Chapter 44 - Anatomy and Physiology of the
Kidneys and Urinary Tract
Chapter 45 - Diagnostic Procedures in Renal
Disease
Chapter 46 - Chronic Renal Failure
Chapter 47 - The Uremic Syndrome
Chapter 48 - The Treatment of Chronic Renal
Failure
Endocrine Lecture Objectives - Spring 2000
Chapter 58
- Principles of Endocrine and Metabolic Control Mechanisms
Chapter
63 - The Pancreas--Glucose Metabolism and Diabetes Mellitus
Review normal anatomy and physiology of the urinary system from Chapter 44 and previous courses.
Students should be able to do the following. Information will come from the text and lecture. Answers to self-test questions at the end of each chapter are at the back of the text.
Chapter 44 - Anatomy and Physiology
of the Kidneys and Urinary Tract
1. List and briefly describe seven kidney functions.
2. List and briefly describe the functions of the parts of nephrons and collecting ducts.
3. Explain the operation of the juxtaglomerular apparatus and the renin-angiotensin system.
4. Explain the operation of the ADH mechanism.
Chapter 45 - Diagnostic Procedures in Renal Disease
1. List four predisposing factors contributing to urinary tract calculi formation.
2. List, briefly describe, and explain the basis of the main problems resulting from urinary tract calculi.
3. Name and briefly describe the physiologic significance of each of the following tests on urine: protein, blood, pH, specific gravity, casts, bacterial tests.
4. Name and briefly describe the physiologic significance of each of the following grouped kidney tests: a) Creatinine clearance and blood urea nitrogen (BUN); b) PAH, concentration and dilution, acidification and sodium concentration tests; and c) intravenous and retrograde pyelogram, renal arteriogram, and renal biopsy.
Chapter 46 - Chronic Renal Failure
1. Briefly describe the difference between acute renal failure and chronic renal failure.
2. List the three parts of the kidney that are the first sites of disease leading to chronic renal failure.
3. Indicate that and explain why regardless of which part of the kidney is first diseased in chronic renal diseases, all parts finally become diseased.
4. List and describe the three stages in chronic renal disease.
5. List the five most common diseases resulting in chronic renal failure and three other causes of renal failure. 6. For each of the following, give the causes, pathogenesis, pathophysiology, signs and symptoms, and final results: acute glomerulonephritis, chronic glomerulonephritis, hypertensive kidney, polycystic kidney, hydronephrosis, acute pyelonephritis, chronic pyelonephritis.
7. Describe how the renin-angiotensin mechanism and the ADH mechanism lead to a worsening of the condition of a person with chronic renal failure.
8. List, briefly describe and explain the mechanism of the following factors predisposing to urinary tract infection: stricture, calculi, neoplasms, prostatic hypertrophy, sex differences, pregnancy, urine refluxing, catheterization and cystoscopy, neurogenic bladder.
9. Describe the causes, pathogenesis, and pathophysiology of the nephrotic syndrome.
10. Describe the histologic condition of an end-stage kidney.
11. Define, "give," and "match" renal reserve, renal insufficiency, renal failure, azotemia, polyuria, oliguria, anuria, nocturia, GFR, end stage kidney, urea, uremic syndrome, nephrotic syndrome, proteinuria, albuminuria, cylindruria, glomerulonephritis, pyelonephritis, polycystic kidney, hypertensive nephrosclerosis, hydronephrosis, cystitis.
Chapter 47 - The Uremic Syndrome
1. Indicate that both glomerular and tubule abnormalities are involved in producing the uremic syndrome.
2. Indicate that the uremic syndrome results in loss of regulation of levels of body chemicals.
3. List seven biochemical changes associated with the uremic syndrome.
4. Briefly describe and give the results of abnormalities of each of the following chemicals: water; sodium; potassium; acid-base balance; creatinine and urea; uric acid; blood proteins.
5. Explain the meaning of a constant urine specific gravity of 1.010.
6. List seven systems (not "Biochemical" or urinary ) that are affected by the uremic syndrome and give one example of a change in each. (Table 47- 1, p. 724)
Chapter 48 - The Treatment of Chronic Renal Failure
1. Briefly describe the first and subsequent stages in the treatment of chronic renal failure and explain the rationale for each. Chapter 49 - Acute Renal Failure
1. List, briefly describe the three general causes of acute renal failure.
2. List and briefly describe the four possible phases in acute renal failure (oliguric phase, diuretic phase, recovery phase, renal failure).
3. Briefly describe and explain the pathogenesis and various outcomes of acute renal failure caused by each of the three general causes.
4. Briefly describe the first and subsequent stages in the treatment of acute renal failure and explain the rationale for each. (These are the same as those for chronic renal failure.)
Endocrine Lecture Objectives -
Chapter 58 - Principles of Endocrine and Metabolic Control Mechanisms
1. Briefly describe the treatment strategies for diseases caused by hormone excess and hormone deficiencies.
Chapter 63 - The Pancreas--Glucose Metabolism and Diabetes Mellitus
1. List the four major types of diabetes mellitus and explain the reasons for their various names.
2. List and briefly describe seven contributing factors in diabetes mellitus.
3. Briefly describe the mechanisms by which blood glucose levels are controlled including the pancreatic hormones involved, the cells which form each, and the effect of each on blood glucose levels.
4. List and briefly describe the four effects of insulin on cell chemistry and metabolism.
5. Briefly describe the mechanism by which blood glucose levels are affected in a diabetic, including items in Objective 3 above.
6. List the two biochemical alterations in the blood that occur in diabetics.
7. List, briefly describe, and explain the mechanisms leading to the final effects of hyperglycemia on five aspects of the body (kidney tubule function, capillaries, small blood vessels, large blood vessels, blood, nervous system, eyes, and bacterial growth).
8. List and briefly explain the reasons for the final effects of ketoacidosis in diabetes.
9. List, describe, and explain the reasons for the four cardinal signs and symptoms of diabetes mellitus.
10. Compare the onset of cardinal signs and symptoms and other effects of diabetes between the two major types of diabetes.
11. List and briefly describe the three goals of treatment
and the six treatment strategies in the treatment of diabetes mellitus,
including the reasons for each.
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