Exam I Renal Flashcards
(159 cards)
1
Q
4 components of the urinary system:
A
- Kidneys
- Ureters
- Urinary Bladder
- Urethra
2
Q
Which of the following are functions of the kidney?
a. Maintaining constant ECF
b. Elimination of wastes
c. Acid-Base balance
d. Glucose synthesis
e. Synthesis of hormones
f. All of the above
A
f. all of the above
3
Q
List the 7 functions of the kidneys:
A
- Filtration of blood
- Production of urine
- Reabsorption of filtered substances
- Excretion of metabolic wastes and xenobiotics
- Water and acid-base balance
- Production of glucose
- Endocrine functions
4
Q
Which of the following clinical signs may be associated with a chronic renal failure?
a. Presence of urine sediments
b. inc. urine specific gravity
c. Pale mucous membranes
d. Polydipsia
e. All of the above
A
c. Pale mucous membrane
5
Q
What are 3 important hormones produced by the kidney?
A
- Calcitriol
- Renin
- Erythropoietin
6
Q
What hormone stimulates the production of Calcitriol?
A
PTH
7
Q
Calcitriol secreted in response to ________
A
Hypocalcemia
8
Q
Why is renin an important hormone secreted by the kidney?
A
regulation of blood pressure
9
Q
Why is erythropoietin an important hormone secreted by the kidney?
A
essential for erythropoiesis
10
Q
What are the 2 types of nephrons?
A
- Cortical nephrons
2. Juxtamedullary nephrons
11
Q
2 characteristics of cortical nephrons:
A
- short loops of henle
2. supplied by peritubular capillaries
12
Q
3 characteristics of juxtamedullary nephrons
A
- located near medulla
- vasa recta
- long loops of henle
13
Q
Structure of the nephron located in the renal cortex, consists of glomerulus surrounded by bowman’s capsule
A
Malpighian body
14
Q
The longest part of the nephron, consisting of PCT and a straight part
A
Proximal tubule
15
Q
What are the 4 limbs of the loop of Henle
A
- Thick Descending limb
- Thin Descending limb
- Thin Ascending limb
- Thick Ascending limb
16
Q
Which portion of the loop of henle extends into the renal medulla?
A
Thick Descending Limb
17
Q
Which portion of the loop of henle is only found in juxtamedullary nephrons?
A
Thin Ascending Limb
18
Q
What are the 2 parts of the distal tubule of the nephron?
A
Straight and convoluted part
19
Q
Structure of the nephron that extends through the renal cortex and medulla
A
Collecting Duct (CD)
20
Q
What percentage of cardiac output goes into the kidney?
A
25%
21
Q
The top one cause of death in humans worldwide is:
a. HIV/AIDS
b. Road Traffic Accidents
c. Cancer
d. Myocardial Infarction
A
d. Myocardial Infarction
22
Q
Interruption of blood supply to a tissue
A
Ischemia
23
Q
Re-establishment of blood supply to a tissue
A
Reperfusion
24
Q
What are 4 main causes of renal IR?
A
- Organ transplant
- Cardiac and vascular surgeries
- Acute renal failure
- Toxins
25
Highly reactive molecules that damage DNA, lipids, and proteins
Reactive O2 Species (ROS)
26
What causes an inc. in ROS in the kidneys?
Inflammatory response and O2 deprivation
usually ischemia
27
Which of the following statements concerning the structure of the nephron is NOT correct?
a. The PCT is located in the cortex
b. Thin limbs of Henle's loop are located in the medulla
c. The collecting Ducts extend through the renal cortex and medulla
d. The Macula Densa is located in the outer medulla
d. The Macula Densa is located in the outer medulla
| located in the cortex
28
What are the 4 main processes in the kidneys?
1. Filtration
2. Re-absorption
3. Secretion
4. Excretion
29
How much of the glomerular filtrate is excreted as urine?
a. 20%
b. 10%
c. 1-5%
d. Less than 1%
d. Less than 1%
30
Which of the following structures is NOT a component of the filtration barrier?
a. Capillary endothelium
b. Bowman's capsule
c. Podocytes
d. Glomerular BM
b. Bowman's Capsule
31
What is the 1st step of urine formation?
