Dr. Rice Renal Final

Question 1

Transport maximum =

Answer 1

Tubular reabsorption

Question 2

The limit to the rate at which a solute can be transported during active reabsorption or secretion is which type of tubular reabsorption?

Answer 2

Transport maximum

Question 3

The type of tubular reabsorption that depends on the electrochemical gradient, permeability and time is called:

Answer 3

Gradient-time transport

Question 4

True/False: Gradient-time transport can exhibit both passive and active elements.

Answer 4

True

Question 5

What is osmosis?

Answer 5

The net diffusion of water across a selectively permeable membrane from a region of high water concentration to one of a lower water concentration

Question 6

Osmosis involves the diffusion of water from _____ to _____ water concentrations.

Answer 6

High to low

Question 7

What effects does capillary hydrostatic pressure have on arterial pressure?

Answer 7

As arterial pressure increases, GFR increases

Question 8

Constriction of afferent arterioles leads to _____, while dilation of afferent arterioles leads to _____.

Answer 8

Decreased glomerular CHP and decreased GFR

Increased glomerular CHP and increased GFR

Question 9

If the blood pressure arriving at the kidney was increased, what would happen to the amount of urine being produced?

Answer 9

Increased amount

Question 10

Constriction of efferent arterioles would have what effects on glomerular CHP and GFR?

Answer 10

Increased glomerular CHP and increased GFR (slightly)

Question 11

Which hormone causes increased water permeability?

Answer 11

ADH/Vasopressin

Question 12

ADH causes increased water permeability where?

Answer 12

Distal tubule, collecting tubule and collecting duct

Question 13

Osmoreceptor cells fire and stimulate the _____ to release ADH.

Answer 13

Posterior pituitary

Question 14

What region is responsible for signaling the posterior pituitary to release ADH?

Answer 14

AV3V region

Question 15

How much does sodium content increase when there is a desire to ingest fluid (thirst)?

Answer 15

Increases 2mEq/L above normal

Question 16

GFR =

Answer 16

RPF x FF

Question 17

Normal GFR is:

Answer 17

110 ml/min

Question 18

How can GFR be increased?

Answer 18

Alter the RPF (increase cardiac output/dilate afferent arterioles) or alter the FF (contract efferent arterioles, increasing glomerular pressure)

Question 19

How are glomerular capillaries different than others in the body?

Answer 19

They have 3 layers instead of 2 (endothelium, basement membrane and epithelial cell layer)

Question 20

The filtration fraction is best defined as:

Answer 20

The proportion of the fluid reaching the kidneys which passes into the renal tubules

Question 21

What separates glomerular and peritubular capillary beds?

Answer 21

Efferent arterioles

Question 22

Which sodium glucose co-transporter transports the most filtered glucose?

Answer 22

SGLT-2 (90%, SGLT-1 is 10%)

Question 23

Sodium reabsorption occurs where?

Answer 23

Proximal tubule

Question 24

Which molecules are rapidly absorbed in the first half of the proximal tubule?

Answer 24

Sodium, glucose, amino acids and water

Question 25

Which molecule is left in high concentrations in the second half of the proximal tubule?

Answer 25

Chloride ions

Question 26

Kidney damage involves:

Answer 26

Impaired sodium excretion

Question 27

What is the trade off that occurs when there is damage to the kidneys?

Answer 27

Increase blood pressure (helps maintain normal sodium excretion); harmful long-term though

Question 28

What are principal cells?

Answer 28

Specialized epithelial cells in the late distal and collecting tubules that secrete potassium for excretion

Question 29

What factors control potassium secretion by the principal cells?

Answer 29

Activity of Na/K ATPase pump, electrochemical gradient and K+ permeability

Question 30

Which hormone stimulates active secretion of potassium via principal cells?

Answer 30

Aldosterone

Question 31

A pH below 7.4 indicates:

Answer 31

Acidosis

Question 32

A pH above 7.4 indicates:

Answer 32

Alkalosis

Question 33

Describe the flow of urine.

Answer 33

Nephrons, collecting ducts, renal calyces, ureters and then the bladder

Question 34

Sodium excretion in the urine describes pressure _____, while water excretion to regulate BP describes pressure _____.

Answer 34

Natriuresis; Diuresis

Question 35

Hypokalemia is caused by excess _____ in the system.

Answer 35

Aldosterone (Conn's syndrome)

Question 36

Excess aldosterone in the system causes:

Answer 36

Hypokalemia

Question 37

True/False: In a healthy adult, the glomerular filtrate should contain proteins and cellular elements.

Answer 37

FALSE; It shouldn't contain ANY cellular elements

Question 38

Which three things have an impact on extracellular fluid volume of H+ concentration?

Answer 38

Secretion of H+, reabsorption of filtered HCO3- and production of new HCO3-

Question 39

The bladder is innervated by:

Answer 39

S2 and S3 nerves

Question 40

The external anal sphincter is controlled by which nerve?

Answer 40

Pudendal nerve

Question 41

The first line of defense against changes in H+ concentration.

Answer 41

Acid-base buffering system (seconds)

Question 42

Reabsorption of sodium and secretion of potassium are both controlled by:

Answer 42

Aldosterone

Question 43

The second line of defense against changes in H+ concentration.

