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Anatomical Sciences > Kidney > Flashcards

Kidney Flashcards

(64 cards)

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1
Q

roughly how many nephrons do humans have

A

1 million

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2
Q

which is most outermost; the medulla or the cortex?

A

cortex

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3
Q

average osmolarity in the PCT

A

300-400mOsm

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4
Q

average osmolarity at the bottom of the loop of henle

A

1000-1200mOsm

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5
Q

average osmolarity of the thick ascending loop of henle

A

100-200mOsm

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6
Q

how many litres of water are filtered a day

A

180 litres

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7
Q

how many litres of water are excreted a day

A

1.5 litres

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8
Q

name the three layers in the filtration membrane of the bowmans capsule

A

endothelial with fenestrations
gel-like basement membrane
slit diaphragms with filtration slits between the podocytes

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9
Q

symptoms of nephrOtic syndrome

A

high prOtein
Oedema
lOw albumin
hyperlipidemia (increased triglycerides and chOlesterOl)

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10
Q

symptoms of nephrItic syndrome

A

mild levels of protein in urine
hematuria
hypertension
blurred vision

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11
Q

post streptococcal glomerulonephritis is caused by?

A

autoimmune reaction 10-14 days after infection caused by streptococcus
immune complexes deposit at glomerular membrane leading to damaged filtration barrier –> loss of protein/albumin in urine

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12
Q

symptoms of post streptococcal glomerulonephritis

A 
hematuria
loss of protein in urine
decreased blood-albumin
oedema 
(pretty similar to nephrOtic syndrome)
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13
Q

how to diagnose streptococcal glomerulonephritis?

A

biopsy –> nothing is linear

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14
Q

how to treat strep glomerulonephritis?

A

no specific treatment - just relieving symptoms
antibiotics used to kill strep
blood pressure meds and diuretics to control swelling and high blood pressure
corticosteroids NOT effective
limit salt diet

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15
Q

what percent of plasma is filtered into the bowman space and PCT

A

20%

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16
Q

what are diuretics

A

drugs that increase urine output

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17
Q

what are diuretics used to treat

A

oedema
congestive heart failure
hypertension

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18
Q

how does mannitol work

A

increases plasma osmolarity
increases osmotic pressure in glomerular filtrate
decreases h20 reabsorption from nephron
draws fluids from tissues - not brain or eye

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19
Q

what conditions would mannitol be used to treat

A

forced diuresis - poisonings
glaucoma
cerebral oedema
must be slow filtration to avoid dehydration

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20
Q

what percent of sodium is reabsorbed in the PCT

A

65-70%

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21
Q

how does sodium leave the nephron tubular lumen into the proximal tubule epithelial cell

A

co-transport with glucose/amino acids

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22
Q

how does sodium leave the proximal tubule epithelial cell to the blood capillary

A

3Na+ - 2K+ antiport

sodium out and potassium in

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23
Q

what is SGLT2

A

sodium/glucose cotransporter

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24
Q

which is more common, SGLT1 or 2

A

SGLT2 (>90%)

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25
how does SGLT2 work
it pumps both sodium and glucose out of the nephron tubular lumen and into the proximal tubule epithelial cell
26
how does glucose leave the proximal tubule epithelial cell into the blood capillary
via facilitated diffusion
27
what do SGLT2 inhibitors treat and how do they work
treat diabetes | by preventing glucose reuptake
28
what does acetazolamide do? (Carbonic anhydrase diuretic)
suppresses H+ production so reduces Na+ - H+ exchange so less Na+ reabsorption causes mildly alkaline urine and metabolic acidosis effect is self limiting
29
loop of henle TAL - impermeable or permeable to water?
impermeable
30
what percent of sodium from original filtrate is reabsorbed in the TAL
25%
31
is the TAL thick or thin?
thick
32
describe the countercurrent multiplication in the loop of henle
- NaCl actively pumped out of TAL until the ascending limb is 200mOsm - descending limb is permeable to salt and water so both move back into the loop of henle - salt and water move up the TAL and salts are pumped out again - this continues making the salt trapped in the lower medullary interstitum and loop of henle
33
where do loop diuretics operate
in the ascending limb of the loop of henle
34
what do loop diuretics target
Na+/2Cl-/K+ co transporter
35
loop diuretics cause what percent of sodium to be excreted
15-25%
36
what percent of sodium is reabsorbed in the DCT
5%
37
how do thiazides work
block Na+/Cl- co transporter resulting in high osmolarity of urine and decreased water reabsorption effect is self limiting
38
where do thiazides work
DCT
39
how are thiazides self limiting
lower blood volume --> renin secretion --> angiotensin formation and aldosterone secretion --> limitation of the effect of thiazides
40
what percent of sodium is reabsorbed in the collecting duct
1-2%
41
control of water excretion in the collecting duct is regulated by......?
ADH
42
what happens to the walls of the distal nephron in the absence of ADH
they are impermeable to water
43
what is the effect of ADH
increases water permeability of the cortical and medullary collecting ducts
44
where is ADH produced
hypothalamus
45
where is ADH stored
posterior pituitary
46
what receptors does ADH bind to
V2 receptors on the apical cell membranes of the principal cells
47
what does ADH stimulate the insertion of
aquaporins
48
what triggers the release of ADH
increase in osmolarity is detected by osmoreceptors which shrink leading to increased frequency of nerve impulses to the posterior pituitary gland leading to the secretion of ADH from nerve terminals
49
what condition does reduced effectiveness of ADH cause
diabetes insipidus
50
Symptoms of diabetes insipidus
excretion of large volumes of dilute urine | thirst
51
what is pituitary (central) diabetes insipidus
head - no/reduced release of ADH from pituitary gland - can be successfully treated by self-administered nasal spray providing ADH replacement therapy
52
what is nephrogenic (peripheral) diabetes insipidus
kidney - unresponsive to circulatory ADH (lack of V2 receptors in collecting duct) - genetic - disrupts ability to synthesise aquaporins
53
what is the mode of action of ENaC blockers
K+ sparing diuretics directly block epithelial Na+ channel (eNaC) in DCT, collecting tubules and ducts used in conjunction with loop and thaizide duiretics to maintain K+ balance
54
what is the mode of action of spironolactone
aldosterone antagonist
55
action of aldosterone on Na+ reabsorption
early phase: increases opening of ENaC | late phase: promotes DNA transcription, increases synthesis of ENaC and Na+,K+-ATPase
56
where in the kidney is renin secreted from
juxtaglomerular cells in afferent/efferent arterioles
57
sympathetic nervous system stimulation increases because of falling blood pressure due to........
baroreceptors in periphery | intrarenal baroreceptors innervating the juxtamedullary nephron
58
renin inhibitor inhibits what converting to what
angiotensinogen to angiotensin 1
59
ACE inhibitor inhibits what converting to what
angiotensin 1 to 2
60
kidney helps the formation of the active form of which vitamin
vitamin D
61
what does vitamin D deficiency result in
weak bones in children and adults
62
what does EPO do in the blood stream
binds with receptors in the bone marrow stimulating red blood cell production
63
how is EPO synthesised
- reduced oxygen delivery to renal cortex (due to anaemia, altitude, CO poisoning, respiratory disease) - HIF - EPO release stimulates bone marrow progenitor cells --> erythrocytes
64
the kidney accounts for ____% of EPO production in adults
80%

Anatomical Sciences (6 decks)

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