Filtration through glomerular capillaries into Bowman's Capsule
32
Fluid produced by the glomerulus that is nearly identical to the plasma
Glomerular Filtrate
33
The rate the kidney is perfused with blood
Renal Plasma Flow (RPF)
34
The Rate of glomerular filtration depends on ______.
RPF
35
What percentage of blood plasma flowing through the kidney is filtered through the glomeruli?
20%
36
A network of branching and anastomosing capillaries covered by podocytes and encased in bowman's capsule
Glomerulus
37
The area b/t glomerular capillaries and bowman's capule
Bowman's space
38
What are the 3 components of the filtration barrier?
1. Capillary endothelial cells
2. Glomerular BM
3. Visceral epithelium (podocytes)
39
what type of junctions are found b/t capillary endothelial cells?
Fenestrated
40
What are the 3 layers of BM of capillaries?
1. Lamina rara interna
2. Lamina densa
3. Lamina rara externa
41
Which layer of the capillary BM contains the most proteins?
middle, Lamina Densa
42
T/F. Glomerular capillaries are highly permeable to Proteins
F. Relatively impermeable
43
The higher the molecular weight of a substance, the ______ the filterability.
Lower
44
T/F Electrolytes and small organic compounds are filtered as freely as water?
T
45
Filterability through the glomerulus is dependent of what factors:
1. Size
2. Electrical charge
3. Plasma protein binding
46
T/F. Anionic substances are more filtered than Cationic
F. Cationic are more filtered
47
The main driving force for filtration in the glomerulu sis:
a. the oncotic pressure of the blood
b. the hydrostatic pressure of the blood
c. the oncotic pressure in Bowman's capsule
d. The hydrostatic pressure in Bowman's Space
b. Hydrostatic pressure of the blood
48
What are the 2 forces opposing filtration ?
1. The hydrostatic pressure in bowman's space
| 2. the oncotic pressure of the blood plasma
49
T/F. the oncotic pressure of the filtrate is nonexistent
T
50
The total volume of fluid filtered by the glomeruli into Bowman's Space per Kg.
GFR
51
What are the nessecary properties of GFR indicator substances?
1. Must be freely filterable
2. filtered amt. must not change due to resorption or secretion
3. must not be metabolized in the kidney
4. must not alter renal function
52
the rate the plasma is cleared of a substance, if the substance is free filterable
GFR
53
If creatine in plasma is elevated, then GFR is _inc/dec_?
Dec.
54
Percentage of the plasma that has been filtered by the glomeruli
Fraction of Filtration (FF)
55
Where is renin produced?
in the wall of cells located in the afferent arterioles
56
What are 2 types of autoregulatory mechanisms for blood flow?
1. Myogenic reflex
| 2. Tubuloglomerular feedback
57
What is the myogenic reflex?
Detects changes in glomerular perfusion
58
What is the tubuloglomerular feedback?
Detects changes in tubule fluid delivery
59
T/F. Aldosterone is produced by cells of the renal medulla?
F. Adrenal cortex
60
List the 2 vasodilatory agents from class.
1. No
| 2. PGE2
61
List the 3 Constricting factors from class.
1. Endothelin
2. TXA2
3. ANG2
62
If you inc. RBF, GFR will _inc/dec_.
inc
63
If systemic pressure inc. then GFR will _inc/dec._
inc
64
if afferent arteriole tone inc, then GFR will _inc/dec_.
dec.
65
If efferent arteriole tone slightly inc., then GFR will _inc/dec._
inc.
66
If hydrostatic pressure of bowman's capsule inc., then GFR will _inc/dec_.
dec.
67
The ultrafiltrate that accumulates inthe capsular space between glomerulus and bowman's capsule and contains the same conc. of salt and glucose as plasma
Primary urine
68
T/F. The proximal tubules are polarized
T
69
What are the 2 mechanisms of the PT that move tubule fluid back into the blood?
1. Transcellular Pathway
| 2. Paracellular Pathway
70
How does the transcellular pathway work?
carrier-mediated transports substances across the apical memb, cytoplasm, and basolateral PM into interstitial fluid
71
How does the paracellular pathway work?
tubule fluids pass through the epithelium across the tight junctions.
