Renal Physio/ Misc Flashcards
(93 cards)
1
Q
Normal GFR is ___ ml/min
A
100
2
Q
Creatinine clearance _____ GFR
A
slightly overestimates
3
Q
effective Renal Plasma Flow (eRPF) _____ Renal Plasma Flow
A
slightly understimates
4
Q
If clearance is more than GFR there is ______ of X
A
secretion
5
Q
If clearance is less than GFR there is ______ of X
A
reabsorption
or not filtered
6
Q
Clearance of INULIN =
A
GFR
7
Q
(Urine concentration of z) x (Urine flow rate)
divided by
(Plasma concentration of z)
equals
A
Clearance of z
use for inulin to get GFR
8
Q
Dilates afferent arteriole
A
Prostaglandins (PDA)
9
Q
Constricts efferent arteriole
A
Angiotensin II (ACE)
10
Q
PDA __ GFR
A
↑
11
Q
Angiotensin II __ GFR
A
↑
12
Q
(GFR) x (Plasma concentration of z) =
A
Filtration of z
13
Q
NSAIDS ___ GFR
A
↓
14
Q
Angiotensin II’s effect on:
RPF
GFR
FF
A
↓ (RPF)
↑ (GFR)
↑ (FF)
15
Q
Filtration Fraction (FF) is calculated how?
A
GFR/RPF
16
Q
Afferent constriction effect on:
GFR
RPF
FF
A
↓
↓
no change
17
Q
Efferent constriction effect on:
GFR
RPF
FF
A
↑ GFR
↓ RPF
↑ FF
18
Q
Ureter constriction effect on:
GFR
RPF
FF
A
↓ GFR
no change (RPF)
↓ FF
19
Q
Dehydration’s effect on:
GFR
RPF
FF
A
↓
↓↓
↑
20
Q
↑ plasma protein concentration effect on:
GFR
RPF
FF
A
↓
no change
↓
21
Q
Glomerulus has 3 NEGATIVELY charged glycoproteins
Size Barrier prevents >100nm/ blood via ___
Slit Diaphragm prevents > 50nm via ____
A
Fenestrated capillaries
Podocyte foot interposed with GBM
22
Q
Total body water is __%
A
60%
- 40% is non water mass (NWM)
- TBW + NWM= body mass
23
Q
Of Total body water:
__% is interstitial fluid (ECF)
__% is plasma (ECF)
__% ICF
A
15% (9% of body mass)
5% (3% of body mass)
40% (24% of body mass) of this like 2.5% is RBCs
ECF= 1/3 of TBW ICF= 2/3 of TBW
24
Q
Completely reabsorbed in PCT
A
Glucose
25
Normal pregnancy has __ GFR
↑
26
On a Transport (y-axis) vs Plasma (x-axis) graph
a straight + linear line =
Filtered substance
27
On a Transport (y-axis) vs Plasma (x-axis) graph
a exponentially + growing line =
Excreted substance
28
On a Transport (y-axis) vs Plasma (x-axis) graph
a straight + linear line that tapers to a plateau =
Reabsorbed substance
29
On a Tubular/plasma (y-axis) vs PCT distance (x-axis) graph
The steepest slope =
The middle steepest slope =
The slanted slope that tapers off quickly=
The line that has no slope =
PAH- fully filtered and completely secreted
Inulin/Creatinine
Urea
Potassium
*pg 587
30
What releases ANP? in response to what?
Atria
| ↑ blood volume
31
What releases BNP? in response to what?
