NURS 5315: Advanced Patho Exam 5
Questions Answers
What iiare iithe iikey iifunctions iiof iithe iikidneys? ii- iiAnswers ii-Excretion iiof iimetabolic
iiwaste. ii
Regulation iiof iiwater iiand iielectrolyte iibalance
Regulation iiof iiarterial iiBP
Erythrocyte iiproduction
1, ii25 ii-dihyydroxy iivitamin iiproduction ii(calcitriol)
Gluconeogenesis
What iimetabolic iiwaste iido iithe iikidneys iiexcrete? ii- iiAnswers ii-Urea
Creatinine
Bilirubin
Drugs
Hormone iimetabolites
How iido iithe iikidneys iiregulate iiarterial iiblood iipressure? ii- iiAnswers ii-RAAS
The iirenin-angiotensin-aldosterone iisystem ii(RAAS) iiis iia iicritical iiregulator iiof iiblood
iivolume, iielectrolyte iibalance, iiand iisystemic iivascular iiresistance.
How iido iithe iikidneys iiregulate iiacid iibase iibalance? ii- iiAnswers ii-Exertion iiof iiH+ iiions
iiand iireabsorption iiof iisodium iibicarb.
How iidoes iiblood iiflow iiinto iiand iiout iiof iithe iikidneys? ii- iiAnswers ii-In iithrough iithe iirenal
iiartery. ii
i. iiInterlobal iiartery. ii
ii. iiArcuate iiarteries. ii
iii. iiCapillary iibeds
Out iithrough iithe iirenal iivein
Renal iicapillary iibeds. ii- iiAnswers ii-1. iiAfferent ii(glomerular iicapillaries) ii
iia. iifiltration
ii2. iiEfferent ii(peritubal iicapillaries) ii
iia. iiWater, iielectrolytes, iisubstances iiexchanged iibetween iiblood iiand iifiltrate iimaking
iiurine. ii
iib. iiVasa iirecta ii(long iiefferent iiarterioles-extend iithrough iimedullar iiglomerulus iito iiform
iithe iijuxtaglomerular iicells) ii
iii. iiRegulate iiurine iiand iiserum iiconcentration iiand iivolume. ii
iiii. iiReabsorb iifiltrate iito iireturn iito iisystemic iicirculation.
How iidoes iifiltrate iiand iiurine iimove iithrough iithe iikidney? ii- iiAnswers ii-1. iiBowmans
iicapsule
2. iiProximal iitubule
3. iiLoop iiof iiHenle
iia. iiDescending ii(thin)
,iib. iiAscending ii(thick)
4. iiMacula iidensa
5. iiDistal iitubule
6. iiCollecting iitubule ii
iia.) ii8-10 iicollecting iitubules iicombine iito iiform
7. iiMedullary iicollecting iitubule
8. iiCollecting iiduct. ii
9. iiRenal iipelvis
What iiare iithe iicomponents iiof iia iinephron? ii- iiAnswers ii-Glomerulus: iiglomerular
iicapillaries
iia.) iiFluid iiis iifiltered iifrom iithe iiblood iito iiform iifiltrate iiwhich iienters iithe iitubule
iib.) iiTubule iiwhere iifiltrate iiis iiprocessed iiinto iiurine.
What iiare iithe iitwo iitypes iiof iinephron? ii- iiAnswers ii-1. iiCortical: iiglomerulus iiin iithe
iiouter iicortex iiand iitubules iithat iiare iisuperficial iiin iithe iimedulla
2. iiJuxtaglomerular: iideep iiin iithe iicortex iiwith iitubes iideep iiin iithe iimedulla ii(vasa iirecta
iiis iihere-determine iiurine iiconcentration)
What iicontributes iito iithe iiglomerular iifiltration iirate? ii- iiAnswers ii-1. iiHydrostatic
iipressure
2. iiColloid iioncotic iipressure
3. iiEquals iinet iifiltration iipressure
Urine iiis iiformed iias iia iiresult iiof ii___________. ii- iiAnswers ii-Tubular iiprocessing iiof
iifiltrate. ii
a. iiGlomerular iifiltration
b. iiReabsorption iiof iisubstances iifrom iithe iirenal iitubules iiinto iithe iiblood.
c. iiExcretion iiof iisubstances iifrom iithe iiblood iiinto iithe iirenal iitubules.
What iiare iithe iistructures iiof iithe iiglomerular iimembrane? ii- iiAnswers ii-Endothelium
Basement iimembrane
Podocyte
What iiis iithe iistructure iiof iithe iiendothelium ii(fenestrae)? ii
(Glomerular iimembrane) ii- iiAnswers ii-Regulates iivasomotor iitone, iihomeostasis iiand
iitrafficking iiof iileukocytes.