72
How is transport across the PT classified?
according to source of energy
73
What is the difference b/t primary and secondary active transport?
P: fueled directly by ATP consumption
S: driven by electrochemical gradient produced by the primary active transporter
74
What is tertiary active transport?
The carrier is driven by the gradient generated by a secondary active transporter.
75
How are low molecular wr. proteins reabsorbed in the PT?
receptor mediated endocytosis
76
protein in the urine
proteinuria
77
What are the 3 types of proteinuria?
1. pre-renal
2. intrarenal
3. post-renal
78
When is proteinuria classified as pre-renal?
when the conc. of free-filterable proteins in the blood is inc.
79
When is proteinuria classified as intrarenal?
If the glomerular filter is damaged
80
When is proteinuria classified as post-renal
when there is tubular loss of proteins
81
What are the 2 carbonic anhydrases in the kidney?
1. one membrane associated
| 2. one located in cytosol of PT cells
82
The major driving force favoring filtration across the glomerular capillary wall is the :
a. oncotic pressure of the plasma
b. oncotic pressure of the glomerular filtrate
c. hydrostatic pressure of the blood
d. hydrostatic pressure of the glomerular filtrate
e. ultrafiltration coeficient
c. hydrostatic presssure fo the blood
83
What is glomerular filtration rate?
volume of glomerular filtrate formed by the kidneys per minute per kilogram of body weight
84
In clinical practice the GFR is often estimated by determining the rate of creatinie clearance. the rate of creatinine clearance is the _____.
Volume of plasma cleared of creatinine per minute per kilogram of body wt.
85
the two major characteristics that determine whether a blood component is filtered or retained in the capillary lumen are its:
a. molecular radius and molecular wt.
b. molecular radius and lipid solubility
c. molecular radius and plasma conc.
d. molecular radius and electrical charge
e. molecular wt. and lenght
d.
86
the GFR is inc. by:
a. A low-protein meal
b. Afferent arteriolar consideration
c. Tubuloglomerular feedback
d. Release of atria natriuretic peptide
e. Activation of the renin- angiotensin-aldosterone system
e.
87
T/F. Organic ions that are protein bound are freely filterable by the glomerulus.
F. poorly filterable
88
How is glucose reabsorbed?
the Sodium-dependent transporter Sodium glucose transporter SGLT
89
What are the 2 types of SGLTs?
1. low affinity located in pars convoluta (SGLT2)
| 2. High affinity located in pars recta (SGLT1)
90
What happens when the glucose carriers are saturated?
less re-absorption, and glucose is secreted in urine
91
If plasm glucose is greater than _____ than glucosuria develops.
10-15 mmol/L
92
What is glucosuria
presence of glucose in the urine
93
The minor component of a solution which is regarded as having been dissolved by solvent
solute
94
A liquid or solid phase containing more than one substance, contains a solvent and solute
solution
95
concentration of all osmotically active particles in a solution expressed as osmoles per liter of solution
osmolarity
96
more suitable for living organisms b/c osmolarity is temperature dependent
osmolality
97
What are the 4 segments of the loop of henle
1. thick descending
2. thin descending
3. thin ascending
4. thick ascending
98
What is another name for the thick ascending loop of henle?
Medullary Thick Ascending Limb (mTAL)
99
Which segment of the loop of henle do cortical nephrons lack?
thin ascending limb
100
T/F. Cortical nephrons are important for urine concentration
F. Juxtamedullary
101
What is the thin descending limb of the loop of henle especially permeable to? Impermeable?
Permeable: Water
impermeable: Na, Cl, Urea
102
If Water is being removed and NaCl remains there. . . What happens with the tubular fluid?
a. It becomes less concentrated
b. It becomes more concentrated
c. It remains unchanged
b. it becomes more concentrated
103
The _____ limb of the loop of henle helps concentrating the tubule fluid
Thin descending
104
T/F. both the thick and thin ascending limbs of the loop of henle are impermeable to water.
T
105
What is the mTAL of the loop of henle especially permeable to?
