N715 Exam 3 New Pt 3
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Questions and Answers

Which of the following conditions is primarily associated with post-renal dysfunction?

  • Decreased perfusion from heart failure
  • Acute tubular necrosis
  • Lupus nephritis
  • Obstruction in the urinary tract (correct)
  • What is the primary cause of post-renal kidney dysfunction?

  • Systemic vasodilation
  • Direct damage to renal tissues
  • Obstruction in the urinary tract (correct)
  • Dehydration and blood loss
  • Which condition results from cell injury within the renal tubules leading to acute tubular necrosis (ATN)?

  • Autoimmune disorders
  • Nephrotoxic agent exposure (correct)
  • Reversible ischemia
  • Prolonged hydration
  • How does aging typically affect kidney function?

    <p>Decreased perfusion leading to lower glomerular filtration rate (D)</p> Signup and view all the answers

    Which of the following urine analysis findings is typically associated with acute tubular necrosis (ATN)?

    <p>Muddy brown casts (D)</p> Signup and view all the answers

    What urinalysis indicator is most commonly associated with intrinsic renal damage?

    <p>High protein levels (B)</p> Signup and view all the answers

    How does post-renal obstruction affect renal function over time?

    <p>It can lead to structural kidney damage if persistent. (C)</p> Signup and view all the answers

    What mechanism primarily leads to renal filtration and regulation in the kidneys?

    <p>Ultrafiltration through glomerular membranes (A)</p> Signup and view all the answers

    What changes occur in urine concentration in prerenal dysfunction due to reduced renal perfusion?

    <p>Concentrated urine with a low sodium concentration (A)</p> Signup and view all the answers

    Which condition is NOT considered a factor in intrinsic renal damage?

    <p>Chronic dehydration (A)</p> Signup and view all the answers

    Which of the following can lead to intrinsic renal damage over time?

    <p>Unresolved urinary obstruction (D)</p> Signup and view all the answers

    What is a critical pathological condition contributing to prerenal kidney issues?

    <p>Inadequate blood flow to the kidneys (C)</p> Signup and view all the answers

    Which of the following best describes the effect of sepsis on kidney function?

    <p>Potential for acute tubular injury and dysfunction (D)</p> Signup and view all the answers

    What does a BUN/Creatinine ratio of closer to 10:1 suggest in the context of renal dysfunction?

    <p>Intrinsic renal damage (A)</p> Signup and view all the answers

    Which condition is commonly associated with inflammation of the vascular structures surrounding the kidneys?

    <p>Vasculitis (D)</p> Signup and view all the answers

    Which factor is commonly associated with a decrease in renal function as indicated by rising creatinine levels?

    <p>Decreased renal perfusion (A)</p> Signup and view all the answers

    Which of the following is a primary indication of post-renal dysfunction?

    <p>Decreased urine output (A), Urinary tract obstruction (B)</p> Signup and view all the answers

    How does aging primarily affect kidney function?

    <p>Decreased glomerular filtration rate (D)</p> Signup and view all the answers

    Which urinalysis indicator is typically used to assess glomerular filtration?

    <p>Proteinuria (B)</p> Signup and view all the answers

    What role do smooth muscle cells play in the renal process?

    <p>Urine transport to the bladder (D)</p> Signup and view all the answers

    Which of the following causes could lead to intrinsic renal damage?

    <p>Genetic disorders (A), Toxin exposure (D)</p> Signup and view all the answers

    What is the primary function of the renal pelvis?

    <p>Collection of urine from calyces (B)</p> Signup and view all the answers

    In the context of glomerular filtration, what is Bowman’s space?

    <p>The space that collects filtered fluids and solutes (A)</p> Signup and view all the answers

    Which structure in the kidney is primarily responsible for the formation of urine?

    <p>Nephron (D)</p> Signup and view all the answers

    Flashcards

    Prerenal AKI

    Kidney injury caused by reduced blood flow to the kidneys, often due to factors outside the kidneys.

    Causes of Prerenal AKI

    Dehydration, blood loss, low cardiac output, or systemic vasodilation (e.g., septic shock).

    Intrinsic AKI

    Kidney injury caused by direct damage to kidney tissues.

    Acute Tubular Necrosis (ATN)

    Common intrinsic AKI cause; damage to kidney tubules.

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    Postrenal AKI

    Kidney injury due to urinary tract obstruction that blocks urine outflow.

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    Causes of Postrenal AKI

    Kidney stones, tumors, prostatic hypertrophy, or strictures.

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    BUN/Creatinine Ratio (Prerenal)

    High ratio (greater than 20:1) in prerenal kidney injury.

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    Decreasing renal function

    Rising creatinine levels indicate declining kidney function as creatinine is a muscle breakdown product.

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    Glomerulonephritis

    Inflammation of the glomerulus, the filtering unit in the kidney. This can lead to leakage of protein into the urine.

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    Tubular Necrosis

    Death of the kidney tubules, which are responsible for reabsorbing water and electrolytes.

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    Nephrotoxin

    A substance that is toxic to the kidneys. This can be a drug, chemical, or even a natural substance.

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    Nephrotic Syndrome

    A group of symptoms caused by damage to glomeruli, leading to protein leakage in the urine, low blood protein levels, high cholesterol, and swelling.

