Nephro Uro Anderson

Question 1

the afferent arteriole is sensitive to

Answer 1

epinephrine

Question 2

the efferent arteriole is sensitive to

Answer 2

angiotensin 2

Question 3

interpretation of clearance > GFR

Answer 3

filtration + net secretion

Question 4

interpretation of clearance = GFR

Answer 4

filtration only or secretion = resorption

Question 5

interpretation of clearance

Answer 5

filtration + net resorption

Question 6

contraction of afferent arteriole ___ GFR

Answer 6

decreases

Question 7

contraction of efferent arteriole ___ GFR

Answer 7

increases

Question 8

hyperosmolarity results in what response

Answer 8

thirst, ADH release

Question 9

osmoregulation is through what part of the brain

Answer 9

hypothalamus

Question 10

volume regulation is through what two things

Answer 10

baroreceptors and macula densa

Question 11

volume blood loss results in what response

Answer 11

sympathetic activation, renin release from JGA

Question 12

2/3rds of Na and H2O are reabsorbed in the

Answer 12

proximal tubule

Question 13

all glucose, HCO3, and amino acids are reasorbed in the

Answer 13

proximal tubule

Question 14

in the proximal tubule Na is resorbed using

Answer 14

Cotransport (glucose, AA, PO4) and countertransport (H+ exchange)

Question 15

where is the site of Carbonic Anhydrase Inhibitor activity

Answer 15

proximal tubule…blocks HCO3 reabsorption

Question 16

25% of Na is reabsorbed in the

Answer 16

thick ascending loop on henle

Question 17

in the thick ascending loop of henle, Na is reabsorbed using

Answer 17

Na-K-Cl cotransporter

Question 18

% of Na is reabsorbed in the

Answer 18

distal tubule/collecting duct

Question 19

in the distal tubule/collection duct Na is reabsorbed via

Answer 19

Na-Cl cotransporter

Question 20

67% of K is reabsorbed in the

Answer 20

proximal tubule

Question 21

20% of K is reabsorbed in the

Answer 21

thick limb…Henle

Question 22

in the tick limb…Henle the K is reabsorbed via

Answer 22

Na-K-2Cl cotransporter

Question 23

if you have low Na/Cl at the macula densa, what happens

Answer 23

release of active renin from JGA = angiotenisin

Question 24

what does angiotensin II do

Answer 24

constricts the efferent arteriole causes increased GFR

Question 25

where does angiotensinogen come from

Answer 25

liver

Question 26

enzyme that converts angiotensinogen to angiotensin I

Answer 26

renin

Question 27

where is renin from

Answer 27

JGA

Question 28

angiotensin I is converted to angiotensin II by

Answer 28

ACE

Question 29

where is ACE from

Answer 29

lung

Question 30

why is renin released from JGA

Answer 30

when GFR is low, low blood volume, increased blood osmolarity

Question 31

in addition to constricting the efferent arteriole, angiotensin II does this to the adrenal cortex zona glomerulosa

Answer 31

causes release of aldosterone which tell distal tubule to reabsorb Na and excrete K...sodium reabsorption leads to increased water reabsorption, increased blood volume, and decreased blood osmolarity

Question 32

where are osmoreceptors located

Answer 32

anterior hypothalamus

Question 33

where does ADH come from

Answer 33

posterior pituitary

Question 34

glutamic acid can undergo oxidative deamination to become

Answer 34

alpha ketoglutarate

Question 35

what does ALT (alanine aminotransferase) do

Answer 35

takes alanine to pyruvate using vit B6

Question 36

what does AST (aspartate aminotransferase) do

Answer 36

takes aspartate to oxaloacetate using vitamin B6

Question 37

what are the two original substrates of the urea cycle

Answer 37

CO2 and NH4

Question 38

where does the urea cycle happen

Answer 38

liver

Question 39

what happens in the mitochondria portion of the urea cycle

Answer 39

CO2 and NH4 and put together using carbamoyl phosphate synthetase to create carbamoyl phosphate. Carbamoyl phosphate is them cobined with L-ornathine using ornithine transcarbamoylase and to create L-citruline which goes to the cytosol

Question 40

what happens in the cytosol portion of the urea cycle

Answer 40

L-citruline undergoes several transaminations to become L-arginine. L-arginine has urea taken out of it by arginase. L-ornithine is the left over and that goes back into the mitochondria.

Question 41

Acute Nephritis: acute post-strep Glomerulonephritis

Answer 41

Red cell casts, 1-2 weeks after recovery from sore throat; Children 6-10 yrs, moderate proteinuria.

Question 42

IgA Nephropathy/Berger's dz

Answer 42

Increased IgA in response to viruses, bacteria, food proteins...Antibodies injure glomerulus (precipitative nature of Ab’s)...Hematuria comes & goes; chronic GN

Question 43

Henoch-Schonlein Purpura

Answer 43

Purpuric skin lesions on extensor surface of extremities & buttock...IgA precipitation after respiratory infection, kids 3-8 yrs...Hematuria recurrences for yrs.

Question 44

Goodpasture's Syndrome

Answer 44

Rapid GN with auto-antibodies to basement membrane...Young men who smoke...Death due to renal failure or lung hemorrhage

Question 45

Nephrotic syndrome

Answer 45

Heavy proteinuria, hypoalbuminemia, severe edema, hyperlipidemia, lipiduria ...Kids > dt primary kidney dz ...Adults > SLE, DM, amyloidosis, membranous GN most common cause ...More in men. Immune complexes in basement membrane, food allergy

Question 46

pyelonephritis

Answer 46

Affects tubules or interstitium | ...Ascending fecal flora, females, pregnancy, BPH (secondary to stasis of urine). Pyelo- indicates renal Pelvis.

Question 47

hydronephrosis

Answer 47

dilation of renal pelvis & calyces associated with progressive atrophy of kidney dt obstruction of urine outflow

Question 48

Urolithiasis

Answer 48

75% Ca oxalate, radiopaque(show up on X-ray); 25% Radiolucent (no X-ray); Proteus or Staph infection cause alkaline urine / increase crystal formation Staghorn calculi = large obstructive stomes in pelvis; 6% uric acid calculi, secondary to gout, radiolucent

Question 49

cystitis

Answer 49

Females > males, E. coli, urethral trauma, bacterial contamination, Can lead to PN, chronic cystitis, Frequency, urgency, dysuria, suprapubic pain

Question 50

interstitial cystitis

Answer 50

Usually women, chronic cystitis, inflammation of all layers of bladder, normal urinalysis. Suprapubic pain when bladder is full which is relieved by voiding.

Question 51

Adenocarcinoma/Hypernephroma

Answer 51

Cigarette, pipe, & cigar smokers; upper kidney pole, solitary, unilateral... Metastasize to lung & bone before sx appear

Question 52

Wilm's Tumor

Answer 52

Common primary renal tumor in kids, genetic, age 2-5 yrs, | Large abd mass, painless hematuria, good prognosis with tx

Question 53

Benign Ureteric Tumors

Answer 53

polyps. May be too small to cause obstruction

Question 54

malignant ureteric tumors

Answer 54

primary rare, transitional cell CA, obstruction, painless hematuria

Question 55

Tumors of the Bladder

Answer 55

Risk factors; Industrial solvents, > cigarette smoking. Transitional cell tumors, benign papilloma; 90% transitional cell carcinoma, squamous cell carcinoma, Painless hematuria, HCG in urine is marker of aggressive tumor, tends to recur after excision