Na, Cl, K, Ca, Mg, HCO3
106
If NaCl is being reabsorbed and water cannot follow. . . What happens now with the tubular fluid?
a. It becomes more diluted
b. It becomes more concentrated
c. It remains unchanged
b. It becomes more concentrated
107
The ____ limb of the loop of henle is known as the diluting segment
Thick ascending
108
What does the descending thin limb of the loop of henle reabsorb?
Water
109
What does the thin ascending limb of the loop of henle reabsorb?
NaCl
110
What Three transporters are located in the mTAL
1. NKCC
2. Cl- channels
3. ROMK
111
Are NKCC primary active transport or secondary active transport?
Secondary
112
What are NKCC inhibited by
Furosemide
113
What is reabsorbed in the DCT?
Ions such as: Na, K, Cl, Ca, Mg
114
What 5 transporters are located in the DCT?
1. Ca channels (TRPV)
2. NA/Cl cotransporters (NCC)
3. Cl channels
4. K channels
5. Ca/Na exchanger (NCX)
115
What inhibits NCX?
thiazide
116
What is reabsorbed in the DCT and CD?
Water
117
If ADH levels are high, then there will be an _inc/dec_ in water reabsorption in the DCT and CD.
Inc
118
What are the 2 main cell types of the CD?
1. Principal cells
| 2. intercalated cells
119
Which type of principle cell is responsible for mantaining acid base homeostasis?
Intercalated
120
Which type of CD cell has few mitochondria and few intracytoplasmic vesicles
Principal cells
121
Which type of CD cell has basolateral PM infoldings?
Principal
122
Which type of CD cell has numerous mitochondria?
Intercalated
123
What are the 2 transport systems of principle cells of CD
1. NaCL reabsorption by ENaC
| 2. K secretion by ROMK
124
What are the two types of intercalated cells?
1. Type A
| 2. Type B
125
What is the transport system of Type A intercalated cells?
Secretes H and reabsorbs HCO3-
126
What is the transport system of Type B intercalated cells?
Reabsorbs H and Secretes HCO3-
127
Which segment of the nephron is responsable for the reabsorption of the bulk of filtered solutes?
a. Proximal Tubule
b. Thin limbs of Henle's loop
c. Thick ascending limb of henle's loop
d. Distal convoluted tubule
e. Collecting duct
a. Proximal tubule
128
What transporters are located on the apical surface of the PCT?
1. Na/H antiport
| 2. Na dependent Symport carriers
129
What transporters are located on the Basolateral surface of PCT?
1. Na, K ATPase
| 2. Na,HCO3 symport
130
What transporters are located on the apical surface of the loop of henle?
1. K symport
| 2. paracellular Cl (NKCC)
131
What transporters are located on the basolateral surface of the loop of henle?
1. Na, K ATPase
132
What transporters are located on the apical surface of the DCT and CD?
1. Na, Cl Symport
| 2. Na Channels (ENaC)
133
What transporters are located on the basolateral surface of the DCT and CD?
1. Na, K ATPase
| 2. Na, Ca exchanger
134
Which hormone increases Na reabsorption in the PT, TAL and DCT?
Angiotensin II
135
Which hormone stimulates Na Reabsorption in the CD?
Aldosterone
136
Which hormone stimulates NKCC in the TAL
ADH
137
Which 3 hormones stimulate solute reabsorption?
1. Angiotensin II
2. Aldosterone
3. ADH
138
Which 3 hormones inhibit solute reabsorption
1. NO
2. Endothelin-1
3. ANP
139
Which hormones increases Na excretion through inhibition of NHE3, NA, K-ATPase, NKCC, and ENaC
NO, Endothelin-1
140
Which hormone inhibits aldosterone and renin release and inc. Na excretion?
ANP
141
The ultimate rate of K+ excretion is determined by the
a. CD, which reabsorbs or excretes K depending on the need of the body
b. PT, which reabsorbs or secretes K
c. TAL, which reabsorbs K, Na, and Cl
a
142
The kidneys are responsible for maintaining a constant composition of the following body fluids:
a. the plasma
b. the interstitial fluid
c. the intracellular fluid
d. a and b
e. all of the above
d.
