Renal Flashcards
(110 cards)
1
Q
What are the breakdown of your body fluids?
A
60% water
40% ICF
20% ECF (15% IF, 5% plasma)
2
Q
What is the marker used for ECF
A
- Sulfate
- Inulin
- Mannitol
3
Q
What is the marter for TBW
A
- Tritiated water
2. D2O antipyrine
4
Q
What is the marker for plasma
A
- Radioactive Iodinated Serum Albumin
2. Evans blue
5
Q
What is the marker for IF?
A
ECF-plasma volume indirect
6
Q
What is the marker for ICF
A
TBW-ECF (indirect)
7
Q
[Changes in ECF/ICF Compartments]
Loss of isotonic fluid in the feces initially comes from the ECF
A
ECF = same concentration, same volume
ICF = same concentration, same volume
8
Q
[Changes in ECF/ICF Compartments]
Excessive sweating
A
ECF concentration increase,
volume decrease,
ICF concentration increase, volume decrease
9
Q
[Changes in ECF/ICF Compartments]
adrenal insufficiency
A
ECF concentration decrease, volume decrease
ICF concentration decrease, volume decrease
10
Q
[Changes in ECF/ICF Compartments]
infusion of isotonic NaCL
A
ECF concentration same, volume increase
ICF concentration same, volume increase
11
Q
[Changes in ECF/ICF Compartments]
Excessive NaCl intake
A
ICF concentration increase, volume decrease
ECF volume increase, concentration increase
12
Q
[Changes in ECF/ICF Compartments]
SIADH
A
ICF concentration decrease, volume increase
ECF concentration decrease, volume increase
13
Q
[Type of nephron]
shorter loops of henle, with peritubular capillaries
A
cortical nephron
14
Q
[Type of nephron]
longer loops of henle with vasa recta
A
juxtamedullary nephron
in the corticomedullary junction
15
Q
which part of the nephron does filtration occur?
A
renal corpuscle or malphigian corpuscle
in the renal cortex
16
Q
which part of the nephron does tubular reabsorption and secretion occur?
A
renal tubular system
17
Q
The juxta countercurrent exchanger is located in the
A
Vasa recta
18
Q
EPO is secreted in
A
interstitial cells in the peritubular/ cortical nephron
19
Q
[Part of Glomerulus]
fenestrated
A
capillary endothelium
20
Q
What is the charge of the basement membrane
A
negatively charge
deflects negatively charged proteins
21
Q
What part of the renal corpuscle that is capable of phagocytosis
A
Mesangial cells (intraglomerular)
22
Q
Which part of the mesangial cells capable of autoregulation, RAAS and EPO secretion?
A
Lacis Cells/ Extraglomerular Mesangial Cells
23
Q
Which cell triggers RAAS?
A
Macula Densa in the Distal tubule
24
Q
Which cells secrete renin?
A
Juxtaglomerular Cells
25
What gives rise to the glomerular tuft?
Afferent arteriole
26
What cell is found in the walls of the afferent arteriole?
Juxtaglomerular cell
27
What cell is found in the walls of the distal tubule?
macula densa
28
The cortical collecting tubule is part of the _____
distal tubule
29
The medullary collecting duct is part of the ____
collecting duct
30
The convulutions ands microvili present in the PCT is due to ____
increased number of carrier-mediated transport
31
Which part of the nephron is susceptible to hypoxia and toxins?
PRCT
32
The countercurrent multiplier is located in ____
loop of henle
33
The ascending limb of LOH is permeable to
solutes
ASINding limb
34
The descending limb of LOH is permeable to
water
35
What transporter is present in the thick ascending LOH?
NaK2Cl symport
36
Which part of the nephron is called the diluting segment?
Ascending LOH
37
Which distal tubule is seen in the cortex
early distal tubule
38
Which part of the nephron is referred to as the cortical diluting segment?
early distal tubule
39
What cells are found in the late distal tubule?
1. Principal cells
| 2. Intercalated cells
40
What will be the response of principal cells if you increase your dietary K intake
Stimulate principal cells to secrete K
Low dietary K - stimulates intercalated cell to resorb
41
What is the action of principal cells in controlling the Na and K?
