Download BIO 669 Quiz 6 Exam: Questions & Answers (2025 Update) and more Exams Pathophysiology in PDF only on Docsity!
Bio
BIO 669 QUIZ 6 EXAM (NEW 2025 UPDATE)
QUESTIONS & VERIFIED ANSWERS| GRADE A|
100% CORRECT
What hormones affect the GFR and renal blood flow? - ANS ✓renin- angiotensin- aldosterone system= renin Natriuretic peptides How does renin affect GFR and renal blood flow? - ANS ✓triggered by decrease in BP, decreased nacl concentration, stimulation of B-adrenergic receptors, and release of prostaglandins Decreases sodium loss via reabsorption= increased fluid volume, also vasoconstricts and thereby increases pressure. (think aldosterone release due to the renin) How do natriuretic peptides affect GFR and Renal blood flow? - ANS ✓opposes aldosterone: increasing sodium and water=decreasing fluid volume and also vasodialates= decreased pressure
Bio What does urodilantin do? - ANS ✓increases renal blood flow= diuresis. What does glomerular filtration do? - ANS ✓produces cell and protein free filtrate What is the countercurrent exchange system? - ANS ✓Vasa Recta Contributes to production of concentrated urine Creates concentration gradient What are the 3 different types of natriuretic peptides? - ANS ✓atrial, brain,- stimulate sodium release into urine and decreasing overall plasma volume. C-type (endothelial cells, vasodilation in nephron) Urodilantin- affects DCT and collecting ducts= vasodilation and can lead to natriuresis What does diuretic hormone do? - ANS ✓increases urine output What does aldosterone do? - ANS ✓stimulates reabsorption of sodium (which intern=reabsorbs water) Increases potassium and hydrogen excretion.
Bio What is the relationship between the kidneys and vitamin D? - ANS ✓for vitamin D to be active it needs 2 hydrogens. 1 of these hydrogens is in the kidneys. What happens to vitamin d if there is kidney damage? - ANS ✓the vitamin D remains inactive and causes vitamin D deficiency= decreased absorption and retention of calcium When is erythropoietin released? - ANS ✓in response to hypoxia What does erythropoietin do once it is released? - ANS ✓stimulates the production of red blood cells. What is renal clearance and glomerular filtration rate? - ANS ✓ways to evaluate how well the kidneys are filtering the blood and how functional they are What is BUN? - ANS ✓measures kidneys overall ability to filter blood and functioning through looking at amount of urea nitrogen in blood. Shows dehydration and or that you are having difficulty removing nitrogen from the urine.
Bio If BUN is high what happens to GFR? - ANS ✓the GFR drops. What are the differences for pediatric renal function? - ANS ✓decreased ability to remove excess water and solutes Decreased ability to concentrate Narrow margin for fluid and electrolyte- easily off balance with dehydration Increased risk for drug toxicity- kidneys can not break down. What are the differences for aging renal function? - ANS ✓decreased renal blood flow and GFR- altered sodium and water balance Decrease in nephrons- damages to nephrons, glomerular membranes, decreased vascular to nephrons Delayed acid-base response Increased drug toxicity Alteration in thirst drive and water intake. What is a urinary tract obstruction? - ANS ✓anything that can block the flow of urine from the kidneys to the urethra What are possible causes of urinary tract obstruction? - ANS ✓anatomic or functional defect
Bio What happens when a urinary tract obstruction is not corrected? - ANS ✓the prolonged dilation leads to enlargement and tubulointerstitial fibrosis. How does the kidney compensate? - ANS ✓hyperfunctioning Larger glomeruli and tubules, but non total number of functioning nephrons via: obligatory growth and compensatory growth What is post-obstructive diuresis? - ANS ✓following correction of blockage via surgery, catheterization, or passing of stone they would undergo a brief but significant diuresis What do you need to monitor in regard to post-obstructive diuresis? - ANS ✓electrolytes and volume (dehydration) What is nephrogenic diabetes insipidus? - ANS ✓the receptor in the kidney are unresponsive to the ADH. (impaired RENAL response). Why do kidney stones develop? - ANS ✓high levels/ super saturation of fluids that have substances that can form into crystals or proteins that may obstruct the urinary tract What are the risk factors for kidney stones? - ANS ✓Gender
Bio Age Race Geographic location Seasonal factors Fluid intake Diet Occupation What helps to prevent the development of kidney stones? - ANS ✓pyrophosphates, magnesium, tamms-horsfall porteins, uromodulin, and potassium citrate What are the most common kidney stones? - ANS ✓Calcium oxalate and calcium phosphate What is struvite kidney stones comprised of? - ANS ✓combination of phosphate, ammonium, & magnesium What would you do to try to determine the kind of stone and its course of treatment? - ANS ✓urinanalysis Take a 24 hour urine and try to catch passed stones. Imaging studies- ultrasound
Bio While detrusor constricts, sphincter constricts= feeling of fullness but unable to void. What is overactive bladder syndrome? - ANS ✓frequency, urgency, nocturne Involuntary detrusor contractions during bladder filling, spontaneous or provoked Contracting bladder and external sphincter work together, but detrusor is too weak to empty= urinary retention with overflow or stress incontinence What can obstruction of lower urinary tract lead to? - ANS ✓low bladder wall compliance- difficult to expand= diminished ability to go long periods of time without urinating. What are examples of renal tumors? - ANS ✓renal adenomas, renal cell carcinoma What are renal adenomas? - ANS ✓benign and capsulated tumors but can become malignant= surgical removal. What is renal cell carcinoma? - ANS ✓-most common solid renal tumor
- origninate near renal cortex