143
In a patient with an acute renal vein thrombosis. . .
a. the surface area available for filtration is dramatically reduced
b. the GFR is reduced
c. The filtration barrier permeability is inc.
d. a and b
b
144
T/F. After a damage to a nephron, tubular cells cannot be regenerated
F
145
Which of the following structures is not a component of the filtration barrier?
a. Capillary Endothelium
b. Bowman's capsule
c. Podocytes
d. Glomerular BM
B
146
The main driving force for filtration in the glomerulus is
a. the oncotic pressure of the blood
b. hydrostatic pressure of the blood
c. the oncotic pressure in bowman's space
d. the hydrostatic pressure in bowman's space
b
147
The glomerular filtrate:
a. Is the total volume of fluid entering the glomerulus
b. Is the total volume of fluid enterin bowman's space
b.
148
Which renal parameter can be calculated dividing GFR by RPF?
a. renal blood flow
b. Fractional excretion
c. Fractional Filtration
c.
149
Which of the following is not an effect of angiotensin II?
a. stimulation of fluid intake
b. Arteriolar contraction
c. Renal excretion of sodium
d. Stimulation of aldosterone release
c.
150
The main mechanism by which some drugs and toxins are excreted in the kidney is
a. Glomerular filtration
b. Active transport in the PT
c. Passive transport in the PT
d. Exocytosis in the PT
b
151
T/F. Magnesium is mainly reabsorbed in the TAL
T
152
Which segment of the nephron is responsible for reabsorption of most of the Ca.
a. DCT
b. CD
c. Loop of Henle
d. PT
d.
153
What do glucose and AA transport have in common?
a. both processes take place in the PT
b. Both processes can be saturated
c. Both are reabsorbed with sodium
d. A and C
e. All of the above
e
154
Which of the following could be a cause of glucosuria?
a. inc. blood levels of glucose
b. An inflammation of the urinary system
c. reduced capacity in the PT
d. A and C
e. B and C
d
155
```
Which segment of the renal tubule is responsible for the reabsorption of the bulk of filtered solutes?
a. PT
b. Thin limbs of Henle's loop
c. TAL
d. DCT
e CD
```
a
156
The main driving force for the reabsorption of solutes from the tubule fluid is
a. active transport of solutes across the apical PM
b. Secondary active transport of solutes across the apical PM
c. Active transport of Na from the tubule epithelial cell across the basolateral PM by the electrogenic Na channel
d. Active transport of Na from the tubule epithelial cell across the basolateral PM by the Na,k-ATPase
e. Passive diffusion of solutes through paracellular pathway
d
157
Glucose is found in the urine of an animal when:
a. Glucose transport in the PT are inhibited by furosemide
b. Glucose secretion in the PTis stimulated by angiotensin 2
c. Glomerular filtration barrier is defectiv casing increased glucose in the tubule fluid
d. plasma glucose is elevated, inc. glucose conc. in the tubule fluid above the pt transport capacity
e. elevated plasma glucose stimulates pt glucose secreation
d
158
The ultimate rate of excretion of K in the urine is determined by the
a. conc. of K in the glomerular filtrate
b. PT, which reabsorbs or secretes K to meet the physiological requiremnts of the animals
c. TAL, where K secretion is enhanced by high plasma K conc.
d. DCT, which has the K pumps that are inserted in the apical or basolateral PM, depending on the need for reabsorption or secretion of K
e. CD, where the principle cells are capable of K secretion, and the intercalated cells are capable of K reabsorption
e
159
Which of the following are effects of aldosterone on Na tranport in the connecting segment and collecting duct?
a. Enhances the permeability of Na channels in th eapical PM, thereby enhancing Na reabsorption
b. stimulates Na,K-ATPase activity in the basolateral PM, thereby enhancing Na reabsorption
c. reduces Na permeability of the apical PM, thereby inhibiting Na reabsorption
d. Reduces Na,K-ATPase activity in the basolateral PM, thereby inhibiting Na reabsorption
e. Reduces the K permeability of the apical PM, thereby inhibiting K reabsorption
a,b