Principal cells
Reabsorb Na, Secrete K
Remember: PNR train - principal Na reabsorb
42
What hormone acts on the late distal tubule?
Aldosterone
43
What is the action of Intercalated cells in controlling the K and H?
Intercalated cell
Reabsorb K
Secrete H
Remember: IKR
Intercalated K reabsorb
i know right
44
ADH increases urea reabsorption by
increasing the production of urea transporter type 1
increasing urine volume
45
What is the response of the body if you increase ADH
Inc aquaporin 2 channels leading to increased intravascular volume
Increase VR, Inc CO, BP
46
In the countercurrent mechanism, which part of the nephron creates graded osmolarity?
Loop of Henle
47
In the countercurrent mechanism, which part of the nephron creates preserves the graded osmolarity?
Vasa recta
maintains by circulating water and solutes around
48
What are the factors that enables the LOH to make a graded osmolarity?
1. Shape of LOH
2. Slow flow
3. Characteristics of the limb: ASINding
4. Presence of NaK2Cl symport
49
[Basic movements in urine formation]
movement from glomerular capillaries to bowman's capsule
Filtration
50
[Basic movements in urine formation]
movement from tubules to interstitium to peritubular capillaries
Reabsorption
51
[Basic movements in urine formation]
movement from peritubular capillaries to interstitium to tubules
secretion
52
What is the formula for excretion?
Excretion = Amount filtered - (amount reabsorbed + secreted)
53
____ refers to when the substance appear in the urine since some nephrons exhibit saturation
Renal Threshold
54
____ refers to all excess substance appear in the urine since all nephrons exhibit saturation
Renal Transport Maximum
55
Glucose reabsorption occurs using what transporter?
SGLT2 in PCT
56
What is the renal threshold for glucose reabsorption
200mg/dL
Some nephrons are saturated
57
What is the renal transport maximum for glucose reabsorption?
>375mg/dL
all nephrons saturated
58
If 200 mg/dL of PAH is filtered, what will be the the resulting plasma concentration
0
since PAH is filtered, secreted, not reabsorbed
59
What ionic form of weak acid predominates in an acidic urine?
HA form predominates
Alkalinize the urine so that A- predominates
60
What ionic form of weak base predominates in an acidic urine?
BH+ form predominates, it is more excreted
61
A high clearance substance will mostly be found ind ____
urine
e.g.PAH
62
A low clearance substance will most likely be found in the ____
Blood
i.e. CHON, Na, Gluc
63
Arrange in descending order according to relative clearance
Glucose, Na, Urea, Inulin K, PAH
PAH > K > Inulin > urean > Na > glucose, amino acod HCO3
Remember: PaKI UNa GA
64
What substance is more concentrated at the end of PCT than at the start of PCT?
creatinine
65
How many percent of CO goes as part of the renal blood flow?
25%
66
What substances vasodilate the renal arterioles?
Increases RBF
1. PGE2
2. PGI2
3. Bradykinin
4. NO
5. Dopamine
Remember: NOD BradIE
67
What substances vasoconstrict the renal arterioles?
Decreases RBF
1. Sympathetic NS
2. Angiotensin II
68
What substance estimates the renal plasma flow?
PAH
underestimates true RPF by 10% due to RPF
69
What will be the effect to the RPF if you
vasoconstrict the efferent arteriole?
decrease RPF
Increase RBF
70
What will be the effect to the RPF in the presence of ureteral stone
no change
but GFR decreases
71
What will be the effect to the RPF if you
vasodilate the afferent arteriole
decrease RPF
GFR decreases
72
An increase in GF and RBF is due to vasodilation of:
1. Vasodilation of afferent
| 2. Vasodilation of efferent arteriole
73
What is the BP range that maintains the constant GFR of >125 mL/min
BP 80-200mmHg
74
What are the responses of the kidney to a BP <80mmHg to increase the GFR?
1. Macula Densa increases secretion of Ang II then efferent arteriole constriction
2. NO vasodilates afferent arteriole
75
Wha are the responses of the kidney to a BP >200mmgHg?
1. Macula densa increases secretion of adenosine, thereby constricting the afferent arteriole
76
what is the normal GFR?
