Glomerular structure and function

Question 1

Basic functions of the urinary system:

Answer 1

• Maintain water balance
• Maintain salt balance
• Maintain pH
• Excrete metabolic waste
• Blood glucose regulation
• Endocrine
• Vitamin D

Question 2

2 hormones produced by the kidneys:

Answer 2

1. Renin

2. EPO

Question 3

Urethras cross what on the way to the bladder?

Answer 3

Bifurcation of the common illiac vessels

Question 4

Order of arteries in kidney:

Answer 4

Renal –> Segmental –> interlobar –> arcuate –> cortical radiate

Question 5

What kind of capilary beds are found in the nephron?

Answer 5

Double capillary beds

Question 6

Capilaries that follow the renal tubule:

Answer 6

Peritubular capillaries OR vasa recta

Question 7

What % of nephrons are cortical?

Answer 7

80%

Question 8

What % of nephrons are juxtamedullary?

Answer 8

15%

Question 9

Vasa recta are found in what type of nephron?

Answer 9

Juxtamedullar

Question 10

Special features of renal corpuscle for filtration:

Answer 10

1. Fenetrated endothelium
2. Basement membrane
3. Podocytes, foot processes, filtration slits

Question 11

Charge of basement membrane:

Answer 11

Negative

Question 12

Ultrafiltration =

Answer 12

Passive process in which hydrostatic pressure forces fluids and solutes through a membrane

Question 13

Glomerular filtrate contains:

Answer 13

Amino acids
Glucose
Ions
Water
Urea
Creatinine etc.

Question 14

JGA =

Answer 14

Juxtaglomerular appartus

Question 15

Cells of the JGA =

Answer 15

Juxtaglomerular cells
Macula densa cells
Mesangial cells

Question 16

Where are juxtaglomerular cells?

Answer 16

Afferent arteriole

Question 17

Where are macular densa cells?

Answer 17

DCT

Question 18

Function of mesangial cells =

Answer 18

Communicate between MD and JG cells

Question 19

Type of autoregulation/intrinsic regulation of GFR =

Answer 19

Tubulo-glomerular feedback

Question 20

Function of MD cells =

Answer 20

Respond to [NaCl] and release or inhibit vasoconstrictors.
High NaCl = vasoconstrict
Low NaCl = dilate

Question 21

Ex vasoconstrictor released by MD

Answer 21

ATP

Question 22

What kind of receptor is a MD cell?

Answer 22

Chemoreceptor

Question 23

RAAS =

Answer 23

Renin- angiotensin - aldosterone system

Question 24

Renin is made in the

Answer 24

Kidneys

Question 25

Function of renin

Answer 25

Converts angiotensinogen into angiotensin I

Question 26

Angiotensinogen is formed...

Answer 26

In the liver

Question 27

Function of ACE

Answer 27

Convert angiotensin I to angiotensin II

Question 28

ACE is made in the ...

Answer 28

Lungs

Question 29

Function of angiotensin II =

Answer 29

- Hypothalamus: Increase thirst and ADH - Increase Na+ and H2O resorbtion - Increase K+ excretion - Vasoconstriction - Formation of aldosterone

Question 30

Aldosterone is produces in the

Answer 30

Adrenal glands

Question 31

What kind of molecule is aldosterone?

Answer 31

Mineralcorticoid

Question 32

Function of aldosterone:

Answer 32

Upregulate the Na+-K+ exchanger. Increased Na+ and H20 retention. Increased K+ excretion.

Question 33

What is common in patients activating RAAS?

Answer 33

Hypokalaemia

Question 34

RC =

Answer 34

Renal clearance. Volume of plasma that is cleared of a substance in 1 min (ml/min)

Question 35

Quick and dirty measure of GFR =

Answer 35

Creatinine

Question 36

More accurate measure of GFR =

Answer 36

Renal clearance ratio

Question 37

GFR =

Answer 37

amount of fluid filtered into the Bowman's space per unit time.

Question 38

Equation for RC =

Answer 38

c = ([u]x x V) / [p] x Conc of substance x in urine times flow rate. divided by Conc of x in plasma

Question 39

Renal clearance ratio equation =

Answer 39

Cx / Cinulin

Question 40

Inulin =

Answer 40

Freely filtered not secreted or reabsorbed

Question 41

RCR = 1

Answer 41

Clearance same as inulin. Neither reabsorbed or secreted.

Question 42

Ex of substance with RCR =1

Answer 42

Creatinine

Question 43

RCR < 1

Answer 43

Substance isn't freely filtered OR is reabsorbed

Question 44

Ex of substance with RCR < 1

Answer 44

Isn't freely filtered = albumin | Reabsorbed = glucose

Question 45

RCR > 1

Answer 45

Substance is secreted

Question 46

Ex of substance with RCR > 1

Answer 46

Drug metabolites

Question 47

Common causes of acute renal injury can be broken into ...

Answer 47

1. Pre-renal 2. Renal 3. Post-renal

Question 48

Pre-renal causes of AKI

Answer 48

Hypovolemia, low DP, heart failurw, vasoactive mediators/drugs

Question 49

Renal causes of AKI

Answer 49

1. Acute tubular necrosis (ischemia) 2. Glomerularnephritis 3. Interstitial nephritis

Question 50

Post-renal causes of AKI

Answer 50

Uretal/bladder obstruction, kidney/bladder stones

Question 51

Common causes of CRF:

Answer 51

Hypertension T2 diabetes Glomerular diseases

Question 52

How many stages of chronic kidney diseases are there?

Answer 52

5

Question 53

stages of CKD:

Answer 53

1. Normal GFR, kidney damage 2. Mild reduced GFR 3. Moderate reduced GFR 4. Severe reduced GFR 5. End-stage renal disease

Question 54

Renal function of end-stage renal disease:

Answer 54

< 15 ml/min (or dialysis)

Question 55

Clinical manifestations of chronic renal failure:

Answer 55

1. Accumulation of nitrogenous wastes 2. Altered water, electrolyte and acid-base balance 3. Mineral and skeletal disorders 4. Anemia and coagulation disorders 5. Hypertension and alterations in CV function 6. Gi disorders 7. Neuro complications 8. Immunological disorders