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Integrated clinical studies > more renal > Flashcards

more renal Flashcards

1
Q

diabetes insipidus

A

caused by a failures of the kidneys to respond to ADH. Can be caused by damage to the hypothalamus or pituitary gland as a result of genetic problem

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2
Q

symptoms of diabetes insipidus

A

a rare condition where you produce large amounts of urine and feel thirsty

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3
Q

diabetes insipidus and diabetes mellitus includes

A

both type 1 and type 2 diabetes

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4
Q

diabetes mellitus

A

causes high blood glucose resulting from the boys inability to use blood glucose for energy §

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5
Q

2 cells of collecting duct

A

intercalated and principle cells

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6
Q

intercalated cells

A

alpha -H+ and beta- HCO3-

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7
Q

principle cells

A

ADH works on these cells- inserting aquaproins

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8
Q

what hormone that is related to blood cells is released by the kidneys

A

erythropoietin

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9
Q

erythropoietin

A

acts on the bone marrow to stimulate the production of RBC

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10
Q

what powers the reabsorption power of the principle cells

A

Na/K ATPase pump

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11
Q

what does the Na/K ATPase pump in the principle cells generate

A

a low intracellular Na+ and a high intracellular K+

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12
Q

how are H+ ions secreted from alpha intercalated cells

A

Via primary active transport.

Using a lumina H+ ATPase pump- H/K ATPase pump that actively reabsorbs K+ ions whilst secreting H+ ions

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13
Q

how does the H/K ATPase pump of the alpha intercalated cells work

A

by actively reabsorbingK+ ions whilst secreting H+ ions

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14
Q

ADH secreted from

A

posterior pituitary

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15
Q

osmolarity of renal medulla: Loop of Henle

A 
PCT: 300
Descending LoH: 400-600-900
Loop: 1,200
Ascending loop: 700--> 400--> 200
Distal: 100
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16
Q

osmolarity of collecting duct

A

at the top 300 and at the bottom 1200

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17
Q

osmolarity refers to

A

measure of solute concentration.

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18
Q

osmolarity of the vas recta

A

descending: 300–> 900
loop: 1,200
ascending: 300 –> 900

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19
Q

what hormone is released by proximal cells

A

calcitriol

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20
Q

calcitriol

A

calcitriol is a steroid hormone that has long been known for its important role in regulating body levels of calcium and phosphorus, and in mineralization of bone

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21
Q

vasa recta

A

blood vessels surrounding the loop of henle

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22
Q

what controls BP

A

1) myogenic auto regulation
2) tubuloglomerulus feedback
3) neuronal regualtion

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23
Q

which cells are related to tubulglomerulus feedback

A

macula densa

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24
Q

typical symptoms of diabetes mellitus

A

glucosuria and polyuria

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25
Q

glucosuria

A

glucose in urine when not sufficiently reabsorbed

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26
Q

polyuria

A

excess urine production

  • not enough salts being reabsorbed- therefore less water to
  • p.pituitary secretes less ADH, therefore little water reabsorbed in collecting duct- decrease in aquaproins
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27
Q

the deeper down the loop of henle..

A

the more salty

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28
Q

filtrain membrane consists of

A

1) capillary endothelial fenestrations
2) gel-like basement membrane
3) slit diaphragms within filtration slits between the foot processes of podocytes

29
Q

whats in the glomerular filtrate

A

water, glucose, amino acids, urea - like plasma

30
Q

how much wine do you produce in a typical day?

A

typically, less than 2L/day - 98-99% of filtrate is reabsorbed

31
Q

what diseases are likely if the GFR is took high

A

if too high filtrate passes through the tubules too quickly and cannot be reabsorbed
-diabetes mellitus and diabetes insipidus

32
Q

a low GFR suggests

A

chronic renal failure

33
Q

why is use of creatine less accurate than inline when calculating GFR

A

due to some being secreted and absorbed in the tubules

34
Q

why is chronic renal failure deadly

A

1) waste products accumulate in blood
2) pH and electrolyte balance jeopardised
3) blood volume control impaired (hypertension and oedema)

35
Q

if the macula dense cells monitor that filtered na+/flow rate increases, GFR is..

A

decreased

36
Q

where are essential nutrients like glucose, amino acids and electrolytes reabsorbed

A

proximal tubule

-rleies on secondary active transport of Na+ (Na+/K+ ATPase pumps)

37
Q

what secretion takes place in the proximal convoluted tubulues

A

H+ and organic ions (acid-base balance and waste)

38
Q

water is reabsorbed… along the descending loop of henle

A

passively

39
Q

Na+ is actively reabsorbed along the ..

A

ascending loop

40
Q

which cotransporters pump Na+ out of ascending loop

A

Na+/K+/2Cl-

41
Q

what powers the Na+/K+/2Cl- co transporter used to reabsorb Na+ in ascending loop

A

Na+/K+ ATPase pump

42
Q

descending loop is permeable to

A

water but not solutes and leaves via osmosis

43
Q

ascending limb is..

A

impermeable to water but not to solutes. Na and Cl exit via AT

44
Q

where does further reabsorption of water take place

A

the collecting duct- ADH

45
Q

higher conc of solutes at

A

both of tubule

46
Q

diuresis

A

urine

47
Q

antidiuresis

A

less urine

48
Q

which cells monitor a fall in BP and GFR

A

juxtaglomerular cells- activate RAAS system

49
Q

which other cells regulate GFR

A

macula dense but short term via tubuloglomerular

50
Q

short term response to dehydration

A

ADH

51
Q

long term response to decreased body fluid volume

A

RAAS

52
Q

parathyroid hormone

A

Ca2+ reabsorption

53
Q

if the K+ conc of the body is reduced by 1/3

A

paralysis due to nerves being unable to generate AP

54
Q

if the Ca2+ conc of the body is reduced by half

A

titanic skeletal muscle contactions

55
Q

hyponatramia

A

not enough Na. Cause hypovoleamia, euvolaemia and hypervolaemia.

56
Q

hypernatramia

A

too much Na- much rarer. Potent stimulator of thirst

57
Q

sodium is largely located

A

extracelullarly

58
Q

potassium is largely located

A

intracellular

59
Q

hypokalaemia

A

causes diuretics, diarrhoea/vomiting

60
Q

hyperkalaemia

A

renal failure, tissue damage, acidosis, aldosterone impairment

61
Q

clinical changes that hyperkalaemia can bring

A

ECG changes, Kussmaul breathing (hyperventilation). Depolarisation of excitable cells.

62
Q

principle cell and K

A

secrete in exchange with Na+

63
Q

interrelated cells and K

A

reabsorb and exchange with H+

64
Q

which aquaporins in collecting duct and DCT

A

aquaporins

65
Q

acidosis results in

A

depression of CNS

66
Q

alkalosis results in

A

over excitability of the CNS and PNS

67
Q

aldosterone causes the insertion of

A

Na/K ATPase pumps, so more Na+ is reabsorbed

68
Q

ANP also inhibits the release of

A

aldosterone and ADH

Integrated clinical studies (23 decks)

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