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