Log in
HomeClass Notes1,200,000AU40,000

EHR522 Lecture Notes - Lecture 4: Natriuresis, Cardiac Output, Hypertension

42 views9 pages
School
CSU
Department
EHR
Course
EHR522
Professor
Lindsay

For unlimited access to Class Notes, a Class+ subscription is required.

Document Summary

Heart disease and kidney disease: reciprocal link between cardiovascular disease and kidney disease, both share common risk factors. Smoking, obesity, diabetes, hypertension: heart failure so common in ckd patients term cardiorenal syndrome (crs) used. Chronic hypertension is caused by kidney dysfunction: chronic hypertension or high blood pressure when readings 135/90 and above, shortened life expectancy, effects of hypertension: Damage to blood vessels in the brain, causing stroke. Injury to kidneys leading to chronic renal disease. Hypertension: fluid build-up in body increases arterial pressure and increases cardiac output. Increased cardiac output then reduces pressure: peripheral resistance begins to increase, after a number of weeks however. Increased peripheral resistance: but left with hypertension. Function: excess weight gain and sedentary lifestyle. 65-75% of risk of developing hypertension: obesity causes: Cardiac output to increase due to extra required blood flow. Sympathetic nerve activity in kidneys is increased. Angiotensin and aldosterone levels increase 2- 3 times.

Get access

Grade+
$40 USD/m
Billed monthly
Grade+
Homework Help
Study Guides
Textbook Solutions
Class Notes
Textbook Notes
Booster Class
10 Verified Answers
Class+
$30 USD/m
Billed monthly
Class+
Homework Help
Study Guides
Textbook Solutions
Class Notes
Textbook Notes
Booster Class
7 Verified Answers

Related Documents

EHR522 Lecture Notes - Lecture 3: Acute Kidney Injury, Peritoneal Dialysis, Hemodialysis
magentaarmadillo146
EHR522 Lecture Notes - Lecture 12: Antihypotensive Agent, Medication Therapy Management, Edema
magentaarmadillo146
EHR522 Lecture Notes - Lecture 13: Edema, Calcium Metabolism, Medication Therapy Management
magentaarmadillo146

Related Questions

6. The site for countercurrent multiplier and exchange in the nephron is ________.
a. proximal tubule b. nephron loop and vasa recta c. distal tubule & collecting duct

7. The function of the kidneys is evaluated by measuring the
a. tubular reabsorption b. tubular secretion c. glomerular filtration rate

8. Abnormal amount of leukocytes in urine is termed _____.
a. ketonuria b. hematuria c. pyuria d. glycosuria e. nitrituria

9. In diabetes mellitus the clinical term for the abnormal urinalysis is called ________.
a. ketonuria b. hematuria c. pyuria d. glycosuria e. proteinuria

10. The possible cause of increase ____________ in urine is liver pathology o gallstones.
a. bile b. erythrocytes c. nitrites d. glucose e. protein

11. Proteinuria is caused by increase glomerular permeability due to kidney trauma, heavy mental, toxins, exertion, hypertension or glomerular nephritis.
a. True b. False

12. The normal pH of urine ranges from _____ to _____.
a. 2.2, 4.5 b. 10.3, 13.5 c. 8.0, 10.2 d. 4.5, 8.0 e. 6.0, 7.0

13. The average specific gravity of urine is slightly higher than 1.000 because the solutes it contains.
a. True b. False


14. __________ is the term for the normal smell of fresh urine.
a. Asparagus b. Nitrites c. Urinoid d. Ammonia

15. The concentration of this pigment in urine change the color of it.
a. Urinoid b. Nitrites c. Urobilin d. Calcium

16. The failure of a kidney to develop is termed _________________.
a. renal agenesis b. horseshoe kidney
c. supernumerary kidney d. pelvic kidney

17 Renal ptosis refers to the ___________ movement of the kidney within the abdominal cavity.
a. anterior b. posterior c. superior d. inferior

18. Renal failure refers to the diminish o absent renal function caused by the destruction of about ___ of the kidney.
a. 20% b. 40% c. 60% d. 90%

19. Renal calculus may occur from crystallized glucose after high levels in blood.
a. True b. False

20. An untreated UTI that spread to the kidneys is termed ____________.
a. urethritis b. cystitis c. pyelonephritis d. dysuria

21. Pain is an associated symptom of an UTI, and this is termed as __________.
a. urethritis b. cystitis c. pyelonephritis d. dysuria

22. Incontinence refers to ___________ whereas retention refers to____________
a. inability to involuntary control urination, failure to eliminate urine normally.
b. failure to eliminate urine normally, inability to voluntary control urination
c. inability to voluntary control urination, failure to eliminate urine normally
d. failure to eliminate urine normally, inability to involuntary control urination

23. All of the following are physical characteristics of urine except:
a. Color and transparency b. Odor c. pH d. specific gravity e. taste

24. Preformed water includes the water absorbed from food and drink whereas metabolic water includes the water from cellular respiration and dehydration.
a. True b. False

