glomerular filtration Flashcards
1
Q
GFR
- ___ml/min
- ___ L/day
A
125
180
2
Q
plasma volume is filtered __ times per day
A
60
3
Q
glomerular filtrate composition is about the same as ___, except for the absence of large ___
A
plasma
large proteins
4
Q
filtration factor = ___/____ ___ ____
A
GFR/ renal plasma flow
5
Q
filtration factor = ___ or ___%
A
.2
20%
6
Q
3 parts to the capillary filtration barrier
A
capillary endothelium
basement membrane
epithelium of glomerular capsule
7
Q
capillary filtration barrier is ____ and repels ____
A
electronegative
proteins
8
Q
mesangial cells: when contracted
- ___ surface area for filtration
A
decrease
9
Q
mesangial cells: when relaxed
- ___ surface area for filtration
A
increase
10
Q
polycationic dextran
- ___ charge
A
positive
11
Q
polyanionic dextran
- ___ charged
A
negatively
12
Q
____: presence of protein in the urine
A
proteinuria
13
Q
early detection of renal disease in at risk patients (4)
A
hypertension
diabetes
pregnancy
annual check up
14
Q
____: urine excretion of >30 but <150 mg albumin per day
A
microalbuminemia
15
Q
3 causes of microalbuminuria
A
early diabetes
hypertension
glomerular hyperfiltration
16
Q
prognostic value: diabetic patients with microalbuminuria are ___-___ fold more likely to develop persistent proteinuria
A
10-20
17
Q
filtration occurs due to a ___ gradient
A
pressure
18
Q
glomerular capillary filtration occurs rapidly due to the increased number of ___
A
fenestrations
19
Q
glomerular hydrostatic pressure and filtration are directly related to ___ ___
A
blood pressure
20
Q
increase afferent arteriole resistance –> __ GFR
A
decreased
21
Q
increase in efferent arteriole reistance –> ___ GFR
A
increase
22
Q
GFR = ___ml/min
A
125
23
Q
net filtration pressure = ___mmHg
A
10
24
Q
filtration coefficient (Kf) = \_\_\_ml/min per mmHg OR \_\_\_\_ml/min per mmHg/100 gm
A
- 5
4. 2
25
Kf (filtration coefficient) = ___ ___ x ___ ___
hydraulic conductivity
| surface area
26
Kf cannot be measure directly but can be estimated by dividing ___ by ___
GFR
| NFR
27
3 diseases that can reduce Kf and GFR
chronic hypertension
obesity/diabetes mellitus
glomerulonephritis
28
bowmans capsule hydrostatic pressure (Pb) normally changes as a ___ of GFR
function
29
2 tubular obstructions that effect Pb (bowman's capsule hydrostatic pressure)
kidneys stones
| tubular necrosis
30
urinary tract obstruction that effects Pb
prostate hypertrophy/cancer
31
GFR =
glomerular filtration rate
32
Kf=
filtration coefficient
33
Pg =
glomerular hydrostatic pressure
34
Pc=
capsular hydrostatic pressure
35
πg =
glomerular oncotic pressure
36
πc =
capsular oncotic pressure
37
___: osmotic pressure caused by protein
oncotic
38
why is the capsular oncotic pressure practically 0?
