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BMS 615 Cardiovascular > Test2: Wk6: 2 Glomerular Hemodynamics - Puri > Flashcards

Test2: Wk6: 2 Glomerular Hemodynamics - Puri Flashcards

1
Q

renal nerves are

A

sympathetic

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2
Q

renal nerves do (4)

A

vasoconstriction
⬆ Renin Secretion
⬆ Na reabsorption
pain fibers

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3
Q

Mesangial Cells function

A

Maintain structural
architecture of
glomerulus

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4
Q

Mesangial Cells Dz

A

IgA nephropathy

Diabetic nephropathy

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5
Q

Glomerular endothelial cells function

A

Fenestrations and glycocalyx

facilitate selective permeability and filtration

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6
Q

Glomerular endothelial cells Diseases (4)

A

ANCA-associated GN
Lupus nephritis
Hemolytic uremic syndrome
Diabetic nephropathy

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7
Q

GBM (glomerular Basement Membrane) Function

A

Regulates filtration

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8
Q

GBM Disease

A

Goodpasture Syndrome

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9
Q

Podocytes Function

A

Foot processes wrap around capillaries; slit diaphragm regulates filtration

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10
Q

Podocytes Disease (3)

A

Minimal change disease
FSGS
Membranous Nephropathy

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11
Q

Parietal epithelial

cells Function

A

Line Bowman’s capsule

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12
Q

Parietal epithelial

cells Dz

A

Crescentic GN

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13
Q

The renal system has two arterials in — and two vascular beds in —

A

series; series

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14
Q

Total renal resistance is the sum of

A

afferent and efferent arteriolar resistances

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15
Q

Step 1 and Step 2

A

Step 1: filtration

Step 2: Reabsorbtion

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16
Q

Plasma filtration at the glomerulus; essential for

A

essential for filtration of toxic metabolites

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17
Q

Reabsorption of essential solutes into in the —

A

peritubular capillaries

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18
Q

Normal GFR

A

125mL/min to 180L/day

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19
Q

how many times per day is the entire ECF filtered

A

> 10x

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20
Q

Peritubular reabsorption

A

As the tubules resorb solutes, including Na+, glucose and amino
acids, they accumulate in the peritubular interstitial space. From this interstitial space the solutes have to re-enter the peritubular capillaries for return to the
circulation.

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21
Q

steps in Na reabsorption from urine to the blood

A

3

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22
Q

Step 1 in Na+ reabsorption from the urine to blood

A

Na+ crosses the lipid bilayer at the brush border by cotransport or antiport

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23
Q

Step 2 in Na+ reabsorption from the urine to blood

A

Na+ exits the cell at the basolateral border via the Na+,K+ ATPase

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24
Q

Step 3 in Na+ reabsorption from the urine to blood

A

Once Na (and water) is in the interstitial space it can be absorbed from interstitium into blood with fluid following the balance of Starling forces or can back-leak (4)

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25
Q

Glomerular filtration depends on balance of

A

hydrostatic and oncotic pressures

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26
Q

The hydrostatic (capillary pressure) is dependent on — and the — around the capillaries.

A

plasma flow and the resistance of arterioles

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27
Q 
glomerular capillary
hydrostatic pressure (PGC) is
A

60mmHg

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28
Q

peritubular capillaries pressure

A

15 mmHg

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29
Q

increase blood flow — is not reached

A

filtration equilibrium

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30
Q

constrict blood flow to AA what happens to blood flow in EA

A

decrease

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31
Q

constrict blood flow to EA what happens to blood flow in AA

A

decrease

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32
Q

reduced renal plasma flow will reduce — more than increased plasma flow will increase it

A

GFR

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33
Q

change filtration by (2 ways) both are changed by

A

1 capillary pressure
2 blood flow through the capillary
both changed by AA and EA

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34
Q

AA and EA control both

A

glomerular plasma flow and glomerular filtration rate

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35
Q

total renal resistance =

A

AA + EA

36
Q

EA constriction GFR

A

will increase except when EA is constricted so much that that GFR falls - ex shock

