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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
ID
14470
Card Set
Pathophys Test 3
Description
Renal 6-11
Updated
2010-04-14T15:50:54Z
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