NO PROTEINS
39
increase arterial plasma oncotic pressure --> ___ glomerular capillary oncotic pressure --> ____ GFR
increase
| decrease
40
increase the filtration factor (FF) --> ____ glomerular capillary oncotic pressure
INCREASE
41
filtration factor = ___/___ ___ ___
GFR
| renal plasma flow
42
filtration is favored at the ___ end of the glomerulus
afferent
43
reabsorption is favored on the ___ end of the glomerulus
efferent
44
___ ___ pressure is the determinant of GFR most subject to physiologic control
glomerular hydrostatic pressure
45
3 factors that influence glomerular hydrostatic pressure
arterial pressure
afferent arteriolar resistance
efferent arteriolar resistance
46
increase in afferent arteriolar resistance --> ___ GFR and ___ renal blood flow
decrease
| decrease
47
increase in efferent arteriolar resistance --> ___ GFR and ___ renal blood flow
increase
| decrease
48
increase the filtration coefficient --> ___ GFR
increase
49
increase hydrostatic pressure of bowmans capsule --> ___ GFR
decrease
50
increase glomerular oncotic pressure --> ___ GFR
decrease
51
increase arterial oncotic pressure --> ___ glomerular oncotic pressure --> ___ GFR
increase
| decrease
52
increase filtration factor --> ___ glomerular oncotic pressure --> ___ GFR
increase
| Decrease
53
increase glomerular hydrostatic pressure --> ___ GFR
increase
54
increase afferent arteriolar resistance --> ____ glomerular hydrostatic pressure --> ___ GFR
decrease
| decrease
55
increase efferent arteriolar resistance --> ___ glomerular hydrostatic pressure --> ___ GFR
increase
| increase
56
Renal Blood Flow (RBF) = ____ _____ / ____
(difference in) pressure / resistance
57
difference in pressure is the difference between renal ___ pressure and renal ___ pressure
artery
| vein
58
high blood flow is needed for ___ GFR
high
59
oxygen and nutrients delivered to kidney normally greatly exceeds their ___ needs
metabolic
60
a large fraction of renal oxygen consumption is related to renal tubular ___ reabsorption
sodium
61
control of renal blood flow and GFR through ___ or ___
neurohormonal
| local
62
```
SP/catecholamines
- greatly increase resistance of ____ arterioles
- increase resistance in ____ arterioles
LEADS TO
- ___ GFR
- greatly ____ RBF
```
afferent
efferent
decrease
decrease
63
```
low levels of angiotensin II
- ___ efferent arteriolar resistance
LEADS TO
- ____ GFR
- __ RBF
```
increase
increase
decrease
64
```
high levels of angiotensin II
- ___ efferent arteriolar resistance
LEADS TO
- ____ GFR
- __ RBF
```
increase
decrease
decrease
65
NSAIDS
- anit-_____
- activates ___ ___
prostaglandins
| renal failure
66
```
prostaglandins
- greatly ___ afferent arteriole resistance
- ___ efferent arteriolar resistance
LEADS TO
- ___ GFR
- greatly ___ RBFs
```
decrease
Decrease
increase
increase
67
prostaglandins counteract ____
catecholamines
68
blockade of prostaglandin synthesis --> ___ GFR
decrease
69
```
endothelial derived nitric oxide
- greatly ___ afferent arteriolar resistance
- ___ efferent arteriolar resistance
LEADS TO
- __ GFR
- greatly ___ RBF
```
decrease
decrease
increase
increase
70
endothelial derived Nitric oxide protects against excessive ____
vasoconstriction
71
```
endothelin
- greatly ___ afferent arteriolar resistance
- ___ efferent arteriolar resistance
LEADS TO
- ___ GFR
- greatly ___ RBF
```
increase
increase
decrease
decrease
72
hepatorenal syndrome - decreased renal function in cirrhosis because of the replacement of liver cells by ___
tissues
73
renal sodium avidity --> ___
ascites
74
renal vasoconstriction --> ___ ___
hepatorenal syndrome
75
myogenic mechanism
- increase arterial pressure --> ___ stretch of blood vessel --> ___ cell calcium entry --> ___ intracellular calcium --> ___ vascular resistance --> ___ blood flow and GFR --> stimulates ___ arterial pressure ect
```
increase
increase
increase
increase
stimulates
inhibits
```
76
macula densa feedback
- decreased GFR --> ___ distal NaCl delivery --> ___ macula densa NaCl reabsorption --> ___ afferent arteriolar resistance --> ___ GFR
decrease
decrease
decrease
increase
77
macula densa feedback
- increase proximal NaCl reabsorption --> ___ distal Nacl delivery --> ___ macula densa NaCl reabsorption --> ___ afferent arteriolar ---> ___ GFR
decrease
decrease
decrease
increase
78
angiotensin II
- decrease GFR --> ___ macula densa NaCl --> ___ renin --> ___ angII --> ___ blood pressure OR ___ efferent arteriolar resistance --> __ GFR
```
decrease
increase
increase
increase
increase
increase
```
79
fever and pyrogens ___ GFR
increase
80
glucorticoids ___ GFR
increase
81
aging ___ GFR by 10%/decade
decreases
82
hyperglycemia ___ GFR
increase
83
dietary proteins
- high proteins ___ GFR
- low proteins ___ GFR
increase
| decrease
84
___: rate at which substances are removed from the plasma
clearance
85
___ ___: volume of plasma completely cleared of a substance per minute by the kidneys
renal clearance
86
glucose and albumin are completely ___
reabsorbed
87
___ is the best way to measure GFR
inulin
