renal physiology
Terms
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- What is renal clearance?
- Process by which a measurement is made of how much a substance can be cleared from the body per given unit of time.
- What is a good measure of the glomerular filtration rate?
- Creatinine
- What is the proportionality of GFR and plasma creatinine concentration?
- Inverse. As GFR goes up, plasma creatinine goes down.
- What is proportionality of BUN to GFR?
- Inverse. As BUN levels increase GFR drops.
- What are the three general renal functions?
-
Regulatory
Excretory
Endocrine - What is renal reabsorption?
- Moving from the tubular system to the peritubular system.
- What is renal secretion?
- Moving from the peritubular system to the tubular system.
- What is renal excretion?
- Moving from the tubular system to urine.
- Is the kidney able to regenerate?
- Yes.
- What is the normal Ph of Urine?
- 6.0
- The aldesterone feedback mechanism is used in balancing what two fluids?
- Potassium, Salt and water.
- What gland is used in balancing calcium and phosphorus?
- Parathyroid.
- What are the eight tests of urinalysis.
-
Specific gravity
Ph
Color
Protein
Casts
RBC
WBC
Glucose - In renal disease, what is the specific gravity?
- Usually fixed at 1.010
- What is azotemia?
- Increased blood level of urea.
- Where is creatinine found mostly?
- Muscle.
- What is osmolality?
- Total number of particles in solution. Normal is 290. Regulates release of ADH.
- Name two types of body fluids.
- ICF and ECF
- Hypovolemia is a deficit of what type of fluid?
- ECF
- In hypervolemia, what type of fluid is involved?
- ECF
- What is the treatment (Tx) for hypervolemia?
- diuretics, restrict fluids
- Where is Na actively absorbed?
- In the intestines.
- What material is the chief base of blood?
- Na
- What is the Tx for hyponatremia?
- Replace Na
- What is the Tx for Hypernatremia?
- Oral Na restricted, diuretics.
- Sodium comprises what percentage of cations in ECF?
- 90%
- What cation comprises ICF?
- Potassium
- If a person has muscular twitching, eyeballs sunken and soft, cramping abdominal pain, and headache/confusion, what is the most likely diagnosis?
- Hyponatremia.
- If a person is agitated, has dry mucus membranes, marked thirst, flulshed face, increased BP, and tachycardia, what is the most likely diagnosis?
- Hypernatremia.
- What is the treatment for hyperkalemia?
- 50% glucose IV with 50 U of insulin, diet low in K, Kayexalate.
- Acute glomerulonephritis is commonly associated with what bacterial infection?
- streptococcus
- What are some symptoms of acute glomerulonephritis?
- hematuria, RBCs, proteinuria, decreased GFR, oliguria, hypertension, edema around eyes.
- What is the most common cause of chronic end-stage renal failure?
- glomerulonephritis
- What are the symptoms of acute glomerulonephritis?
- hematuria, edema, RBC casts, proteinuria, decreased GFR, oliguria, hypertension.
- What are the two types of immune mechanisms commonly contribute to glomerular injury?
-
1. Deposition of circulating soluble antigen-antibody complexes, often with complement components.
2. Formation of antibodies specific for the anti-glomerular basement membrane. - What are the two major changes in urine that are distinctive of severe glomerularitis?
-
1. Hematuria
2. proteinuria - What are three ways to evaluate and treat glomerularnephritis?
-
1. diagnosis confirmed by proteinuria, RBC's, WBC's, casts
2. biopsy
3. treat primary causing disease. - What is epoetin alfa?
- An RBC stimulator.
- Increased Hct leads to:
-
increased energy, activity, excercise
improved eating, sleeping
improved cognitive function
improved sexual function - What are the 3 principles of dialysis?
-
diffusion
osmosis
ultrafiltration - What are some situations that require dialysis?
- azotemia, fluid overload, increased K, acidosis, uremic symptoms, nephrotoxic agents
- Which dialysis method is slower, hemodialysis or peritoneal dialysis?
- peritoneal
- Which gland regulates calcium?
- parathyroid
- What is the importance of calcium?
- bones, teeth, cardiac function, muscle activity
- What is the importance of potassium?
- important for contraction of heart
- What are the different cast indicators?
-
white cell cast = infection
hyaline cast = protein in urine..stress
granular cast = degenerative nuclei
waxy cast = indicate tubular inflammation, chronic renal disease
fatty cast = nephrotic syndrome - What is the clinical progession of acute renal failure?
- oliguria, diuresis, recovery