NURS 5315 Test 5 (Module 10) UPDATED
Questions and CORRECT Answers
Nephron structure - CORRECT ANSWER - - Glomerulus- collection of capillaries and is
responsible for filtering blood, reabsorbs amino acids, bicarb, sodium, chloride, phosphate,
potassium, water
- Proximal tubule- can excrete phosphate, site of action for angiotensin II which stimulates
sodium, water and bicarb reabsorption.
- Descending loop of Henle- passively reabsorbs water, concentrates urine.
- Ascending loop of Henle- actively reabsorbs sodium, potassium, chloride, induces reabsorption
of magnesium and calcium, impermeable to water, therefore, makes water more dilute.
Distal convoluted tubule- actively reabsorbs sodium, permeable to water, causes urine to be more
dilute. Site of action for ADH hormone and aldosterone
Renal blood vessels - CORRECT ANSWER - Autoregulation- autoregulation affects
amount of blood flow to kidneys and also rate of filtration. Decrease in arterial blood pressure
and decrease in arterial blood volume causes a decrease in renal perfusion. Decreased perfusion
causes reduced GFR, and decrease in fluid and sodium in distal tubule. This decrease is senses
by JGA which sends signals to relax blood vessels in order to help bring blood to glomeruli, JGA
releases renin which converts angiotenison to angio I, this passes through lungs and stimulates
release of angiotensin converting enzyme. ACE converts angio I to angio II, which stimulates
vasoconstriction to help increase glomerular back pressure and increase GFR. Angio II also
responsible for stimulating release of aldosterone. This results in additional reabsorption of
water, increased BP and increased GF rate.
aging effect on kidneys - CORRECT ANSWER - Reach adult size by adolescence
Hypertrophy with older age, reduced ability to excrete urine, kyperkalemia from reduced
excretion, more glucose excreted because of decreased reabsorption (not necessarily indicator of
diabetes), drugs not clearing as easily, harder to activate vitamin d, which affects calcium
absorption.
GFR- increased directly after birth, reaches adult levels by age 2, more dilute urine up to 6mo of
age, renal blood flow and GFR decrease with older age (d/t atherosclerosis)
, Nephron- decrease in number and size with age (atherosclerosis), number of nephrons at age 75
decreased by 30%.
Tubular system- immature in infants (harder to excrete potassium, reabsorb bicarb, buffer
hydrogen), matures by age 2. Tubular atrophy is common with age.
Bladder- descends into pelvis after birth, may not void for 12-24 hours following birth.
Frequency and nocturia are common with age.
Renal injury - CORRECT ANSWER - Focal- localized, <50% of glomeruli affected
Diffuse- >50% of glomeruli affected *most common*
Primary glomerular disease- cause is directly related to the kidney - infection, ischemia, free
radicals, drugs, toxins, vascular disorders
Secondary glomerular disease- injury caused by mechanism outside the kidney (lupus, diabetes),
typically as consequence of system disease like HF, SLE, HTN.
Patterns of kidney injury - CORRECT ANSWER - Hypercellularity- increased number of
cells in glomerulus, usually follows immune or inflammatory process
Basement membrane thickening- walls of glomerulus are thickening
Hyalinosis- accumulation of homogenous and eosinophilic cells in the glomerular capillaries,
usuallys are a result of capillary wall injury. Common in focal segmental glomerular sclerosis.
Sclerosis- collection of extracellular matrix, happens in diabetes
Nephrolithiasis - CORRECT ANSWER - Kidney stones from the urine being over
saturated with particular ions
