Renal

Question 1

Where are your osmolality sensors located?
What does it do?

Answer 1

• at the Anterior Hypothalamus
• When you have hyperosmolarity, the Hypothalamus signals pituitary gland to stimulate thirst and secrete ADH.
• signals Cardiac atria ANP release tells kidneys to excrete sodium and water

S3

Question 2

How much is average total body of water?

Answer 2

~ 60%

S3

Question 3

How much is ECF and its components?

Answer 3

1/3 of TBW

• 3/4 is ISF
• 1/4 is Plasma

more immediately altered by kidneys

S3

Question 4

How much is ICF?

Answer 4

2/3 of TBW

S3

Question 5

What controls volume homeostasis?
And what occurs with low volume?

Answer 5

Juxtaglomerular Apparatus (JGA)

• it triggers RAAS to increase Na+/H2O reabsorption

S3

Question 6

On average, GFR decreases by _____ per decade starting from age 20.

Answer 6

10 ml/min

S46

Question 7

Which vertebrae are the kidney’s typically situated between?

Answer 7

T12 - L4

S21

Question 8

Which kidney is slightly more posterior? Why?

Answer 8

Right kidney is more posterior to accommodate the liver.

S21

Question 9

How much of CO do the kidneys receive?

Answer 9

20% ( 1-1.25L/min)

S23

Question 10

Large amounts of what macromolecule would be suggestive of glomerular injury?

Answer 10

protein

S26

Question 11

What are the primary structural/functional unit of the kidneys?

Answer 11

Nephrons

consist of: Glomerulus and Tubular system

1 M each nephron

Renal S22

Question 12

How much blood flow does the Cortex receive?

Answer 12

majority of RBF - 85 to 90 %

S23

Question 13

Which part of the nephron is most vulnerable for developing necrosis in response to HoTN?

Answer 13

Loop of Henle

S23

Question 14

What are the primary functions of the kidneys?

Answer 14

• Regulate EC volume, osmolarity, composition
• Regulate BP
• Excrete toxins/metabolites
• Maintain acid/base balance
• Produce hormones
• Blood glucose homeostasis

S24

Question 15

What is normal urine output in adults?

Answer 15

1 mL/kg/hr

Question 16

Your pre-operative patient has had less than 500 mLs of urine output in the past 24 hours. How would you classify this patient?

Answer 16

Oliguric

S27

Question 17

How can you monitor volume?

Diagnostic test and Hemodynamic parameters

Answer 17

• US to assess IVC
• CVP, RAP
• LAP, PCWP (Powerful stimuli for renal vasoconstriction)
• PAP
• SVV

S28

Question 18

What % of IVC collapse will indicate fluid deficit?

Answer 18

50 %

S29

Question 19

What test can you do to determine fluid responsiveness?

Answer 19

passive leg raise

S29