25. Sensible water los is not measured. In contrast insensible water loss is measured and includes sweat and transpiration.
a. True b, False

26. ____________ water loss is dependent upon the degree of hydration and is hormonally regulated in the tubules and collecting ducts of the kidney.
a. Sensible b. Insensible c. Obligatory d. Facultative
27. ___________ water loss is a loss of water that always occur regales of the state of hydration of the body.
a. Sensible b. Insensible c. Obligatory d. Facultative

28. Fluid is lost from the body through the following normal mechanism except:
a. breathing b. sweating c. defecation d. urination e. vomiting

29. ¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬The stimuli that activates the thirst center include all of the following except:
a. decreased salivary secretions b. distention of the stomach
c. increased blood osmolality d. decreased blood pressure

30. Stimuli for inhibiting the thirst center are produced when fluid intake is greater than fluid output.
a. True b. False

31. Fluid balance is regulated by monitoring blood volume, blood pressure, and blood plasma osmolarity.
a. True b. False

32. This electrolyte imbalance can lead to confusion, coma, paralysis of breathing muscles, and death.
a. hypenatremia b. hyperkalemia c. hypercalcemia d. hypocalcemia

33. _____________ may cause muscle weakness and irregular heart beat that can lead to cardiac arrest.
a. Hyponatremia b. Hyperkalemia c. Hypercalcemia d. Hypokalemia

34. Numbness, tingling, increase heat rate, and muscle spasm that can lead to tetany is caused by _____.
a. hypenatremia b. hyperkalemia c. hypercalcemia d. hypocalcemia

35. If a patient needs IV fluids like 0.9% saline solution it means the solution contains 0.9 gr of _______ to every 100 ml of sterile water.
a. glucose chloride b. calcium chloride c. potassium chloride d. sodium chloride

36. Which of the following individual will be more vulnerable to dehydration?
a. Young adults b. Middle-aged adults c. Elderly d. Infants e. c & d

37. Diabetes insipidus refers to:
a. hypersecretion of insulin b. hyposecretion of antidiuretic hormone
c. hyposecretion of insulin d. hypersecretion of antidiuretic hormone
e. none of the above

38. During vomiting the major loss is ___________ whereas in diarrhea there is an extensive loss of ________.
a. hydrochloric acid (HCl), bicarbonate (HCO3) b. bicarbonate (HCO3), hydrochloric acid (HCl)
c. bicarbonate (HCO3), glucose d. hydrochloric acid (HCl), sodium



39. Lactic acidosis results from:
a. prolongs intense exercise b. congestive heart failure
c. insufficient insulin production d. a & b e. a, b & c

40. Ketoacidosis results from:
a. prolongs intense exercise b. congestive heart failure
c. insufficient insulin production d. a & b e. a, b & c

41. In respiratory alkalosis, respiratory rate increases and blood __________ _____________.
a. CO2 increases b. CO2 decreases
c. O2 increases d. O2 decreases e. none of the above

42. Metabolic acidosis compensate with _____________ ______________.
a. respiratory acidosis b. respiratory alkalosis
c. metabolic acidosis e. metabolic alkalosis e. none of the above

43. The step in the digestive process that deals with a series of catabolic steps in which complex food molecules are broken down into their chemical building blocks by enzymes secreted into the lumen of the alimentary tract is called
a. Propulsion b. Ingestion c. Chemical digestion d. Defecation e. Absorption

44. ________________ is the passage of digestive end products from the lumen of the GI tract by active or passive transport into the blood or lymph.
a. Propulsion b. Ingestion c. Chemical digestion d. Defecation e. Absorption

45. In which part of the digestive tract is chemical digestion essentially completed?
a. stomach b. pancreas c. liver d. small intestine e. large intestine

46. The organ that carries most metabolic function in the body is the
a. stomach b. liver c. small intestine d. pancreas

47. The main function of these organs is propulsion: peristaltic waves move food bolus to stomach accomplishing the phase of deglutition
a. Mouth and associated accessory organs b. Pharynx and esophagus
c. Stomach d. Small intestine e. Large intestine

48. Which hormone will be secreted especially if the bolus contains proteins?
a. gastrin b. cholecystokinin c. secretin

49. The following target organs are stimulated by secretin except:
a. stomach b. pancreas c. liver d. gallbladder

50. The stimulus of chime containing amino acids and fatty acids entering the small intestine releases ____________.
a. gastrin b. cholecystokinin c. secretin

51. The cells that produce intrinsic factor, important in the absorption of B12, is the ______ cells.
a. surface mucous b. mucous neck c. parietal d. chief e. G-cells

52. The most numerous of the secretory cells within the gastric glands, which produce zymogen are:
a. surface mucous b. mucous neck c. parietal d. chief e. G-cells

53. The following are functions of hydrochloric acid except:
a. activates pepsinogen b. kills microorganism
c. prevents ulceration of the stomach d. denatures proteins