Bio Often not caught until later and metastasized. What are transitional cell carcinomas? - ANS ✓most common bladder tumor May present as painless but may have hematuria. What are the manifestations for renal tumors? - ANS ✓hematuria, dull and aching flank pain, palpable flank mass, and weight loss What is a urinary tract infection? - ANS ✓inflammation of the urinary epithelium following invasion and colonization by some pathogen within the urinary tract What are the most common organism for UTI? - ANS ✓E. Coli, staphylococcus saprophyticus Why do you need to be concerned about klebsiella and proteus (gram negative)? - ANS ✓they can ascend up the ureter= pyelonephritis What is acute cystitis? - ANS ✓inflammation of the bladder
Bio What is chronic pyelonephritis? - ANS ✓Persistent or recurring episodes of acute pyelonephritis associated with obstructive conditions. Leads to permanent scaring. What is glomerulonephritis? - ANS ✓inflammation of the glomerulus Why does glomerulonephritis occur? - ANS ✓immunologic abnormalities- infection Drugs/ toxins- allergies Vascular disorders Systemic diseases-ischemia, diabetes, metabolic disorders Viral What is type 3 hypersensitivity? - ANS ✓disposition of circulating soluble antigen- antibody complexes, with compliant fragments to promote inflammation What is type 2 hypersensitivity? - ANS ✓antibodies reacting in situ against planted antigens within the glomerulus
Bio What happens when the mechanisms of injury are active for glomerulonephritis? - ANS ✓they become permeable= outflow of fluids and later the damage promotes a decrease in surface area= decreased GFR What happens when GFR drops? - ANS ✓decreased pressure, decreased blood flow, hypoxic injury, increase creatinine and increase in urea What are the manifestations of glomerulonephritis? - ANS ✓oliguria- decreased urine production= volume expansion (shift= edema) Hypertension Renal failure. Severe: hematuria, proteinuria exceeding 3-5 g/day with albumin as major protein. What is good pastures syndrome? - ANS ✓immune complexes are deposited in glomerulus leading to glomerulonephritis What is diabetic glomerulopathy? - ANS ✓glomerular hypertension combined with thickening of basement membrane, and stiffening of efferent arterial due to glycation (glucose directly onto the surface= arterial stiffening) increases the pressure on the inside of the glomerulus initially increases GFR but also cause mesangial cells to hypertrophy and proliferate- increased collagen= increased
Bio What is acute kidney injury? - ANS ✓a sudden decline in kidney function with a decrease in glomerular filtration= increase in nitrogenous wastes, creatinine and BUN And a decrease in urine output What percent of functioning is needed to be considered renal insufficiency?
- ANS ✓25% What is end stage renal failure? - ANS ✓a decrease in GFR below 10% of normal What is prerenal AKI? - ANS ✓before kidney, caused by impaired renal blood flow=ischemia causing GFR to decline b/c the decrease in filtration pressure Most common What is intrarenal AKI? - ANS ✓often acute tubular necrosis Caused by burns, post surgery, ischemia within the kidney, radio contrast dye or amino glycoside antibiotics and myoglobin (muscular tissue injury) What is post-renal AKI? - ANS ✓associated w/ urinary tract obstruction
Bio Beyond kidney but backs pressure up to the kidney Typically has to be bilateral What phase is urine the lowest but creatinine and BUN increase for Aki? - ANS ✓maintenance (oliguric) phase At what phase of AKI is diuresis common? - ANS ✓recovery What Is chronic kidney disease? - ANS ✓progressive loss of renal function that affects nearly all organ systems What is chronic kidney disease associated with? - ANS ✓HTN, diabetes, intrinsic kidney disease (kidney stones, kidney damage) What are hallmarks of CKD? - ANS ✓proteinuria, due to glomerular hyperfiltration= damage to tubules via inflammation decreaseing GFR What does CKD do for sodium and water balance? - ANS ✓causes deficit= concentration and dilution ability diminishes What are the signs and symptoms of CKD? - ANS ✓fatigue, worsening signs of volume overload/edema, and HTN, and/or pruritis; when GFR falls below 15,
Bio Helps form protein free fluid. Fluid volume, electrolyte balance and ph What part of the nephron is the least extended into the medulla? - ANS ✓cortical nephron What part of the nephrons extend the furthest and tries to concentrate the most urine and preserve water?? - ANS ✓juxtamedullary nephrons What is are the nephrons made up of? - ANS ✓cortical, midcorticol, juxtamedullary nephrons What is makes up the renal corpuscle? - ANS ✓the glomerulus, the bowman capsule, and the mesangial cells. What are mesangial cells? - ANS ✓They secrete ____ matrix and lie between and support the glomerular capillaries (connective tissues cells). Some contract similar to smooth muscle cells to regulate glomerular capillary blood flow. Part immune cell: they have phagocytic properties and release inflammatory cytokines and growth factors. And signal as to what gets filtered and how fast the rate of renal blood flow.
Bio What does the Bowman's capsule do? - ANS ✓helps to contain and capture any fluid that leaks out of the glomerulus What is the glomerulus? - ANS ✓ball of capillaries, that filters fluid out of the capillary. What are principle cells and where are they found? - ANS ✓found in distal tubule and reabsorb sodium and secretes potassium (Works with aldosterone) What are intercalated cells? - ANS ✓secrete H+ and reabsorb K and HCO (involved in acid base) What do juxtaglomerular cells do? - ANS ✓release renin Have the ability to constrict the glomerular capillaries when needed by sensing pressure in the afferent tubules. Modified smooth muscle cells What does the macula densa do? - ANS ✓senses sodium levels =determine the need to increase or decrease the flow rate
