Kidney 3

Question 1

What are the two main components of the nephron?

Answer 1

the glomerulus
renal tubule where filtered fluid becomes urine

Question 2

The glomerulus and Bowman’s capsule form a united structure called the

Answer 2

renal corpuscle

Question 3

The initial process of glomerular filtration begins

Answer 3

in the renal corpuscle

Question 4

_____________ is the driving force that pushes fluid from the blood into the Bowman’s capsule

Answer 4

the net filtration pressue

Question 5

The net filtration pressure is equal to

Answer 5

glomerular hydrostatic pressure- Bowman’s capsule hydrostatic pressure- glomerular oncotic pressure

Question 6

Describe the difference between mild versus excessive constriction of the efferent arteriole.

Answer 6

mild constriction reduces flow towards the peritubular capillaries and increases GFR
excessive constriction reduces renal blood flow as well as GFR

Question 7

Describe maximum transport.

Answer 7

For some substances, there’s a maximum amount that can be reabsorbed into the peritubular blood. After the maximum value is achieved, the excess substance will be excreted in the urine

Question 8

Urine formation is the

Answer 8

sum of glomerular filtration, tubular reabsorption and tubular secretion

Question 9

Urinary excretion rate is equal to

Answer 9

filtration - reabsorption + secretion

Question 10

Where does MOST of the sodium reabsorption occur in the nephron?
a. proximal tubule
b. distal tubule
c. collecting duct
d. ascending loop of Henle

Answer 10

a. proximal tubule

Question 11

_____________ of the filtered sodium load is actively transported out of the proximal tubule and the same amount of filtered water follows

Answer 11

65% (much more than anywhere else)

Question 12

The following follow suit in direct proportion to sodium reabsorption in the proximal tubule

Answer 12

potassium
chloride
bicarbonate

Question 13

The descending limb of the loop of Henle is highly permeable to

Answer 13

water and modestly permeable to ions

Question 14

_________________ participates in the countercurrent system where the primary objective is to concentrate the urine by transferring water from the tubular fluid to the peritubular interstitium and ultimately returning it to the blood

Answer 14

The descending limb

Question 15

______________ is impermeable to water

Answer 15

the ascending limb

Question 16

Since water cannot follow sodium into peritubular interstitium, the ultrafiltrate

Answer 16

becomes more dilute and the peritubular becomes concentrated

Question 17

The distal tubule is where _______ of the sodium load is reabsorbed.

Answer 17

5%

Question 18

____________ is impermeable to water except in the presence of aldosterone or antidiuretic hormone

Answer 18

the late distal tubule

Question 19

The following work in the collecting duct

Answer 19

ADH, aldosterone, & ANP

Question 20

Reabsorption of electrolytes requires _________ while reabsorption of water occurs by

Answer 20

energy in the form of ATP; osmosis

Question 21

The following are secreted into the proximal tubule by the sodium counter-transport mechanism

Answer 21

organic bases, acids, and hydrogen ions

Question 22

The primary function of the loop of Henle is to

Answer 22

participate in forming concentrated or dilute urine

Question 23

the loop of Henle separates

Answer 23

the handling of sodium & water (where sodium goes, water does NOT follow)

Question 24

The osmolarity of the peritubular interstitium progressively

Answer 24

increases as the descending limb travels from the cortex towards the medulla

Question 25

_________-- adjusts urea concentration

Answer 25

Distal convoluted tubule

Question 26

__________ regulates the final concentration of urine

Answer 26

Collecting duct

Question 27

The collecting duct adjusts_____________- concentration

Answer 27

hydrogen

Question 28

Where does aldosterone and ADH act on the nephron?

Answer 28

distal tubule & collecting ducts

Question 29

Where in the nephron does parathyroid hormone promote Ca2+ reabsorption?

Answer 29

distal tubules

Question 30

Carbonic anhydrase inhibitors work by

Answer 30

noncompetitively inhibiting carbonic anhydrase in the cells that make up the proximal tubule

Question 31

Carbonic anhydrase inhibitors reduce the reabsorption of

Answer 31

bicarb, na+ & water

Question 32

Carbonic anhydrase inhibitors produce

Answer 32

a mild hyperchloremic metabolic acidosis

Question 33

Carbonic anhydrase inhibitors are used to treat

Answer 33

high altitude sickness central sleep apnea open-angle glaucoma

Question 34

Osmotic diuretics are sugars that undergo

Answer 34

filtration but not reabsorption

Question 35

Osmotic diuretics inhibit water reabsorption in the

Answer 35

proximal tubule (primary site) as well as the loop of Henle

Question 36

With osmotic diuretics describe the ratio of water and electrolyte excretion.

Answer 36

water in excess of electrolytes

Question 37

Osmotic diuretics transiently increase

Answer 37

intravascular volume

Question 38

Osmotic diuretics can lead to ____________ in the patient with congestive heart failure

Answer 38

pulmonary edema

Question 39

Loop diuretics work by

Answer 39

disrupting the Na-K-2Cl transporter in the medullary region of the thick portion of the ascending loop of Henle

Question 40

Key complications of loop diuretics include

Answer 40

hypokalemia hypocalcemia metabolic alkalosis ototoxicity

Question 41

______________ inhibit the Na-Cl co-transporter in the distal tubule

Answer 41

Thiazides

Question 42

Unique side effects of thiazide diuretic include

Answer 42

hypercalcemia hyperuricemia hyperglycemia

Question 43

Potassium-sparing diuretics are designed to prevent

Answer 43

hypokalemia- but can be problematic b/c it leads to hyperkalemia which is a problem for patients who take NSAIDs, beta-blockers, or ACE-inhibitors

Question 44

Examples of carbonic anhydrase inhibitors include

Answer 44

acetazolamide dorzolamide

Question 45

Complications of carbonic anhydrase inhibitor includes

Answer 45

metabolic acidosis hypokalemia in patients with COPD, loss of bicarb in the urine may exacerbate CNS depression from severe hypercarbia

Question 46

Dose of acetazolamide:

Answer 46

250-500 mg

Question 47

Osmotic diuretics include

Answer 47

mannitol glycerin isosorbide

Question 48

______________ is a free radical scavenger

Answer 48

Mannitol- may limit cellular edema & decrease obstruction of renal tubules

Question 49

The dose of mannitol is

Answer 49

0.25-1 g/kg

Question 50

Clinical uses of osmotic diuretics include

Answer 50

prevention of AKI- little evidence to support intracranial hypertension differential diagnosis of acute oliguria (mannitol increases UOP if prerenal but has no effect with intrinsic injury)