Renal Pathology and Pharmacology

Question 1

What is oliguria?

Answer 1

production of abnormally small amounts of urine?

Question 2

What is polyuria?

Answer 2

production of abnormally large volumes of dilute urine

Question 3

What is proteinuria?

Answer 3

presence of protein in the urine; protein should not be in the urine

Question 4

what is hematuria?

Answer 4

blood in the urine; it should not be present

Question 5

What are the primary blood tests used to evaluate kidney function?

Answer 5

blood urea nitrogen and creatinine

Question 6

What is the indicator of the number of functional nephrons in the kidney?

Answer 6

GFR- glomerular filtration rate

Question 7

How is GFR determined?

Answer 7

;by measurement of creatinine clearance

Question 8

What does a rising creatinine level indicate?

Answer 8

it indicates a decreasing GFR

if creatinine production is constant, then plasma concentration is inversely proportional to GFR

Question 9

blood urea nitrogen (BUN)

Answer 9

urea is formed by the liver and eliminated by the kidneys to increase BUN and decrease GFR

Question 10

What can increase BUN?

Answer 10

increased dietary protein
GI bleeding
dehyrdation

Question 11

What do diuretics do?

Answer 11

increase urine volume

normal urine production is 1.5-2L/day

Question 12

How do osmotic diuretics work?

Answer 12

they are given by an IV to reduce intracellular water volume. This non-reabsorbable solute is filtered into tubular fluid to stay in the tubule so that water will follow
-used to decrease intracranial pressure

Question 13

how do carbonic anhydrase inhibitors work?

Answer 13

they inhibit NaHCO3 reabsorption in the proximal convuluted tubule to decrease glaucoma and CSF
results in retention of water
weak diuretic

Question 14

How do loop diuretics work?

Answer 14

these are the most potent diuretics that act more proximally in the nephron
they affect the Na/K/Cl co-transporters so that water is held in the tubular fluid to produce diuresis

Question 15

What results from loop diruetics?

Answer 15

diruresis and loss of K+

used to manage heart failure

Question 16

How do thaizide diuretics (hydrochlorothiazide) work?

Answer 16

inhibits NaCl transporters at the luminal membrane of the distal convuluted tubule
used to manage HTN
most commonly used diuretics

Question 17

What is ADH (vasopressin) antagonist used to treat?

Answer 17

hyponatremia or edema

also Syndrome of inappropriate ADH secretion(SIADH)

Question 18

Where can kidney stones cause obstruction?

Answer 18

the renal pelvis, ureters or urethra

Question 19

what can cause kidney damage?

Answer 19

urine stasis and increased risk of infection

increased pressure in the urinary tract

Question 20

What are the types of stones in nephrolithiasis?

Answer 20

calcium oxalate (most common)
magnesium ammonium phsophate
uric acid
cystine

Question 21

What are the symptoms of kidney stones

Answer 21

pain is primary and varies with location

Question 22

what is glomerulonephritis?

Answer 22

a group of diseases resulting in inflammation and injury to glomeruli
it is a leading cause of acute and chronic renal failure

Question 23

What causes glomerulonephritis?

Answer 23

commonly due to an immune system attack on glomerular antigens (occurs
in lupus) or trapping of circulating antigen-antibody complexes in glomeruli
(post-strep infection, more common)

Question 24

What is azotemia?

Answer 24

accumulation of nitrogenous wastes in the blood; elevated BUN

Question 25

what is nephrotic syndrome?

Answer 25

non-inflammatory dysfunction of glomerular cells that results in
- gross proteinuria is the major characteristic
• albumins, globulins, fibrinogen all lost in urine
-hyperlipidemia and increased LDL
primary disease occurs the most in children

Question 26

how can hypertension cause renal disease?

Answer 26

causes sclerotic changes in glomeruli resulting in a decrease in
GFR and decreased blood flow to the nephron resulting in
- azotemia
- proteinuria
- loss of concentrating ability
- increased frequency of urination