Answer 43

Respiratory center (minutes)

Question 44

The last line of defense against H+ concentration changes.

Answer 44

KIdney via acidic/basic urine (hours-days) --> most powerful mechanism

Question 45

Renal blood flow accounts for what percentage of cardiac output?

Answer 45

22%

Question 46

True/False: Kidneys consume more oxygen and blood than the brain.

Answer 46

True; 2x more oxygen, 7x more blood flow

Question 47

How are glomerular and peritubular capillary beds different?

Answer 47

Glomerular- High hydrostatic pressure, rapid fluid filtration Peritubular- Low hydrostatic pressure, rapid fluid reabsorption

Question 48

Foamy urine is a sign of _____ in the urine, indicative of which disease?

Answer 48

Protein; Nephrotic syndrome

Question 49

If osmolarities stay equal throughout the structure:

Answer 49

Isotonic

Question 50

If osmolarities increase throughout the structure:

Answer 50

Hypertonic

Question 51

If osmolarities decrease throughout the structure:

Answer 51

Hypotonic

Question 52

Overhydration results when there is overly high secretion of:

Answer 52

ADH (over retention of water; hyponatremia) and aldosterone (excess NaCl; hypernatremia)

Question 53

Intracellular edema is the result of:

Answer 53

Hyponatremia, metabolic depression and poor nutrition

Question 54

Extracellular edema is the result of:

Answer 54

Fluid leakage and lymphatic failure (lymphedema)

Question 55

When voluntary urination is desired, the micturition reflex is excited and the _____ signals for voluntary external urethral sphincter relaxation.

Answer 55

Pudendal nerve

Question 56

The transport of sodium from the tubular cells into the interstitial fluid during reabsorption requires:

Answer 56

Potassium

Question 57

A person who is sweating profusely is at risk for:

Answer 57

Hypernatremia

Question 58

Someone with hyponatremia has very low levels of _____ in their blood.

Answer 58

Sodium

Question 59

Juxtamedullary nephrons are distinct from cortical nephrons in that they have:

Answer 59

Significantly longer loops of Henle

Question 60

If a patient is in a standing/upright position, where should the kidneys be located (approximately)?

Answer 60

Between L1-L4

Question 61

Name the muscle responsible for contraction of the bladder.

Answer 61

Detrusor

Question 62

A person experiencing flank pain and blood in their urine is likely going to be diagnosed with:

Answer 62

Polycystic kidney disease/Nephrolithiasis

Question 63

This messed up kidney is showing signs of severe:

Answer 63

Polycystic kidney disease

Question 64

Which of the following is a symptom of pyelonephritis?

Answer 64

Bilateral loin pain

Question 65

Colloidal osmotic pressure in the glomerulus is proportional to the concentration of:

Answer 65

Proteins in the blood

Question 66

Both norepinephrine and epinephrine have what effects on GFR?

Answer 66

Inhibitory

Question 67

When arterial pressure is increased, some blood vessels have the ability to resist stretching. This is called:

Answer 67

Myogenic mechanism

Question 68

Kidneys consume twice as much oxygen as the brain due to the high rate of _____ in the renal tubules.

Answer 68

Active sodium reabsorption

Question 69

Angiotensin II is a powerful renal:

Answer 69

Vasoconstrictor

Question 70

True/False: The renal cortex receives significantly less of the blood arriving at the kidneys than the renal medulla.

Answer 70

FALSE, the renal medulla receives less than the renal cortex

Question 71

The kidneys can autoregulate, which means that even if arterial pressure varies greatly, there will be little net change in:

Answer 71

GFR

Question 72

Glomerular filtration is _____, and tubular reabsorption is _____.

Answer 72

Non-selective; highly selective

Question 73

Before a solute can be reabsorbed into the renal blood supply, it must first be:

Answer 73

Transported into the interstitial fluid

Question 74

True/False: Secondary active transport is coupled directly to solute gradients.

Answer 74

FALSE, coupled INDIRECTLY

Question 75

What is represented by the yellow colored portion of this diagram?

Answer 75

Filtrate

Question 76

Where is energy (ATP) expended during glucose reabsorption in the kidneys?

Answer 76

By the Na/K ATPase transporters

Question 77

The limit to the rate at which a solute can be transported during active reabsorption or secretion is called the:

Answer 77

Transport maximum

Question 78

Osmosis causes a:

Answer 78

Solvent drag

Question 79

Which segment of the Loop of Henle is impermeable to water? Which one is highly permeable to water?

Answer 79

Thick ascending segment is impermeable; Thin descending is highly permeable

Question 80

The specialized principal cells of the kidneys are located in the:

Answer 80

Distal tubule

Question 81

The presence of a high concentration of ADH in the cortical collecting tubule will make the membrane:

Answer 81

Permeable to water

Question 82

Filtrate that has passed through the proximal tubule stays _____ relative to the blood plasma.

Answer 82

Isotonic

Question 83

Which mechanism is driven by sodium movement in the proximal tubule and the thick ascending loop of Henle?

Answer 83

Countercurrent mechanism

Question 84

True/False: The same urea may be secreted back into the nephron and recirculate multiple times.

Answer 84

True

Question 85

One of the first systemic adjustments the body will make if the kidneys aren't maintaining fluid balance is to:

Answer 85

Change blood pressure