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Elderly female presents blood in urine, history of osteoporosis, chronic…
Elderly female presents blood in urine, history of osteoporosis, chronic DM II, and high BP. Kidney function? BP? Bone mass?
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Nephron structure
The microscopic, functional filtration unit of the kidney; each consists of two major structures: a renal corpuscle and a renal tubule
Renal corpuscle
an enlarged, bulbous portion of a nephron housed within the renal cortex. the glomerular capsule (Bownman capsule) is formed by an internal visceral layer directly lining the glomerular capillaries and external parietal layer composed of simple squamous epithelium. consists of a vascular pole and tubular pole where the renal tubule originates
Renal tubule
portion of the nephron composed of the proximal convoluted tubule (PCT), nephron loop, and distal convoluted tubule (DCT)
Filtration
Movement of substances from the blood within the glomerulus into the capsular space. Occurs in the glomerulus by passive transport, blood enters the glomerulus by an afferent arteriole and exits by an efferent arteriole
Reabsorption
The movement of substances from the tubular fluid back into the blood; bulk reabsorption occurs mainly in the PCT by active and passive transport
Secretion
Movement of solutes out of the blood within the peritubular and casa recta capillaries into the tubular fluid. Occurs in the PCT by active transport; secreted substances include potassium ions and hydrogen ions
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Underlying Conditions
Osteoporosis
Porous bones, results in decreased bone mass and causes weakened bones prone to fracture; The occurrence of osteoporosis is highest among elderly, postmenopausal women as they no longer produce estrogen to stimulate bone growth
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Hypertension
BP over 120/80, increased amount of force placed by blood on blood vessels as it moves through the body; causes blood to exert excessive pressure against vessel walls, forcing the heart to work harder to maintain pressure
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Blood in urine
Likely caused by albumin passing through the nephron and into the urine during filtration due to kidney disease or failure
If nothing changes
Kidney failure, cardiovascular disease, loss of eyesight, necessary amputation of lower or upper extremities, increased risk of cardiac arrest/attack, stroke, death
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