Etc. I

Question 1

2 major causes of edema

Answer 1

Changes in the capillary hemodynamics.

Renal retention of dietary Na and water expansion of ECF.

Question 2

Non-pitting edema is due to:

Answer 2

Swollen cells due to increased ICF

Question 3

Pitting edema is due to:

Answer 3

Increased interstitial volume.

Question 4

Crystalloids

Answer 4

Do not cross the PM - remain in the ECF and can easily diffuse between compartments of the ECF. Increase ECF vol.

Question 5

Colloids

Answer 5

Cannot pass semipermeable membranes and remin in the vessels. Must be given IV and expand the intravascular volume.

Question 6

Plasma osmolarity equation

Range

Answer 6

2Na + Glc/18 + BUN/2.8

Range is 275-295

Question 7

Hypotonic/natremic dehydration

Answer 7

Loss of Na is greater than the loss of water.
Fluid shifts from ECF to ICF.
Serum sodium/osm is less than normal.

Question 8

Hypertonic/natremic dehydration

Answer 8

Loss of water is greater than loss of Na.
Fluid shifts from ICF to ECF.
Serum sodium/osm is greater than normal.

Question 9

Isoosmotic volume contraction

Answer 9

Acute loss of isoosmotic fluid.

Decrease in ECF, no change in ICF or osm.

Question 10

Hyper-osmotic volume contraction

Answer 10

Loss of hypotonic fluid (dehydration, diabetes, alcoholism).

Decrease in ECF and ICF, increase in osm.

Question 11

Isoosmotic volume expansion

Answer 11

Gain of isoosmotic fluid.

Increase in ECF, no change in ICF or osm.

Question 12

Hypoosmotic volume expansion

Answer 12

Gain of hypoosmotic fluid.

Increase in ECF and ICF, decrease in osm.

Question 13

Gibbs-Donnan effect

Answer 13

Proteins are largely negative and cannot cross the PM.

This provides both an oncotic and electrical gradient to attract molecules.

Question 14

3 layers of the glomerular filtration barrier

Answer 14

Capillary endothelium
Glomerular BM
Podocyte epithelium

Question 15

Filtered load =

Answer 15

[X] x GFR

Question 16

Urinary excretion =

Answer 16

Filtrate - amt reabsorbed + amt secreted

Question 17

Reabsorption =

Answer 17

Filtrate - excretion + amt secreted

Question 18

Urinary excretion rate =

Answer 18

(Ux) x V

Ux is urine conc of X and V is urine flow rate

Question 19

Renal clearance definition

Answer 19

Vol of plasma completely cleared of a substance by the kidneys per unit time

Question 20

Cx =

Answer 20

(Ux x V)/Px

Question 21

Characteristics if glomerular filtrate

Answer 21

Protein free
Cell free
Isoosmotic
20% of RBF

Question 22

FF =

Answer 22

GFR/RBF

Question 23

Inulin

Answer 23

Freely filtered at the glomerulus.
Not reabsorbed or secreted.
Not ideal.

Question 24

Creatinine

Answer 24

Used clinically.
10% secreted.
Used to measure GFR.

Question 25

Vasocontriction RAAS Na/K ATPase Receptors

Answer 25

a1 B1 a1

Question 26

Prerenal problem

Answer 26

>20:1 BUN/creatinine | Hypovolemia, dehydration, high protein diet

Question 27

Intrarenal problem

Answer 27

<10:1 bun/creatinine Liver dz Low protein diet

Question 28

PAH

Answer 28

Best way to measure GFR, but needs to be administered in an IV

Question 29

Net filtration =

Answer 29

GPC - piGC - PBC

Question 30

3 factors influencing GFR

Answer 30

``` Hydraulic conductivity (Lp) Surface area (Sf) Capillary ultrafiltration pressure (PUF) GFR = Lp x Sf x PUF ```

Question 31

PGC is affected by:

Answer 31

Renal BP Afferent resistance Efferent resistence

Question 32

Kf =

Answer 32

Lp x Sf

Question 33

Function of mesangial cells:

Answer 33

Adjust Sf

Question 34

Relationship between PUF and piGC

Answer 34

Inverse. | As filtrate leaves the capillary, the oncotic pressure will increase.

Question 35

Which end of the arteriole is more regulated by symapthetics?

Answer 35

Afferent. More a1 receptors.

Question 36

Constriction of the afferent arteriole causes: GFR RBF PGC

Answer 36

Decrease in all

Question 37

Constriction of efferent arteriole causes: GFR RBF PGC

Answer 37

GFR up then down due to RBF. RBF down PGC up

Question 38

Vasodilators

Answer 38

``` PGs NO Bradykinin DA ANP ```

Question 39

Vasoconstrictors

Answer 39

Synpathetics Angiotensin II Endothelin

Question 40

Myogenic reflex

Answer 40

BVs stretch due to increase in BP. SM contracts. AA constricts and EA dilates.

Question 41

Tubuloglomerular feedback with increased renal perfusion pressure (5)

Answer 41

1. Increased RBF and GFR 2. Increased delivery of NaCl 3. Release of adenosine 4. Resistance of AA 5. Decreased RBF and GFR

Question 42

Tubuloglomerular feedback with decreased renal perfusion pressure

Answer 42

1. Decreased GFR and RBF 2. Decreased delivery of NaCl 3. Release renin leading to increased EA resistance OR release of NO leading to decreased AA resistance.

Question 43

Dilation of the AA | RBF, GFR, PGC

Answer 43

All increase

Question 44

Constrict AA | RBF, GFR, PGC

Answer 44

All down

Question 45

Dilation of EA | RBF, GFR, PGC

Answer 45

RBF up GFR down PGC up

Question 46

Constriction of EA | RBF, GFR, PGC

Answer 46

RBF down GFR up PGC down

Question 47

NaH exchanger location, function

Answer 47

PCT, reabsorption of Na and bicarb.

Question 48

AQP-1 is present in:

Answer 48

PCT

Question 49

AQP-2 is present in: | What is special about them?

Answer 49

CD | They are under the control of ADH

Question 50

AQP and TJ availability in both regions of the LoH

Answer 50

Many AQP and few TJ in descending loop. | No AQP and many TJ in ascending loop.

Question 51

SGLT1 SGLT2 And their location

Answer 51

SGLT1 is low affinity and in S3 | SGLT2 is high affinity and in S1

Question 52

How is Glc reabsorbed?

Answer 52

Exchanged for Na against its gradient

Question 53

What is the diluting segment? Why?

Answer 53

Thick ascending limb of LoH. | Because it sends out a lot of Na and therefore has lots of Na/K pumps.

Question 54

Where does furosemide act?

Answer 54

Thick ascending limb via blocking Cl- binding on the Na-K-2Cl transporter

Question 55

What transporter helps reabsorb some Na in the DCT?

Answer 55

Na-Cl transporter

Question 56

Where do thiazides act? | What else do they do?

Answer 56

DCT on the Na-Cl transporter | Reduce excretion of Ca and reduce risk of kidney stones.

Question 57

What causes the release of aldosterone? Other than increasing BP, what does it cause?

Answer 57

Increased plasma K+. | Reabsorption of Na and excretion of K.

Question 58

K+ sparing spirolactone

Answer 58

Inhibits Na/K exchange in the DCT and CD. | Promotes K retention and Na/water loss.