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Apex Review > Kidney 2 > Flashcards

Kidney 2 Flashcards

1
Q

Which factor increases renin release?
a. positive end-expiratory pressure
b. hypervolemia
c. angiotensinogen
d. increased chloride delivery to the macula densa

A

a. positive end-expiratory pressure

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2
Q

____________________ located in the distal tubule, monitors renal perfusion, and solute concentration.

A

The juxtaglomerular apparatus

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3
Q

the juxtaglomerular apparatus maintains GFR by

A

modulating renal vascular resistance and renin release

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4
Q

The RAAS plays an integral role in regulating

A

systemic vascular resistance and the composition of the extracellular volume

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5
Q

Conditions that increase renin release include

A

decreased renal perfusion pressure
SNS activation
tubuloglomerlar feedback

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6
Q

Antidiuretic hormone controls serum osmolarity because it

A

increases reabsorption of water but not sodium

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7
Q

______________ is a steroid hormone that’s produced by the zona glomerulosa of the adrenal gland

A

Aldosterone

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8
Q

Aldosterone facilitates the

A

reabsorption of Na+ and water
excretion of K+ & H+

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9
Q

Unlike renal blood flow, __________ is not auto-regulated

A

urine output- instead there’s a linear relationship between UO & MAP

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10
Q

Urine output typically comes to a halt when MAP is

A

less than 50 mmHg

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11
Q

Angiotensinogen is produced in the

A

liver

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12
Q

Describe the RAAS system.

A

Renin released by the juxtaglomerular cells converts angiotensinogen into angiotensin 1
ACE release by the lungs converts angiotensin 1 to angiotensin 2

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13
Q

Angiotensin 2 leads to

A

vasoconstriction of peripheral vessels & efferent arteriole
release of aldosterone
release of ADH
Na+ reabsorption
thirst

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14
Q

Causes of tubuloglomerular feedback that lead to increased renin release are

A

decreased sodium and chloride in distal tubule

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15
Q

Causes of decreased renal perfusion pressure that lead to increased renin release include

A

hemorrhage
PEEP
CHF
liver failure with ascites
sepsis
diuresis

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16
Q

In addition to RAAS stimulation, aldosterone release is increased by

A

hyperkalemia
hyponatremia

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17
Q

Disorders of aldosterone release include

A

Conn’s disease- excess aldosterone production
Addison’s disease- destruction of cortical zones

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18
Q

Antidiuretic hormone
a. upregulates aquaporin-2 channels
b. is produced in the posterior pituitary gland
c. increases sodium reabsorption in the proximal tubule
d. agonizes the V1 receptor to decrease cAMP

A

a. upregulates aquaporin-2 channels

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19
Q

______________ is the principal determinant of osmolarity

A

Sodium concentration

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20
Q

Normal serum osmolarity is

A

280-290 mOsm/L

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21
Q

Antidiuretic hormone is released into the systemic circulation from the

A

posterior pituitary gland

22
Q

When is ADH released?

A

blood volume is decreased
osmolarity of the ECF is increased

23
Q

Perioperative factors that increase ADH release include

A

PEEP
positive pressure ventilation
hypotension
hemorrhage

24
Q

ADH restores blood pressure in two ways:

A
  1. V1 receptor stimulation causes vasoconstriction in the vasculature (increased SVR)
  2. V2 receptor stimulation in the collecting ducts causes water retention
25
Q

ADH is produced in the

A

supraoptic and paraventricular nuclei of the hypothalamus

26
Q

The half-life of ADH is

A

5-15 minutes

27
Q

ADH leads to what effect on cAMP?

A

increased cAMP in the collecting ducts

28
Q

All of the following enhance renal perfusion EXCEPT:
a. fenoldopam
b. PGE2
c. natriuretic peptide
d. thromboxane A2

A

d. thromboxane A2

29
Q

_________ pathways promote renal vasodilation

A

Three

30
Q

What are the pathways that promote renal vasodilation?

A

vasodilating prostaglandins
natriuretic peptides
dopamine receptors

31
Q

Discuss the use of dopamine in prevention or treatment of AKI.

A

does increase UO but no solid evidence to support the notion that renal-dose dopamine either prevents or treats AKI

32
Q

Vasodilating prostaglandins antagonize

A

the effects of RAAS

33
Q

Natriuretic peptides inhibit

A

RAAS and stimulate sodium and water excretion

34
Q

DA1 dopamine receptors lead to

A

vasodilation, increased renal blood flow, increased GFR, diuresis, and sodium excretion

35
Q

DA2 dopamine receptors lead to

A

decreased NE release from the presynaptic SNS nerve terminal

36
Q

_______________ is liberated from the cell membrane in response to ischemia, hypotension, norepinephrine, and angiotensin 2

A

Arachidonic acid

37
Q

______________ inhibit cyclooxygenase. These drugs can reduce renal blood flow by inhibiting the production of vasodilating prostaglandins

A

NSAIDs

38
Q

How do DA1 & DA2 receptors affect cAMP?

A

DA1- increased cAMP–> vasodilation
DA2- decreased cAMP–> decreased NE release

39
Q

Does fenoldopam decrease AKI?

A

selective DA1 receptor agonist that increases renal blood flow, GFR, and facilitates Na+ excretion without affecting arterial blood pressure

40
Q

List three compounds that promote renal vasodilation.

A

dopamine
natriuretic peptide
prostaglandins

41
Q

Which condition increases the glomerular filtration rate?
a. increased plasma protein
b. afferent arteriolar constriction
c. cyclooxygenase inhibition
d. increased efferent arteriolar resistance

A

d. increased efferent arteriolar resistance

42
Q

The normal glomerular filtration rate is

A

125 mL/min.

43
Q

What is freely filtered in the glomerulus?

A

water, electrolytes, and glucose

44
Q

What is not filtered in the glomerulus?

A

plasma proteins (i.e. albumin)

45
Q

The most important determinant of GFR is

A

glomerular hydrostatic pressure

46
Q

How is GFR determined?

A

by arterial blood pressure
afferent arteriole resistance
efferent arteriole resistance

47
Q

_________ is the process where a substance is transferred from the tubule to the peritubular capillaries

A

Reabsorption

48
Q

______________- is the process where a substance is transferred from the peritubular capillaries into the tubule

A

Secretion

49
Q

______________ is the process where a substance is removed from the body in the urine

A

Excretion

50
Q

Kidney disease destroys the _______________ which allows the filtration of ___________ into the tubules

A

basement membrane; proteins

Apex Review (224 decks)

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