Ventricles
| ↑ blood volume
32
ANP/BNP ___ the release of Renin
↓
33
ANP/BNP ____ the afferent arteriole
Dialate
34
ANP/BNP ___ the excretion of sodium (Na+)
↑
| promotes naturesis
35
ANP/BNP ___ GFR
↑
36
ANP/BNP ___ smooth muscle via ↑cGMP
relax (vasodialate arteries)
37
Primarily regulates ECF volume and Na+ content
Aldosterone
38
Aldosterone acts on alpha intercalated cells to
↑ H+ ATPase for H+ excretion
39
Angiotensin II works on ____ receptor on vasculature to promote ____
```
ANG1
vasoconstriction (↑BP)
```
40
Angiotensin II works on the ____ to increase Sodium reabsorption
PCT
41
JG cells release Renin in response to ↓ renal perfusion detected by renal baroreceptors in the ___
afferent arteriole
42
JG cells release Renin in response to ↑ renal ____ receptor stimulation
Beta 1
| sympathetic tone
43
JG cells release Renin in response to ↓ NaCl delivery to the _____ cells at the DCT
macula densa
44
modified smooth muscle cells of the afferent arteriole
JG cells
45
JGA maintains GFR via the _____ system
RAAS
46
Beta blockers __ renin release
↓
47
List 4 Kidney endocrine hormones
EPO
Calcitriol (active vit. D) in PCT via 1-alpha-gydroxylase
Prostaglandins (increase RBF)
Dopamine
48
PCT cells release _____ which promotes naturiuresis
Dopamine
49
at ___ doses dopamine ___ afferent/efferent arterioles
LOW
| Dialates
50
at ___ doses dopamine acts as a _____ of afferent/efferent arterioles
High
| Vasoconstricts
51
Dopamine's effect on
RBF
GFR
↑ RBF
| no appreciable change to GFR
52
Calcidiol is
25-OH-D3 (Vitamine D inactive)
53
Calcitriol is
1, 25- OH-D3 (Active Vit. D)
*Calciferol is just Vitamin D
54
Stones, Bones, Groans, Thrones, and Psychiatric overtones indicates what?
Hypercalcemia
55
```
Nephrolithiasis (Renal Calculi)
Bone pain
Abdominal pain
↑ urinary frequency
altered mental status/ anxiety
indicates what?
```
Hypercalcemia
56
```
Tetany
Seizures
LOOOOOOONG QT
Twitchin (Chvostek sign)
Spasms (Trousseau sign)
indicates what?
```
Hypocalcemia
Chvostek sign: short contractions (twitching) of the facial muscles elicited by tapping the facial nerve below and in front of the ear
Trousseau sign: ipsilateral carpopedal spasm occurring several minutes after inflation of a blood pressure cuff to pressures above the systolic blood pressure
57
```
Arrythmias
Muscle cramps
Spams
weakness
indicates what?
```
Hypokalemia
58
Wide QRS
Arrythmias
weakness
indicates what?
Hyperkalemia
59
Gain of function mutation causing
| ↑ Na+ reabsorption in CT
Liddle syndrome
60
↓ Renin
↓ Aldosterone
Hypertensive
Liddle syndrome
(due to high Na+ reabsorption+ water in CT)
(possibly SIADH)
61
↑ Renin
↑ Aldosterone
↑ Urine Calcium
Bartter syndrome
| renin tumor has normal calcium levels in urine
62
↑ Renin
↑ Aldosterone
↓ Urine Calcium
Gittleman syndrome
| renin tumor has normal calcium levels in urine
63
Reabsorption defect in THICK ascending loop of henle
Bartter syndrome
64
Reabsorption defect of NaCl in DCT
Gittleman syndrome
| ↓ Urine Calcium bc too much + ions in tube (Na+) so calcium goes into the cell
65
Reabsorption defect in PCT
| wastes glucose, amino acids, bicarb, phosphate, NA+, water etc.
Fanconi syndrome
66
Where is the water and sodium most absorbed in the nephron?
PCT
67
All the Renal tubular defects
Fanconi's BaGeLS cause:
metabolic alkalosis/ Hypokalemia
EXCEPT
Fanconi syndrome
it causes
metabolic acidosis/hyphosphatemia
(osteopenia)
68
Hereditary deficiency of 11-Beta-HSD
Syndrome of apparent Mineralcorticoid excess
| SAME
69
Hereditary deficiency of 11-Beta-HSD causes
__ cortisol
__ Aldosterone receptor activity
↑
↑
*presents with LOW aldosterone
70
Inability of alpha intercalated cells to secrete H+ causing
metabolic acidosis/ hypokalemia
Distal RTA (type 1)
*Fanconi: metabolic acidosis/ hypophosphatemia
71
Defect in PCT Bicarb reabsorption causing
| metabolic acidosis/ hypokalemia
Proximal RTA (type 2)
72
Hypoaldosteronism or Aldosterone resistance causing hyperkalemia and less ammonium (NH4) excretion
Hyperkalemic tubular Acidosis (type4)
73
Person (especially child) with
edema/swelling &/or ascities
with proteinuria
(+/– recent URI) suspicious for
Minimal change disease
74
Protrusion of the GBM through the deposits resemble spikes and domes when stained with a silver stain.
