1. decreased acetylcholine
2. hypotention/bradycardia
3. absent Deep Tendon Reflexes
Manifestations of Hypermagnesemia (3)
1. tetany
2. hyperactive deep tendon reflexes
3. cardiac arrest
4. seizures
Manifestations of Hypomagnesemia (4)
Bowman's space
Fluid-filled space within bowman's capsule into which protein-free fluid filters from the glomerulus
Glomerular Filtration Rate
Rate at which kidneys are able to filter blood.
MARKER OF KIDNEY FUNCTION
constriction and relaxation of afferent and efferent arterioles
filtration pressure and GFR are determined by:
sodium, potassium, chloride, calcium, phosphate, glucose, amino acids
What is reabsorbed by active transport into the blood from renal tubules? (7)
water and urea
What is reabsorbed by passive diffusion into the blood from renal tubules?
hydrogen, potassium and uric acid
What substances are secreted into the tubular fluid back to blood? (3)
30-60 mL/hour
Average normal urine output
proximal convoluted tube
Where does most of tubular reabsorption occur?
End products of metabolism (Urate, Oxalate)
Exogenous compounds such as PCN, aspirin, morphine
What is secreted by proximal tubules?
more sodium and chloride reabsorption than water
What is the net effect of the LOOP of HENLEY?
Distal convoluted tubule
Place where action thiazide diuretics takes place.
It is impermeable to water and where urine is diluted.
Sodium, chloride and calcium are reabsorbed here.
collecting tubules (and end of the distal tubule)
Where is the site of aldosterone function.
SODIUM REABSORPTION-POTASSIUM SECRETION AND ELIMINATION takes place.
ADH
What determines urine concentration?
Osmolarity
Changes in blood pressure
Changes in blood volume
ADH responds to what 3 things?
renal clearance
The amount of a substance removed from the blood by the kidneys.
24 hour urine
What test can tell the function of the glomerulus to filter and the capacity of the renal tubules to reabsorb and secrete?
sodium and potassium elimination
Aldosterone regulates?
hydrogen, uric acid, urea
What are 3 things are eliminated by the kidney?
uric acid
What is a product of purine metabolism?
Gout
Too much uric acid in the blood gives you?
Stones
Too much uric in the kidneys gives you?
urea
What is the end product of protein metabolism?
urea
BUN
If GFR declines, what builds up? What can we look at to tell?
bacterial infection
If urine is more basic, it indicates?
nitrate
What is food for bacteria?
Renin-Angiotenson-Aldosterone Mechanism
Hormonal regulation of blood pressure
converts angiotensinogen to Angiotensin I
What does renin do?
After circulation throughout the lungs
When is Angiotensin II made?
Angiotensin II
A hormone that stimulates constriction of precapillary arterioles and increases reabsorption of NaCl and water by the proximal tubules of the kidney, increasing blood pressure and volume.
aldosterone secretion
What does angiotensin II stimulate?
ACE inhibitors
Blocks ACE enzyme, also blocks angiotensin II and bradykinin. Lowers blood pressure.
Erythropoietin
A hormone released by the kidneys that stimulates red blood cell production
Hypoxia
What stimulates erythropoietin?
kidney
What activates Vitamin D?
Low pH, protein in urine, high urine osmolarity, infection, stones
What can give you casts? (5)
kidney
reabsorbed
Creatinine is filtered by ______ , BUT not ______ by tubules.
50
If creatinine is doubled normal amount, _______% GFR declines.
75
If creatinine, is tripled, ______% of GFR declines.
03-Feb
What fraction of renal function loss has to occur before BUN significantly elevates?
Headache, seizure, coma
What are manifestations of a fat brain cell?
thirst
What are manifestations of a shrunken brain cell?
ventricular
Hyperkalemia causes what kind of fibrillation?
ECF
Electrolyte imbalances are in the________?
straw colored, clear
Normal urine color?
dehydration
Dark yellow urine means?
infection
cloudy or turbid urine means?
>180 mg/dL, Diabetes
A positive glucose in urine is________?
starvation or last meal > than 8-12 hrs. ago, Diabetes
Positive ketones in urine is from?
infection, kidney stone, bladder cancer, or menses
Positive blood in urine means?
jaundice or urine sample contaminated with stool
Positive bilirubin in urine means?
.5-4 mg/dL
Normal Urobilinogen level?
hemolysis or liver disease
High Urobilinogen level in urine means?
infection
Positive nitrate in urine means?
bacterial infection by gram negative rods particularly E. coli
Positive Leukocyte esterase in the urine indicates?
infection or stones
low pH, proteinuria, high specific gravity
RBC and WBC Casts in the urine means?
Hyaline casts means?
elevated serum calcium or uric acid "stones
Crystals in the urine means?
infection or contaminated sample
WBC's in the urine means?
contaminated sample
Epithelial cells in urine means?
infection, nephritis, nephrosis, glomerular injury
Positive protein in urine means.....