Pathophys Test 3

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What are the systemic and local effects of angiotensin II? (p.20)
- Powerful vasoconstrictor – one of the most powerful known to men
- Causes rapid vasoconstriction by acting on vascular smooth muscle --> increases BP
- Stimulates adrenals to release aldosterone --> increases Na+ reabsorption in distal tubules --> water reabsorption
- Net effect = increased vascular volume --> increased BP
Angiotensin II - functions
- Increased Na+ reabsorption
- Increased H2O reabsorption
- Increased vascular volume
- Increased BP
What is the effect of ADH in the collecting ducts?

Increased H2O reabsorption
Review disorders for glomerular and renal function. (p.8-10)
- Glomerulonephritis – autoimmune disease
- o Capillary wall injured = increased membrane permeability
- o Can result in permanent kidney damage
- o Inflammatory condition
- o Classic form develops in child 1-4 weeks after Group A Streptococcus infection
- o Kidney can be primary organ or secondary
Know significance of blood creatinine level as marker for renal function. (p.2-3)
- Average creatinine clearance = 120 mL/min
- Approximates GFR of 90 – 130 mL/min
- Good marker for evaluating renal function
- If GFR falls, creatinine clearance overestimates
- Gold standard to measure creatinine clearance = 24-hour urine
Review sequence of events that take place in an inflammatory process that leads to glomerular injury. (p.10)
- (1) Endothelial cells and epithelial cell damage
- (2) Increased glomerular permeability to proteins
- (3) Accumulation of proteins in surrounding matrix with deposition of fibrin
- (4) Proliferation of mesangial cells
- (5) Sclerosis
Goodpasture's Syndrome (p.10)
- Autoantibodies react with basement membrane of glomerulus and basement membrane of lung alveoli
- Lesions develop at same time in both lung and kidney
Nephrotic Syndrome - clinical findings (p.11)
- Massive amounts of proteinuria
- o Daily loss of protein in urine can be 3.5 grams or more
- o Immunoglobulins lost in urine --> increased susceptibility to infections
- o Plasma proteins loss --> pro-coagulation and anti-coagulation imbalance --> increased arterial/venous thrombosis
- Generalized edema (most obvious sign)
- Hypoalbuminemia - plasma levels < 3 g/dL
- o Normal = 3.4 – 5.4 g/dL
- Hyperlipidemia and lipiduria
- o Proteinuria --> increased synthesis in liver --> VLDL --> hyperlipidemia
- o VLDL = look for nephrotic syndrome
Causes of Nephrotic Syndrome - children vs. adults
- Children <15 y.o. = cause R/T primary lesion in kidney
- Adults = cause secondary to systemic disease, especially diabetes and systemic lupus erythmatosus
Nephritic Syndrome - clinical findings
- Hematuria –
- o Initially microscopic
- o Produces cola-colored urine
- Some degree of oligura and azotemia
- Hypertension
- (Less likely to have generalized edema)
Nephritic syndrome - causes
- Primary lesion of glomerulus
- Secondary to systemic disease
- Post-streptococcal glomerulonephritis developing in children after Group A streptococcal infection

Author

cgordon05

14470

Card Set

Pathophys Test 3

Description

Renal 6-11

Updated

2010-04-14T15:50:54Z

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