Exam 3: Kidneys Flashcards

(37 cards)

1
Q

Name the Parts of the Nephron

A

Renal Corpuscle, Podocytes, Proximal Tubule, Loop of Henle, Distal Convoluted Tubule

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2
Q

Name the 2 Parts of the Renal Corpuscle

A

Glomerulus and Bowman’s Capsule

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3
Q

What are Podocytes used for?
*Where are they located?

A

Filtration
*On top of the glomerulus

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4
Q

Name the 4 Parts of the Loop of Henle

A

Thick/Thin Ascending/Descending Limb

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5
Q

What does the Distal Convoluted Tubule do?

A

Dumps into collecting ducts/tubule

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6
Q

Where does Filtration Primarily Occur in the Kidney?

A

Glomerulus moves fluid from the blood to Bowman’s Capsule
*Bowman’s Capsule produces 100% of the filtrate

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7
Q

Where does Reabsorption happen in the Kidneys?

A

All through the tubules; Mainly Proximal Tubule

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8
Q

Where in the Kidney does secretion happen?

A

Thru the tubules

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9
Q

What does the Proximal Tubule Reabsorb? 6 things

A

Glucose, Water, Bicarb, K+, AA, Na+

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10
Q

Where is the Macula Densa Located?
*Function

A

Located at the end of the Ascending Loop of Henle, touching the Glomerulus
*Monitors Osmolality and volume of fluid in the distal tubule

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11
Q

Where is the JG Apparatus Located?
*Function

A

At the Vascular Pole of the Renal Corpuscle
*Regulates BP by Synthesizing Renin

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12
Q

What controls the GFR in the Kidneys?

A

JG Apparatus

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13
Q

How is GFR controlled in the kidneys?

A

Increase Na+ = Increase BP
Alter Capillary SA
Control Arteriole Diameter
Autoregulation
Neural Regulation [NE and Epi]
Hormonal Regulation

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14
Q

Describe the Function of the Sodium Hydrogen Exchanger (NHE3)
*What does this Exchanger form?

A

Na+ is pumped into the ISF back to the body and H+ is pumped out into the urine
*H+ binds w HCO3 to form Carbonic Acid H2CO3

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15
Q

What is the end result of the NHE3 Exchanger?

A

Na+, H2O, and HCO3 are put back into circulation

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16
Q

What Drug/Drug class blocks the NHE3 Exchanger?

A

Acetazolamide; Carbonic Anhydrase Inhibitors

17
Q

What are the 5 (6) Major Diuretic Classes?

A

Carbonic Anhydrase Inhibitors
Loop Diuretics
Thiazides
K+ Sparing
Osmotic
SGLT2 Inhibitors

18
Q

What is the MOA of Acetazolamide?
*What Drug Class
*What pH imbalance can it cause?

A

Oldest Class of Diuretics; mostly used for altitude sickness
*Blocks the NHE3 Exchanger, which wastes NaHCO3, K, and Na+
*Can lower pH and cause Metabolic Acidosis, as it has more free floating H+
*Carbonic Anhydrase Inhibitors

19
Q

What is the MOA of Furosemide?
*Drug Class?
*pH Imbalance
*Toxicity
*Electrolyte SE

A

Works in the Thick Ascending Limb of the Loop of Henle
*Loop Diuretics
*Increased pH: More likely to develop Alkalosis
*Targets the NKCC2 Transporter [Sodium Potassium 2 transporter] - more Na+ builds up in the lumen, so more Na+ is sent into the urine followed by water
*Allergy is most toxic effect
*Lose Mg and Ca

20
Q

What is the only Loop Diuretic that is not a sulfa?

A

Ethacrynic Acid

21
Q

If a Pt has a sulfa allergy, what diuretic can they not take?

A

Loop Diuretic, Thiazides

22
Q

What is the MOA of Hydrochlorothiazide?
*Drug Class
*Synergistic effect when combined with which diuretic class?
*What electrolytes does it lose (little amount)

A

Targets the NCC co-Transporter (Sodium and Chloride co-transporter) - Inhibits Na+ Transport in the distal convoluted tubule
*Thiazide Diuretics
*Loop + Thiazide
*Bicarb and K

23
Q

Name 2 K+ Sparing Diuretics?

A

Spironolactone and Amiloride

24
Q

MOA of Spironolactone/Amiloride
*Drug class

A

Antagonize the effects of aldosterone and inhibit Na+ influx in luminal membrane by slowing down the ENAC

25
What is ENAC in the kidneys? *What does it do
Epithelial Sodium Channel *Increases Na+ reabsorption, H2O = Increased BP
26
Where does Mannitol mainly work? *Where can it effect in the kidney *Drug Class
Proximal Convoluted Tubule *Any water soluble area of the tubule is affected by Mannitol *Osmotic Diuretics
27
What is a normal body Osmolality?
300 mOsm/Kg
28
What are SGLT2 Inhibitors
Glucose Transporters that assist in removing water in the urine
29
What are indications for K+ Sparing Diuretics? *Toxicity?
Conn's Syndrome, CHF, Nephrotic Syndrome, Pit Tumor, Adrenocortical Tumor *HyperK+
30
Indications for Mannitol
Increased ICP, hemolysis, radiocontrast agents
31
Mannitol Toxicity
Renal Failure - Acute Hyponatremia Dehydration - HyperK and Na+
32
Diuretics in Pts w DI
Insufficient ADH - excessive urination and thirst Thiazides - Decrease Plasma Volume = Decrease GFR
33
Where is aldosterone located? *Where is it secreted *How does it increase BP
Collecting Tubule *Adrenal Cortex *Increase Na+ and H2O uptake via ENaC
34
ADH Agonist vs Antagonist
Agonist - Vasopressin Antagonist - Conivaptan
35
What is the most common use for a Diuretic
Peripheral or Pulmonary Edema
36
What is DI
Insufficient ADH = Polyuria and Polydipsia
37
Tx for DI
Thiazides *Decrease Plasma volume, GFR