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48 Cards in this Set
- Front
- Back
what are the major function of the kidneys
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regulate 1homeostasis,2filters/regulates content of blood,water content,blood volume
3 concentration of electrolytes 4excretes metabolic waste like urea,uric acid,creatinine,drugs 5 endocrine functions,erythropoieten,renin,calcitrol |
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what is the functional unit of kidney
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nephron-1.2mil and glomerulus filters blood
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there r 2 types of nephrons
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corticol- short loops reduce sodium reabsorption into the blood and filtrate is diluted
Juxtamedullary-long loops of henle, provide increased sodium reabsorption and filtrate is CONCENTRATED |
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normal ph in urine
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5.0-6.5
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normal specific gravity
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1.010-1.020
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what is normal in urine
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sediment ,clear light yellow,few or no RBCs,normal urine contains metabolic wastes and few or no plasma proteins blood cells or glucose. produce 1.5 L of urine a day. urine LEFT STANDING MAY CONTAIN LYSED RED BLOOD CELLLS DISINTERGTING CASTS,AND RAPIDLY MULTIPLING BACTERIA.what are casts?molds of distal nephron lumen
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RBC cast in urine are due to-----, WBC cast due to -------, epitheial cells due to ---------,
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bleeding, inflammation,necrosis
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crystals in urine are what
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r uric acid,calcium oxalate,or phosphate=inflammation,infection,or metabolic disorder
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protein in urine is due to
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exercise,stress,fever,cold
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sugar in urine is due to
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emotional stress,pregnant,high CO meal
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GFR
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is the rate at which plasma is filtered as it flows thru the glomerular capillary filtration membrane---rate at which the glomuerli filters blood. NORMAL IS 125ML/MIN. or 180L/day ITS REGULATED BY THE ARTERIAL BLOOD PRESSURE AND RENAL BLOOD FLOW IN NORMALLY FUNCTIONING KIDNEYS
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Aldosterone
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PRODUCED BY-ADRNAL CORTEX, major action is regulates the reapsorption of sodium and excretion of potassium by kidneys,changes urine concentration by sodium reabsorption.
Action in the renal tube to retain sodium,conserve reabsorbtion , and increase potassium excretion |
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ADH
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antidiuretic hormone that decreases the production of urine BY INCREASING REABSORPTION OF WATER. secreted by hypothalamus and stored in pituitary gland
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when is ADH is released
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if there is a decrease in blood volume or increased concentration of sodium or other substances in plasma
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What is BUN
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urea is formed in the liver, as a byproduct of protein(nitrogen waste)
normal excretion = 10-20mg |
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when the bun is off this is what ocurs
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urine flows slower thru nephron,deceased renal blood flow,metabolic rate(fever/infection/trauma)
drugs=damge to kidneys diet-high protein diet, TPN |
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Creatinine
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waste product=metabolism is in the muscle which is freely filtered by the glomeruls. Is neither reabsorbed nor secreted by the renal tuble. When it is high it is directly related to nephron damage
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normal creatinine
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0.6- 1.2
2x normal=50% nephron damge 3x normal= 75% damage |
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what are renal stones
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crystaalline structures made by materials the kidney normally excreted in urine
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how to prevent stones
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urine test,blood chemestries,stone analysis. FLuids-diet changes-medication-measures to change the PH
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What are the 2 types of stone pain
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colic-stretching of the ureters. move into ureters and obstruct flow.acute and intermittent. cool,clammy skin, nausea, vomiting
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Noncolicky pain
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distention of the renal pelvis or calices. Dull deep pain from to severe. pain often exaggerated by drinking lots of fluids.