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    Nephritic Syndrome

    Characterized by inflammation of the glomeruli, causing blood and protein in the urine, high blood pressure, and decreased urine output.

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    Kidney Function

    Maintain acid-base and water balance, regulate electrolytes, remove toxins, control blood pressure, produce erythropoietin, and metabolize vitamin D.

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    Kidney Structures

    Includes hilum (entry/exit for vessels), cortex (outer layer), medulla (inner portion with pyramids), calyces (collect urine), renal pelvis (upper ureter extension), and lobes (structural unit).

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    Glomerular Filtration

    The initial step in urine production where the glomerulus filters fluid and small solutes from blood into Bowman's space.

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    Bowman's Space

    The space between the glomerulus and the Bowman's capsule, where filtered fluid collects before entering the tubules.

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    Renal Cortex

    Outer layer of the kidney, containing glomeruli and proximal tubules.

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    Study Notes

    Kidney Structure and Function

    • The basement membrane lines the endothelium, with immune response processes.
    • Mesangial cells help regulate sodium while protecting the kidneys from damage.
    • Glomerular filtrate is plasma without plasma proteins (albumin).
    • The glomerulus and basement membrane are crucial for homeostasis.
    • Glomerular capsules enter nephrons, some shorter and found in the cortex.
    • Nephrons that are bigger and longer are found deeper in the medulla, and have a larger surface area for reabsorbing sodium chloride, and water.
    • The final glomerular filtrate becomes urine after passing through collecting ducts, renal pelvis, and ureters for eventual bladder storage.
    • The juxtaglomerular apparatus allows filtered substances to re-enter the vascular system.

    Glomerular Filtration and Loop of Henle

    • Glomerular filtration in the descending loop of Henle causes rapid water reabsorption, increasing osmolality from very dilute to very thick.
    • The maximum osmolality of filtrate in the loop of Henle is 1200 millimoles.
    • Reabsorption of sodium chloride and the elimination of waste products takes place at this point, decreasing osmolality.

    Acute Kidney Injury (AKI)

    • Prerenal AKI is due to poor blood flow to the kidneys.
    • Intrinsic AKI is due to damage within the kidneys. This may be due to inflammation, infections, or other issues in the glomeruli, tubules, or interstitial tissue.
    • Postrenal AKI is due to obstructions in the urinary tract.

    Ureters

    • Ureteropelvic junction (UPJ) is the junction between the renal pelvis and the proximal ureter.
    • The pelvic brim is where iliac blood vessels cross over the ureter.
    • The ureterovesical junction (UVJ) is where the ureter enters the bladder.
    • Urine moves downward due to peristalsis and gravity.

    BUN/Creatinine Ratio

    • Normal BUN/creatinine ratio is 10-20 to 1.
    • Creatinine is another nitrogenous product of the body.
    • Pre-renal issues, like reduced kidney perfusion, can lead to a rise in the BUN/creatinine ratio.
    • Post-renal issues, like obstructions, can also lead to a rise.
    • A decrease in the BUN/creatinine ratio may indicate renal problems.

    Glomerulonephritis

    • Glomerulonephritis is a type of kidney disorder that causes inflammation of the glomeruli.
    • Different types of glomerulonephritis can cause different issues.
    • Clinical manifestations of glomerulonephritis can vary depending on the specific type or presence of associated diseases.
    • Causes include autoimmune conditions and infections (infective, genetic, metabolic, ischemic).

    Renal Function

    • Kidneys remove waste products, like urea, creatinine, uric acid, and drugs.
    • They maintain acid-base balance, water balance, electrolyte levels, and remove toxins.
    • Kidneys produce erythropoietin for red blood cell production and activate vitamin D.

    Urine Analysis

    • Key elements of urinalysis include color, clarity, specific gravity, the presence of blood, protein, glucose, and bacteria.
    • Abnormal results may suggest certain renal or urinary issues.

    Renal Function in Aging

    • By age 40, kidney function can decrease by 10% per decade.
    • This is partly due to the loss of glomeruli in the kidneys.
    • There are also changes to the structures of tubules and loops of Henle.

    Kidney Stones

    • Kidney stones are deposits of minerals and salts.
    • Different types of stones are most common, including calcium stones, uric acid stones, and struvite stones.
    • Formation of stones can be affected by levels of calcium, pH in urine, hydration, diet, and more.
    • Clinical manifestations can include acute onset of abdominal pain, with symptoms of blood in urine/hematuria and pain that may change location or severity.

    Hormone Function and Transportation

    • Many hormones are transported unbound.
    • Lipid-soluble hormones travel through the blood with carrier proteins, while water-soluble hormones travel freely.
    • Different hormone actions result in different effects based on their properties. Hormone receptors play a vital role in these interactions.

    Positive and Negative Feedback Loops

    • There are positive feedback loops that are present throughout the various body systems.
    • Negative feedback loops regulate hormone levels and maintain homeostasis.

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    N715 Exam 3 Pt 3 PDF

    Description

    Test your knowledge on the intricate structures and functions of the kidneys. This quiz covers essential concepts such as glomerular filtration, nephron anatomy, and the role of juxtaglomerular apparatus. Dive into how the kidneys maintain homeostasis and regulate body fluids.

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