125mL/min
77
[Starling force]
promotes GFR; water pressure in the GC
increased by vasodilation of afferent arteriole or moderate vasoconstriction of efferent
GC hydrostatic pressure
78
[Starling force]
opposes GC hydrostatic pressure and GFR; water pressure at the BS increased by ureteral obstruction
BS Hydrostatic pressure
79
[Starling force]
opposes GFR; proteins attracting warer; increased by plasma protein concentration
GC oncotic pressure
80
[Starling force]
increased by histamine
Kf
81
Feedback mechanism used for autoregulation of GFR
Tubuloglomerular feedback
82
The macula densa detects changes in what _____
increase or decrease in GFR
83
What is the first line of defense of the body to regulate K
movement of K across ECF and ICF?
84
What causes K efflux leading to hyperkalemia?
1. Insulin deficiency
2. Beta adrenergic antagonist
3. Acidosis
4. Hyperosmolarity
5. Hyperosmolarity
6. Digitalis
7. Exercise
8. Cell lysis
85
What causes K influx leading to hypokalemia?
1. Insulin
2. Beta adrenergic agonist
3. Alkalosis
4. Hypoosmolarity
86
What are the causes of distal K secretion?
1. high K diet
2. Hyperaldosteronism
3. Alkalosis
4. Thiazide diuretics
5. Loop diuretics
6. Luminal anionis
87
What causes decreased distal K secretion?
1. Low K diet
2. Hypoaldosteronism
3. Acidosis
4. K sparing diuretics
88
What drug is an aldosterone antagonist thereby decreasing K secretion to the urine?
spironolactone
AE: gynecomastia
89
What compound increases the maximum urine osmolality?
Urea
90
Hyper/hypocalcemia can cause arrythmias
hypercalcemia
91
____ binds with calcium in the intestine; stimulated by vit D
calbindin
92
What drug class increases Ca reabsorption?
PTH, Thiazide
93
What drug class decreases Ca reabsorption?
loop diuretics
94
What cotransporter reabsorbs phosphate in the PCT?
Na-PO4 cotransporter
95
What hormone inhibits Phosphate reabsorption?
PTH
can cause phosphaturia and increase urinary cAMP
96
What is the relationship of Calcium and Magnesium?
Hypercalcemia causes hypomagnesemia
Hypocalcemia causes hypermagnesemia
97
What electrolyte is not reabsorbed in the PCT?
Magnesium
98
Magnesium is reabsorbed in which part of the nephron?
TAL of LH
99
Water deprivation stimulates the osmoreceptors in which part of the brain?
anterior hypothalamus
100
What is the response of the posterior pituitary during water deprivation?
increases ADH scretion
101
What happens to the urine osmolarity in water deprivation test
Increase urine osmolarity, urine volume decreases
102
Which part of the nephron wherein the filtrate is isotonic to plasma in the presence of ADH?
cortical collecting tubule
103
Which part of the nephron wherein solute free water is produced?
diluting segment of kidney or areas where NaCl is reabsorbed but not water
1. TAL LH
2. EDT
104
The presence of ADH means that the free water will be ___ (positive or negative?
negative
since free water is reabsorbed, water is not excreted
105
What causes hyponatremia in patients with Small Cell Lung CA?
Arginine Vasopressin (SIADH)
106
What is the hallmark of Diabetes Insipidus?
increased free water clearance
107
What are examples of body fluid buffers?
1. CO2 + H2O = H2CO3
2. Phosphate buffer system
3. Intracellular proteins
108
What are the effects of acidosis to the levels of cakcium and potassium
Hypercalcemia
| HyperKalemia
109
What are the causes of HAGMA?
1. Methanol
2. Uremia
3. DKA
4. Paraldehyde
5. Propylene Glycol
6. Iron
7. Isoniazid
8. Idiopathic Acidosis
9. Lactic Acidosis
10. Ethylene Glycol
11. Ethanol
12, Salicylic Acid
110
What are the causes of NAGMA
1. Hyperalimentation
2. Acetazolamide
3. RTA
4. Diarrhea
5. Ureteroenteric fistula
6. Pancreaticoduodenal fistula