54. Barrett esophagus refers to an advance case of GERD in which the epithelium changes from columnar secretory to stratified squamous.
a. True b. False

55. Gastric and duodenal ulcer are both peptic ulcers; the difference is that one occurs in the stomach and the other in the first part of the duodenum respectively.
a. True b. False

56. The following are common complication of advanced liver cirrhosis except:
a. jaundice b. edema c. ascites d. gastritis e. intense itching

57. Most cases of appendicitis occurs because fecal matter obstructs the appendix. As the inflammation worsens the parietal peritoneum becomes inflamed as well.
A. True b. False

58. The majority of colorectal cancer appears in the following areas except:
a. descending colon b. sigmoid colon c. rectum d. proximal ileum

59. Polyps are outgrowths from the colon mucosa whereas diverticulosis are bulges in the intestinal lining.
a. True b. False

60. Celiac disease is an autoimmune disorder. The damage in the small intestine is the smooth muscle which interferes with absorption.
a. True b. False



1. Martha’s first patient on the pediatric floor is a 12-year oldboy named Sam who is undergoing kidney dialysis treatment. Sam hasbeen on dialysis for the last week, and the treatments willprobably be discontinued because his kidneys are becoming fullyfunctional again. Martha questions Sam’s mother concerning hisillness. Three weeks ago, Sam had a sore throat, which kept himhome from school for two days but was not medically treated. Oneweek ago, Sam told his mother his urine looked red-brown and foamy.He was admitted to the hospital. Physical exam revealedcostovertebral tenderness and blood pressure of 135/90. Theurinalysis and other studies revealed the following:

Color: red-brown tinged
Specific gravity: 1.030
RBC’s: numerous RBC’s per high powered field
Protein: > 1g/24 hr
Casts: epithelial cells and RBC’s
BUN: 90 mg/dl
Creatinine: 4mg/dl
Creatine Clearance Test: 50 ml/min


a. What is your diagnosis?
i. Glomerulonephritis
ii. Cystitis
iii. Urinary obstruction
iv. Pyelitis

b. The etiology would be a(n):
i. Virus
ii. Bacteria
iii. Genetic or developmental anomaly
iv. Anatomic malfunction after birth


2. Fred suffers from chronic emphysema. His arterial blood gasresults are as follows: pH 7.30; bicarbonate 32 mEq/l; PCO2 50 mmHg. Which of the following best describe Fred’s condition?
a. Metabolic acidosis with respiratory compensation
b. Respiratory acidosis with metabolic compensation
c. Metabolic alkalosis with respiratory compensation
d. Respiratory alkalosis with metabolic compensation

3. Hypocalcaemia may develop in a patient with which of thefollowing conditions?
a. Chronic renal failure
b. Hyperparathyroidism
c. Thiazide therapy
d. Vitamin D overdose

4. Which of the following conditions would cause prerenalfailure?
a. Nephrotoxicity
b. Glomerulonephritis
c. Acute tubular necrosis
d. Hypovolemia

5. Abnormal serum laboratory findings common to patients with acuterenal failure are:
a. Increased potassium and BUN; decreased creatinine
b. Increased potassium and creatinine; decreased BUN
c. Decreased potassium; increased BUN and creatinine
d. Increased potassium, BUN and creatinine

6. In the diuretic phase of acute tubular necrosis (ATN), theclinician must be alert for which of the followingcomplications?
a. Fluid overload
b. Hypokalemia
c. Hypertension
d. Hypernatremia

7. The primary acid-base disorder associated with renal failureis:
a. Respiratory acidosis
b. Metabolic acidosis
c. Respiratory alkalosis
d. Metabolic alkalosis

8. Patients with acute renal failure may have all of the followingcomplications EXCEPT:
a. Peaked T wave EKG and pericarditis
b. Sinus tachycardia and ST elevation
c. Heart failure and Friction rub
d. Mitral insufficiency and Mobitz type II heart block

9. A patient’s glomerular filtration rate can be measure byevaluating:
a. Serum creatinine
b. Blood urea nitrogen
c. Serum osmolarity
d. Creatinine clearance

10. A patient taking medication that acts to block or inhibit theaction of aldosterone would:
a. Have high blood potassium levels
b. Have high blood sodium levels
c. Have high levels of circulating aldosterone
d. A, B, and C
e. A and C only

11. A patient exhibits the following signs and symptoms: Elevatedblood pressure, elevated blood glucose, muscle weakness, poor woundhealing, red cheeks, thin arms and legs with fat deposits in thetrunk, neck and face. The patient findings are consistentwith:
a. Addison’s Disease
b. Myxedema
c. Cushing’s disease or long-term high dose steroid use
d. Grave’s disease
e. Pheochoromocytoma

12. The MOST dramatic functional change that occurs in theendocrine system due to aging is
a. A decrease in blood and tissue concentrations of ADH andTSH
b. And overall decrease in circulating levels of mosthormones.
c. A decline in the concentration of reproductive hormones
d. And increase in the secretion of glucocortioids