37
Q

AA Constriction

A

⬇ PGC
⬇ GFR
⬇ RBF

38
Q

EA Constriction

A

⬆ PGC
⬆ GFR
⬇ RBF

39
Q

EA Dilation

A

⬇ PGC
⬇ GFR
⬆ RBF

40
Q

AA Dilation

A

⬆ PGC
⬆ GFR
⬆ RBF

41
Q

always solve for — first

A

RPF

42
Q

Filtration Fraction Equation FF =

A

FF = GFR / RPF

43
Q

Filtration Fraction is

A

the percent of plasma water flowing through the glomerular capillary that is filtered

44
Q

peritubular capillaries have — hydrostatic pressure

A

decreased

45
Q

peritubular capillaries have — oncotic pressure

A

increased

46
Q

increased oncotic pressure favors

A

reabsorption

47
Q

High filtration fraction means

A

more plasma filtered at glomerulus and protein is more concentrated in peritubular capillaries

48
Q

High filtration fraction = — = —

A

higher oncotic pressure = higher Na reabsorption

49
Q

low filtration fraction = — = —

A

lower oncotic pressure = less Na reabsorption

50
Q

FF for high Na diet

A

low

51
Q

FF for low Na diet

A

high

52
Q

— FF is desired during reduced MAP/ CO and reduced Na and vice a versa

A

high

53
Q

4 Systems that regulate GFR/RPF and FF

A
  1. RAAS
  2. SNS
  3. Arginine Vasopressin AVP
  4. Atrial Natriuretic Peptide ANP
54
Q

RAAS, SNS, and AVP — FF by and — Na

A

increase FF by constricting EA conserve Na

55
Q

ANP dilates — and constricts — resulting in

A

AA, EA
⬆⬆ GFR
⬆ RPF
⬆FF

56
Q

ANP is supposed to get rid of Na but increases FF

A

doesn’t change Na reabsorption at this step but effects the late nephron

57
Q

Angiotensin II — both AA and EA but is preferential for — of —

A

constriction, constriction, EA

58
Q

Angiotensin II is a strong

A

vosoconstrictor

59
Q

Angiotensin II effect on GFR

A

GFR falls slightly or doesn’t change

maintain GFR

60
Q

when is Angiotensin II activated

A

when volume depleted ➡ CO falls ➡ GFR decreases

61
Q

SNS — GFR and RPF by — AA and EA resulting in — FF

A

decrease; constrict; increased

62
Q

if SNS is maximally activated what happens

A

shut down kidney, massive constriction GFR is almost 0

63
Q

what protects the kidney during state of SNS shock

A

prostaglandin system

64
Q

— and — oppose vasoconstriction of AA induced by SNS and ANGII

A

PGI2 and PGE2 - dilate AA

65
Q

NSAIDS during shock

A

block prostaglandins

66
Q

NSIADS in kidney Dz

A

no

67
Q

Tubuloglomerular feedback Mechanism

A

the myogenic response regulates GFR by negative feedback

68
Q

Macula Densa produces (2)

A

Renin and ANGII

69
Q

master regulator of Renal System

A

Macula Densa

70
Q

Macula Densa is part of the — and touches the —

A

thick ascending limb, AA

71
Q

Macula Densa exchanges information between

A

blood and urine

72
Q

clearance estimates the volume of

A

plasma that contained that much of a substance at plasma concentration

73
Q

clearance =

A

Clearance = Ux x V / Px

74
Q

Filtered Load =

A

GFR x Plasma Conc.

75
Q

Excreted load =

A

V x urine conc.

76
Q

Fx > Ex

A

net tubular absorption

77
Q

Fx < Ex

A

net tubular secretion

78
Q

Ex = Ex

A

used to calculate GFR - inulin

79
Q

increase plasma inulin concentration; what happens to inulin clearance

A

unchanged - inulin clearance is independent of plasma concentration

80
Q

Creatinine is — related to GFR

A

inversely

81
Q

Creatinine can be used to estimate

A

GFR

82
Q

Creatinine — GFR by —

A

overestimate by 10%

83
Q

if GFR falls plasma creatinine will

A

rise

84
Q

Fractional excretion Na <1%

A

renal hypo-perfusion

85
Q

fractional excretion Na >2%

A

acute tubular necrosis

BMS 615 Cardiovascular (49 decks)

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