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types of stones
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calcium(in blood and urine)
stuvite(form only in alkaline urine in the presecnce of bacteria that possess urease, which splits urine into ammonia and C02 uric acid stones- gout/not seen on xray and high concentraions of uric acids in the urine cystine stones- rare, genetic, resemble stivute except that infection is unlikely to be present |
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Nephrotic Syndrome
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protein wasting secondary to diffuse glomerulus damage. Marked by protein in urine,hypoalbunemia,edema, from in creased glomular permeability in the plasma protiens. causes= diseases that produce proliferative inflammatory response that decrease permeabilty of glomular cap membrane EDEMA IS KEY
complications-- open to infections,clots,renal vein clots,hyperlipidemia,liiduria |
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diuretic
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promotes formation and excretion of urine
a diuretic reduces the volume in the extracellulr fluid in hypetension,edema,CHF loop and thiazide |
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polycystic renal disease
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cystic formation and hypertrophy of the kidneys which lead to rupture , infection, fibrosis and damged nephrons
autosomal dominant trait that ends in renal disease |
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hydro nephrosis
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distention of renal pelvis and calyces of kidney by urine that cannot flow past an obstruction in a ureter with progressive atrophy of kidneyURINE IS STAGNANT
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WHAT CAUSES HYDRO NEPHROSIS
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tumor,stone in ureter,inflammation of prostate gland,edema from UTI
stasis of urine predisposes to an infection or stones Surgery and removal of obstruction |
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Nephritic syndrome
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caused by diseases that provoke a proliferation inflammatory response that decreases the pemeabilty of the glomular capillary mmebrane , RBCS escape into the urine and damge to cap walls from inflammtion
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What are symptoms of nephritis
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blood in urine,red cell casts,diminished GFR,azotemia,oliguria,hypertension
types are 1.acute proliferative glomerulnephrits 2.rapid progressive glomerulonenephritis 3. chronic glomerulonephritis |
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Causes of nephrtis
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occurs in glomerular abnormality is the only disease present or it can be secondary condtion to disease s like diabetes or SLE
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Erythopoeiten
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glycoprotein hormone that regulaaets the differentiation in RBCs in bone marow. made in the kidneys and released in the blood in response to anoxia. stimulated by tissue hypoxia. This increases oxygen carrying capapcity in the blood.
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ABG
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measures the dissolved o2 and oxygen in the arterial blood and reveals the acid base state and how well the oxygen is being carried to the body
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respiratory failure
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cant eliminte co2 from alveoli
02 reaches the alveoli but cant be absorbed, can vntilate but cant oxygenate the pulmonry blood |
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ARDS
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extravascular lung fluid, alveolar cap membrane damage, reduced complince= bc of edema and compression of terminal airways, respiratory acidosis and hypxemia
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Pnuemonia
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inflammation that stiffens the lungs, and decreases lung compiance, causes hypoxemia
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Pulmonary embolism
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clot forms in deep vein and detaches and travels to right side of the heart and then lodges in a branch of the pulmonary artery
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In copd how much 02 is given
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no more than 2l bc of long standing hypercapnia, the respiratory drive is triggered by low 02 levels rather than increased C02 like in normal lungs
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pursed breathing
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helps in maximal expiration breathing with obstructive disease like asthma by increasing airway pressure keeps passages open during exhalation
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low Pa02 arterial in ARDS
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increasing hypoxemia
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Acute tubular necrosis
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destruction of tublar epithelial cells with acute suppression of renal function. sudden failure of the kidney tubular.COMMONLY CAUSED BY AN INTERRUPTION OF BLOOD SUPPLY TO THE TUBES RESULTING ISCHEMIA
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DIFFER STAGES OF ATN
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1. ONSET-HRS TO DAYS UNTIL INJURY OCCURS
2. MAINTANENCE-DECREASE IN GFR,SUDDEN RETENTIONOF METABOLITES THAT ARE NORMALLY CLEARED BY THE KIDNEYS, FLUID RETENTION AND LOW OUTPUT 3. RECOVERY-REPAIR OF OF TISSUE TAKES PLACE AND SLOW INCREASE OF URIN OUTPUT, EDEMA destruction of tubular epithelial cells with acute suppression of renal fnction |
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causes of ATN
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ischemia of tubulars, nephotoxic effects of drugs, obstruction, toxins from massive infection, major surgery, hypovolemia,sepsis severe, trauma, and burns
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kidney failure is what
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kidneys fail to remove metabolic end products from the blood and regulate fluid,electrolyte, and ph balance of extrcellular fluid
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CHRONIC VS ACUTE
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chronic is slow to develop
acute is sudden onset and can be reversed if caught early, rapid decline in renal function |
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manifestations of kidney failure
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inability to concentrate urine,hypertension,cardio issues, uremia, anemia
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diagnosis of kidney failure
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look at urine output,tests for osmoality sodium concentration and inabilty to concentrate urine
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causes of kindney failure
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conditions that cause acute shutdown in renal funciton like renal disease systemic disease urinary tract disorders
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