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25 Cards in this Set
- Front
- Back
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brush border cells |
hair like structures that increase surface area in proximal convoluted area help to reabsorb sodium, maintain pH, exchange bicarbonate excretes organic acids |
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loop of henle |
create concentration gradient so water leaves loop as it descends and sodium stays in in ascending loop it is impermeable to water so reabsorbs ions but not water- uromodulin produced which bind to ecoli to protect against renal calculi- reabosrbs ions |
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distal convoluted tubule |
regulates water and potassium and sodium and calcium Aldosterone, PTH, ADH |
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glomerulus |
afferent enters stuff is filtered out to bowman's capsule or stays in blood filtrate is water, sodium, chloride, potassium, bicaronate, glucose, creatinine, and urea |
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urine |
contains mostly waste products mostly water, sodium, potassium chloride, creatinine, urea, should not containe glucose, proteins, blood, bacteria could indicate disease |
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urinalysis |
study of urine sample for major constituents should be clear to yellow can see reddish brown because of hemoglobin or drugs (antibiotics), or beets, porphyria can lead to this white/ greenish- pyuria (puss), probifal medication purple- purple urine syndrome from bacteria that create chemical that converts sulfate into indigo leukocyte esterase- presence of white blood cells from lysis of wbc and macrophages. suggests infection nitrite- produced from bacteria, from conversion of nitrate to nitrite for energy protein- could indicate injury to glomerulus, preeclampsia, hypertension, pH- wide range is normal, low pH for metabolic acidosis, glucose- plasma glucose above 180 ml/dl (glycosuria) white blood cells- infection rbc- kidney stones, trauma, glomerular disease bacteria- infection crystals- uric acid crystals, gout, toxic ingestion of ethylene glycol (antifreeze), floresine chemicals- ethylene glycol (antifreeze), |
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ADH |
responsible for controlling final concentration, from posterior pituitary, increases water reabsorption |
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Aldosterone |
synthesized by adrenal cortex, stimulates distal convoluted tubule to reabsorb sodium and therefore water |
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atrial natriuretic peptide |
secreted from right atrium in response to increased pressure inhibit renin to increase excretion of water increases pressure in glomerular capillaries stimulates distal convoluted tubule to decrease sodium reabsorption increases aldosterone production |
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urodilatin |
from distal convoluted tubules in response to increase mean arterial pressure |
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vitamin D |
can be ingsted from tuna, eggs, samon, cheese, mushroom calcium regulation bone and muscle strenght muscle reactivity deficiency: osteomalacia, osteoporosis |
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erythropoietin |
glycoprotein controls formation of rbc produced from fibroblast in kidneys hypoxia stimulates this |
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types of UTI |
lower UTI- cystitis (acute) bladder infection acute hemorrhagic cystitis acute pyelonephritis- kidney infection urosepsis- systemic response to UTI |
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acute cystitis |
bladder infection inflammation of bladder fecal colonization of urethra ecoli- 80-85% staphrophidicus- 10-20% fungal infections- candida albicans viral is pretty uncommon uropathogenic ecoli- specialized to infect urinary tract, invade umbrella cells- multinulceated and line the bladder, adhesive organelles attach to umbrella cells through fimbriae that adhere to the cells, have adhesins attached to fimbriae. Once in form IBC (intracellular bacterial communities) and cover with biofilm that protects them. once it reaches capacity, goes out to infect other tissue toll like receptors and cd 14 bind to bacteria which leads to burst of cytokines which cause inflammation and signal for neutrophils to come to help kill bacteria. ROS are produced leading to exfoliation of bladder epithelium which can lead to blood in urine during infection |
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schistosomiasis |
parrasite that can cause bladder infection from bathing in water with the parasites |
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acute cystitis symptoms |
sometimes asymptomatic, urinary frequency, urgency, dysuria, suprapubic pain, hematuria diagnosed through history, or urinary sample. |
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pyelonephritis |
can be caused from kidney stone reflux from bladder goest to kidneys common during pregnancy CVA tenderness, percus over angle and if pain is produced it can mean it |
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pyelonephritis treatment |
need antibiotics through IV, pain medicine, percutaneous nephrostomy to remove stone |
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renal calculi |
kidney stones, accumulation of stones made of crystals, proteins or other materials, located in kidney, ureter, nephrolithiasis in bladder it is asymptomatic until in urethra floride in water may lead to it stones are formed from super saturation when there is more solute than can be held in the solution. more of a given solute becomes super saturation leading to crystals |
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chelaters |
decrease rate of kidney stone formation peptides that can surround and inactivate cations making it hard to get into stone citrate is natural chelater |
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types of stones |
calcium oxylate- supersaturation of urine with calcium from high levels of intake and low levels of secretion struvite- ammonium magnesium phosphate, chemical caused by bacteria, use urease to split urea which alkalynizes urine forming struvite, stag horn calculi uric acid crystals- purine- gout, meat, cheeses, alcohol, alkaline urine |
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signs and symptoms of kidney stones |
flank pain, groin pain, waxing/ waning pain, urgency, frequency, dysuria, hematuria, nausea |
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glomerulonephritis |
inflammation of glomerulus primary- ischemia, ROS, toxins, vasculitis, infection secondary- systemic, diabetes mellitus, lupus, HIV, types: focal segmental glomerulosclerosis- genetic (6 genes- actin binding, cytoskeletal structure, APOL1- defense against african sleeping sickness), patchy sclerosis of glomerulus, hardening s/s peripheral edema, hypertension, hyperlipidemia, protein urea. Kidney biopsy done for diagnosis lasiks, Ace inhibitors, steroids membranous glomerulonephritis- result of thickened basement membrane of glomerulus secondary to IGG. idiopathic, can be lupus, malaria, hep B, medications (ace inhibitor), mercury poisoning, tumors. Trigger complement 5b and c9 to form attack complex which targets glomerular cells. s/s: edema, proteinuria, hypertension, renal failure immunosuppression post-infectious glomerulonephritis, after strep pyogenes infection, 10-14 days later. pharyngitis. type 3 hypersensitivity reaction producing antigen antibody complexes. Complement activated to destroy basement membrane s/s the same self resolving. supportive treatment |
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acute kidney disease |
accumulation of waste products, blood urea nitrogen and creatinine. pre renal azotemia- decrease in volume loss, vomitting, heat loss, sweating, marathon, hemmorhage treatment: fluid replacement acute tubular necrosis- injury to tubular system, IV contrast for CT scan, ischemia, antibiotics, myoglobin (muscle protein) can clog tubes, chronic hypertension, inflammation of blood vessels elevation of BUN and creatinine, eosinophils in urine obstructive- post renal acute renal injury, from stone or tumor |
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chronic kidney disease |
progressive loss of renal function Glomerular filtration rate of less than 60 mL per minute per 1.73 m squared for 3 months or more 5 stages- degree of dysfunction (don't need to memorize) compensate, inflammation and cellular death diabetes, hypertension, lupus, vasculitis s/s hyperkalemia, proteinuria, hypertension, edema, heart failure, anemia, treatment: sodium and fluid restrictions, maintenance of potassium (low potassium), vitamin D supplementation, epogen (restores erythropoesis), ace inhibitors, dialysis |