What iiis iithe iifunction iiof iithe iibasement iimembrane ii(collagen ii& iiproteoglycan)
(Glomerular iimembrane) ii- iiAnswers ii-Scaffold iisupporting iithe iifunction iiof iithe
iiendothelium iiand iipodocytes ii(problems iiwith iithe iibasement iimembrane iiresult iiin
iialbumin iileaking iiinto iifiltrate)
What iiis iithe iifunction iiof iithe iiPodocyte ii(filtration iislits/slit iimembranes)? ii(Glomerular
iimembrane) ii- iiAnswers ii-The iislits iiserve iias iia iibarrier iibetween iithe iifoot iiprocess iito
iiprevent iileaking iiof iialbumin iiinto iithe iifiltrate.
How iican iiGFR iibe iimanipulated? ii- iiAnswers ii-Increase iior iidecrease iiGFR.
What iiis iithe iibig iiidea iiand iimechanism iifor iiincreasing iiGFR? ii- iiAnswers ii-Big iiidea: ii
Hormones iiand iiautocoids: iilocal iiangiotension iiII.
Mechanism: iiConstricts iiefferent iiarterioles; iiincreased iiblood iiflow; iiincreased iiGFR. ii
Big iiidea: iiNitric iioxide, iiprostaglandins. iibradykinin
Mechanism: iiDilate iiafferent iiartioarterioles; iiincreased iiblood iiflow; iiincreased iiGFR.
, What iiis iithe iibig iiidea iiand iimechanism iifor iidecreasing iiGFR? ii- iiAnswers ii-Big iiidea:
iiSNS: iiNorepinephrine iiand iiEpinephrine ii(adrenal iimedulla)
Mechanism: iiConstricts iiafferent iiarterioles, iidecreases iiblood iiflow, iidecreased iiGFR.
Big iiidea: iiHormones: iiendo-thelin ii(vascular iiendothelium) ii
Mechanism: iiConstricts iiafferent iiarterioles, iidecreased iiblood iiflow, iidecreased iiGFR.
What iihappens iiin iithe iiproximal iitubule? ii- iiAnswers ii-Sodium, iiChloride,
iiPhosphourous, iisodium iibicarbonate, iiglucose, iiamino iiacids, iiare iireabsorbed. iiVery
iiwater iipermeable. ii
Hydrogen, iiorganic iiacids, iiorganic iibases ii(metabolic iiby iiproducts, iibile iisalts, iiuric
iiacid, iicatecholamines) iiare iisecreted.
Controlled iiby: iiAngiotensin iiII ii(increased iisodium iiand iiH20 iiabsorption) iiPTH
ii(decreased iiPhosphorous iireabsorption).
What iihappens iiin iithe iithin iidescending iiloop iiof iiHenle? ii- iiAnswers ii-Small iiamounts iiof
iisodium iiare iireabsorbed. iiHighly iiwater iipermeable.
What iihappens iiin iithe iithin iiascending iiloop iiof iiHenle? ii- iiAnswers ii-Dilutes iifiltrate.
iiHighly iiwater iipermeable.
What iihappens iiin iithe iithick iiascending iiloop iiof iiHenle? ii- iiAnswers ii-Sodium, iichloride,
iipotassium, iicalcium, iimagnesium, iibicarb, iiare iireabsorbed. iiImpermeable iito iiwater;
iidilutes iifiltrate. ii
Hydrogen iiions iiare iisecreted iihere. ii
Controlled iiby iiangiotensin iiII ii(NaCl iireabsorption/H+ iisecretion) iiParathyroid iihormone
ii(calcium iireabsorption)
What iihappens iiin iithe iicollecting iitubules? ii- iiAnswers ii-Sodium, iichloride, iicalcium,
iibicarb iiare iireabsorbed iihere. iiPermeable iito iiwater. iiAntidiuretic iihormone iirequires.
Potassium, iihydrogen, iiand iiurea iiare iisecreted iihere. ii
Controlled iiby iialdosterone ii(increased iiNaCl iiand iiK iisecretion) iiVasopressin/ADH
ii(increased iiH20 iireabsorption); iiANP ii(decreased iiNa iireabsorption).
What iihappens iiin iithe iimedullary iicollecting iiducts? ii- iiAnswers ii-Urea iiand iiH20 iiare
iireabsorbed iihere. iiVasopressin/ADH.
Sodium, iipotassium, iihydrogen, iiand iibicarb iiare iisecreted iihere. ii
Controlled iiby iivasopressin/ADH ii(increased iiH20 iiabsorption).
What iilabs iican iiassist iiin iimonitoring iikidney iifunction? ii- iiAnswers ii-1. iiCreatinine
iiclearance. ii
2. iiCystatin iiC
3. iiCells iiin iiurine ii(RBC, iiWBC, iiCasts)
4. iiBiomarkers ii(NGAL, iiKIM ii1, iiIL-18, iiIGF iiBIP7, iiTIMP-2, iiUrokinase)
What iidoes iicreatine iiclearance iimeasure? ii- iiAnswers ii-Reflects iiGFR