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Patho 3
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Review the
renin-angiotensin-aldosterone
mechanism.
(p.4)
JG apparatus --> [
renin
] --> [
angiotensin I
] --> lungs --> [
angiotensin II
] --> adrenals --> [
aldosterone
] --> tubules --> increase Na+ --> increase H2O (ADH) --> increase BP
What are systemic and local effects of
angiotensin II
? (p.20)
powerful vasoconstrictor
stimulates adrenals to release aldosterone
increases Na+ reabsorption
increases H2O reabsorption
increases vascular volume
increases BP
What is effect of ADH in collecting ducts?
Increased H2O reabsorption
Disorder of
glomerular
and
renal function
.
(p.8-10)
Glomerulonephritis
- autoimmune disease
capillary wall injured = increased membrane permeability
may result in permanent kidney damage
inflammatory condition
classic form develops in child 1-4 weeks after Group A Streptococcus infection
kidney can be primary or secondary organ
Know significance of
blood creatinine level
(
creatinine clearance
) as marker for
renal function
.
(p.2-3)
Average creatinine clearance = 120 mL/min
Approximates GFR = 90-130 mL/min
Good marker for evaluating renal function
If GFR falls, creatinine clearance overestimates
Gold standard - creatinine clearance = 24-hour urine
Review sequence of events in the inflammatory process that lead to
glomerular injury
.
(p.10)
endothelial and epithelial cell damage
increased glomerular permeability to proteins
accumulation of proteins in surrounding matrix with fibrin deposit
proliferation of mesangial cells
sclerosis
Goodpasture's Syndrome
(p.10)
Autoantibodies react with basement membrane of glomerulus and alveoli
Lesions develop simultaneously in kidney and lung
Nephrotic syndrome
- clinical findings
(p.11)
massive
proteinuria
generalized
edema
hypoalbuminemia
hyperlipidemia
and
lipiduria
Causes
of
nephrotoxic syndrome
Age dependent:
children <15 years - primary lesion in kidney
adults - secondary to systemic disease -- diabetes, lupus erythmatosus
Nephritic Syndrome
- clinical findings
hematuria - cola-colored urine
oliguria and azotemia - to some degree
hypertension
*less likely to have generalized edema
Causes
of
nephritic syndrome
primary lesion of glomerulus
secondary to systemic disease
common occurrence
from post-Streptococcal glomerulonephritis
developing in children after Streptococcal infection
Author
cgordon05
ID
16741
Card Set
Patho 3
Description
renal part 2
Updated
2010-04-29T23:11:05Z
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