frequency, urgency, dysuria, suprapubic, low back pain, hematuria, cloudy urine, and flank pain are manifestations of what?
cystitis
How much bacteria must be present in urine for a diagnosis of cystitis?
10,000 bacteria/mL
What is the treatment for cystitis?
3, 5 or 10 day dose of antibiotics (culture specific)
What is the condition in which symptoms of cystitis are present, but urine cultures are negative?
nonbacterial cystitis
What structures are inflammed with nonbacterial cystitis?
microscopic glands in the urethra (urethral syndrome)
What age group is usually affected by urethral syndrome?
women ages 20-40 years old
What is the chronic inflmmatory process of the bladder wall?
interstitial cystitis
Infection of the renal pelvis.
pyelonephritis
What is usually the causative organism in pyelonephritis?
E.coli
Acute onset of fever, chills, flank pain, groin pain, frequency, nausea, vomiting and dysuria are manifestations of what condition?
acute pyelonephritis
In acute pyelonephritis, what characteristic do the bacteria contain in the urine culture?
antibody coated
What forms in the kidney when acute pyelonephritis is present?
WBC casts
What is the treatment for acute pyelonephritis?
antibiotics and follow up urine culture
What is persistent or recurring infection of the kidney with inflammation and scarring of the kidney?
chronic pyelonephritis
How does the kidney appear on an x-ray under chronic pyelonephritis conditions?
smaller than normal
Hyptertension, edema, and elevated BUN levels occur in an onset of what type of disorders?
glomerular disorders
How are glomerular disorders diagnosed?
renal tissue biopsy
What kind of urine sediment contains massive protein urea, lipidurea, and virtually no hemoturia?
nephrotic
What kind of urine sediment contains hemoturia with RBC casts, WBC casts, and insignificant protein urea?
nephritic
Inflammation of the glomerulus
glomerulonephritis
What is the most common cause of end stage renal failure?
glomerulonephritis
What condition is associated with group A post-streptococcal infections? (7-10 days after infection)
acute glomerulonephritis
Gross hemoturia is associated with what?
acute glomerulonephritis
______ syndrome is a type of rapidly progressive, acute glomerulonephritis.
Goodpasture
In goodpasture syndrome, what basal membranes are attacked?
lungs and kidney basal membranes
What age group is affected by goodpasture syndrome?
young men, ages 20-30 that smoke
How much protein is present in the urine with chronic glomerulonephritis?
3-5g per day
What is the major protein found in the urine in chronic glomerulonephritis?
albumin
What is the treatment for glomerulonephritis?
kidney transplant, dialysis, and treat signs and symptoms
What syndrome is associated with the excretion of 3.5g or more of protein in the urine, along with hypoalbuminemia, edema, hyperlipidemia, and lipiduria?
Nephrotic syndrome
What syndrome is associated with diabetes and lupus?
nephrotic syndrome
What is the treatment for nephrotic syndrome?
low fat diet, salt restriction, albumin supplements, diuretics, steroids
What classification of renal failure is considered a decline in renal function to 25% of normal (GFR 25-30)?
renal insufficiency
What is considered significant loss of renal function?
renal failure
How much of the kidney is functioning under ESRF?
less than 10%
High levels of urea found in the blood.
uremia
Increased urea levels, caused by renal failure.
azotemia (uremia)
Increased BUN and creatinine without signs and symptoms of kidney failure.
nonoliguric failure
Abrupt reduction in renal function causes urine output of less than ___ cc per hour or ___ cc per day.
30, 400
Renal function impaired in areas outside the kidney.
prerenal failure
Renal function impaired somewhere inside the kidney.
intrarenal failure
Renal function impaired after leaving the kidney (ureter, bladder).
postrenal failure
What is the progressive, irreversible loss of renal function that affects all body systems?
chronic renal failure
What abnormality in children causes the urinary meatus to be located on the underside of the penis?
hypospadias
Failure of the kidney to grow.
Renal agenesis
Kidney is absent.
renal aplasia
What is the most common urinary cancer in children?
Wilms tumor
Lack of iris in the eye, horse shoe shaped kidney, polycystic kidney disease are manifestations of what condition?
Wilms tumor
What is the cure rate for Wilms tumor?
90%
What condition accounts for the child never developing voluntary urine control?
primary enuresis
What condition accounts for the child developing voluntary urine control, then losing it later on?
secondary enuresis