19.0 Module Overview

ANATOMY & PHYSIOLOGY II · MODULE 19

Not a trace. An alarm.

A routine urinalysis at forty-seven showed a trace of protein, noted and left for someone to recheck sometime. This module builds the kidney and follows that single line to the most serious complication in the whole case.

Her kidneys look fine from the outside: two well-sized organs, clean architecture, no stones, no obstruction. But the quantified protein climbs over months from a trace into the nephrotic range, and a biopsy finds AA amyloid in the glomeruli.

This is the chapter the whole course has been moving toward. Years of elevated serum amyloid A, produced faithfully by an acute-phase response that never switched off, have been depositing in the filter. Renal AA amyloidosis is the defining, life-threatening complication of untreated FMF — and it announced itself as a line nobody chased.

PATIENT CHART · STINA · CHART CLUE #19

  • Age 47 — Trace protein on routine urinalysis
  • Months — Protein climbing to nephrotic range
  • Imaging — Kidneys structurally normal
  • Biopsy — AA amyloid in the glomeruli

Each part opens with a finding from Stina’s chart and asks you to commit to a prediction before any video plays, then alternates short videos with H5P activities. Work them in order.

19.1

A Little Protein in the Urine

One line on a routine report, and where it leads.

URINALYSIS

OPEN →

19.2

The Kidney from the Outside In

Gross anatomy, blood supply, and the path of urine.

KIDNEY ANATOMY

OPEN →

19.3

The Nephron and the Filtration Barrier

The three layers protein should never cross.

GLOMERULUS

OPEN →

19.4

Reabsorption, Secretion, and How Urine Is Made

Filtration is blind; the tubule does the sorting.

TUBULAR FUNCTION

OPEN →

19.5

Master Regulator

Blood volume, blood pressure, and the kidney’s slow control.

FLUID REGULATION

OPEN →

19.6

When the Filter Breaks

Renal AA amyloidosis, localized to the glomerular barrier.

AMYLOIDOSIS

OPEN →

19.7

Not a Trace, an Alarm

The dismissed trace revealed as the alarm it was.

CHART CLUE #19

OPEN →

The Evidence Behind the Case

Every step of this module’s reasoning, paired with the peer-reviewed literature behind it.

REFERENCES

OPEN →

By the end of Module 19 you will be able to:

1

Describe the gross anatomy of the kidney, ureters, bladder, and urethra.

2

Identify the parts of the nephron and describe the glomerular filtration barrier.

3

Explain glomerular filtration, tubular reabsorption, and tubular secretion.

4

Describe how the kidney regulates blood volume and blood pressure.

5

Explain proteinuria in terms of a failing filtration barrier.

6

Describe AA amyloidosis and its relationship to a sustained acute-phase response.

List of terms