Membranous glomerular nephropathy
75
NOT RENAL RELATED
Anticardiolipin antibodies are characteristic of ______ syndrome, which typically presents with unprovoked/recurrent arterial and venous thrombosis or recurrent spontaneous abortions.
antiphospholipid antibody
76
Antibodies to _____ are typically seen in systemic lupus erythematosus (SLE), particularly in individuals with active lupus NEPHRITIS.
double-stranded DNA (dsDNA)
77
Edema + albuminemia especially in young adults or children suggests
Minimal change disease
*Clinical features: acute weight gain, diffuse edema, and "frothy urine"
78
often occurs after initiation of new drugs (eg, NSAIDS, diuretics) but causes acute kidney injury with WHITE blood cell CASTS on urinalysis
Acute interstitial nephritis
79
Low intravascular oncotic pressure (due to Nephrotic syndrome) stimulates increased _____ production in the liver.
Impaired lipid catabolism due to decreased ____ and abnormal transport of circulating lipid particles also contributes to hyperlipidemia.
lipoprotein
| lipoprotein lipase
80
PSGN immune complexes are visible on IF as granular deposits of IgG, IgM, and ___ on the GBM and mesangium, producing a "starry sky" appearance.
C3
81
associated with IgG4 antibodies to the phospholipase A2 receptor, a transmembrane protein abundant on podocytes
membranous nephropathy
82
This patient has the pentad of fever, neurologic symptoms (progressive lethargy), renal failure, anemia, and thrombocytopenia in the setting of a gastrointestinal illness. She most likely has _____
*Schistocytes, Thrombocytopenia (prolonged BT; normal PT, aPTT), edema, elevated creatinine
thrombocytopenic thrombotic purpura-hemolytic uremic syndrome (TTP-HUS)
*one of the thrombotic microangiopathy (TMA) syndromes.
83
EM shows:
irregular, electron-dense immune deposits located on the GBM with moderate effacement of the podocyte foot processes (spikes and domes) consistent with
membranous nephropathy (MN)
*if you can't tell between MCD and MN choose MN for older people and MCD for young adults/kids
84
typically occurs spontaneously (as in this patient) or within 5-7 days of an upper respiratory or pharyngeal infection. Episodic.
IgA nephropathy
*kids/ young adults
85
diffuse thickening of glomerular capillary walls on light microscopy is characteristic of
membranous glomerulopathy
86
GBM splitting is seen in (2)
Membranoproliferative glomerulonephritis (MPGN)– Nephrotic Syndrome
Alport syndrome–
Nephritic syndrome
87
Palpable purpura/petechiae on the lower extremities
Arthritis/arthralgia
Abdominal pain, GI bleeding (bloody diarrhea), intussusception
Renal disease (hematuria ± proteinuria)
IgA Vasculitis
| Henoch S. Pupura
88
Conjunctival injection is a classic feature of __ infection
adenovirus
89
Aphthous ulcers can occur with (2)
Crohn disease
| SLE
90
can occur after strenuous exercise and results in muscle pain, elevated creatine kinase levels, and myoglobinuria (ie, positive urine dipstick for blood without RBCs on microscopy).
Rhabdomyolysis
91
___ secondary to circulating immune complex deposition may complicate Infective Endocarditis and can result in acute renal insufficiency.
Diffuse proliferative glomerulonephritis (DPGN)
*IVDU
92
Penicillamine is a copper-chelating agent used as first-line treatment in Wilson disease. Adverse effects include
proteinuria due to membranous nephropathy.
93
```
ACE-I effects on:
efferent arteriole
RPF
GFR
Filtration Fraction
Renin secretion
Breakdown of bradykinin
Vasodilation
```
```
Dilates
↑ RPF
↓ GFR
↓ FF
↑ Renin
↓ Breakdown Bradykinin
↑ Vasodilation
```
