Renal Physiology 2 Flashcards Preview

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Flashcards in Renal Physiology 2 Deck (151):
1

___________: only a fraction of the plasma presented to the glomeruli is filtered.

Filtration Fraction: only a fraction of the plasma presented to the glomeruli is filtered.

2

________ of plasma is filtered.

20-30% of plasma is filtered.

3

Filtration rate is measured in units of _______.

Filtration rate is measured in units of mL/min.

4

Secretion, Reabsorption and Excretion are measured in units of _________.

Secretion, Reabsorption and Excretion are measured in units of mg/min.

5

Excretion (E) =  _______________

Excretion (E) =  Filtration (F) + Secretion (S) - Reabsorption (R)

6

___________: maximum rate at which nephron epithelium can remove substances from plasma and secrete them into filtrate

Transport Maximum: maximum rate at which nephron epithelium can remove substances from plasma and secrete them into filtrate

7

Secretion transport is dependent on

Secretion transport is dependent on the number/density of membrane transporters that allow for secretion or reabsorption

8

When transport maximum is reached, substances that should be secreted _____________.

When transport maximum is reached, substances that should be secreted accumulate in plasma.

9

When transport maximum is reached, substances that should be reabsorbed __________.

When transport maximum is reached, substances that should be reabsorbed may be lost in urine.

10

"Splay" in graphs of [Glucose] reflects what

Heterogenicity of nephrons

11

Glucose in the urine can be due to:

Hemorrhage

Increased [Glucose} in plasma

Proximal tubule damage

12

Explain how Fight or Flight response increases plasma glucose

SNS stimulation releases epinephrine that increases glycogenolysis at the liver.

13

Why is the Fight or Flight response important in some species and not others in regards to [Glucose]

In some species the [Glucose] in plasma caused by the Fight or Flight response exceeds transport maximum

14

In what species is the Fight or Flight Response important to be aware of in regards to [Glucose]

Bovine

15

_______ is secreted when there is increased [Glucose] in plasma.

Insulin is secreted when there is increased [Glucose] in plasma.

16

[Glucose] in plasma and Filtration of Glucose is a __________ relationship.

[Glucose] in plasma and Filtration of Glucose is a linear relationship.

17

Normal [Glucose] in plasma for dog

70-100 mg/dL

18

Glucose Transport Maximum of dog

180-200 mg/dL

19

Decreased transport maximum means what in regards to the concentration of a substance in plasma.

More of the substance is excreted in urine when it is increased in plasma.

20

The _________ is the major portion of the nephron responsible for reabsorption and secretion.

The proximal tubule is the major portion of the nephron responsible for reabsorption and secretion.

21

The _______ does not modify osmolarity.

The Proximal Tubule does not modify osmolarity.

22

__________ of water is reabsorbed at the proximal tubule.

50-80% of water is reabsorbed at the proximal tubule.

23

_________ work at the proximal tubule to increase reabsorption of water.

NE, E, AGII work at the proximal tubule to increase reabsorption of water.

24

Increased reabsorption at the proximal tubule can be due to

Decreased blood pressure

Increased osmolarity

25

_______ of water is reabsorbed at the dLoH

20% of water is reabsorbed at the dLoH

26

At the ______ there is more water reabsorption than osmolyte.

At the dLoH there is more water reabsorption than osmolyte.

27

The ________ is considered a passive structure.

The dLoH is considered a passive structure.

28

Filtrate at the dLoH is _____osmotic.

Filtrate at the dLoH is hyperosmotic.

29

Urea from the MCD is secreted at the ________.

Urea from the MCD is secreted at the dLoH.

30

The _______ puts solute into the interstitium.

The aLoH puts solute into the interstitium.

31

The ______ has no aquaporins.

The aLoH has no aquaporins.

32

_______ at the aLoH increase reabsorption of water by the dLoH

NE and E at the aLoH increase reabsorption of water by the dLoH

33

__________ increases the reabsorption of solute at the aLoH

AcH and Aldosterone increases the reabsorption of solute at the aLoH

34

_________ at the MCD increases the number of aquaporins and urea transporters

ADH at the MCD increases the number of aquaporins and urea transporters

35

__________ at the MCD decreases Na+ reabsorption.

ANP at the MCD decreases Na+ reabsorption.

36

__________ at the MCD increases Na+ reabsorption.

Aldosterone at the MCD increases Na+ reabsorption.

37

Osmolytes become non freely filterable when

Osmolytes become non freely filterable when they are bound by plasma protein

38

Secretion of organic molecules occurs only in the ___________.

Secretion of organic molecules occurs only in the proximal tubule.

__________________________

Exception: Urea is secreated in the dLoH

39

Reabsorption of organic molecules  occurs only in the ____________.

Reabsorption of organic molecules  occurs only in the proximal tubule.

_______________________

Exception: Urea at the MCD

40

Urea (increases/decreases) along the nephron.

Urea (increases/decreases) along the nephron.

41

At the dLoH [Urea] (increases/decreases)

At the dLoH [Urea] (increases/decreases)

________________

To allow for diffusion into the filtrate

42

After the aLoH filtrate is ______osmotic

After the aLoH filtrate is hyposmotic

43

All medullary interstitium is ______osmotic.

All medullary interstitium is hyperosmotic.

44

Fractional Excretion = _____________

Fractional Excretion =

Clearance of X (mL/min) / GFR (mL/min)

45

UrineX:UrineCreatinine

Test comparing the ratios of substances in urine to known normals

46

Elevated UrineProtein:UrineCreatinine can be caused by

Tubular Disease

Glomeruplopathies

Lower Urinary Tract Disease

47

UrineCortisol:UrineCreatinine is used as a diagnostic tool for

Cushings Disease

48

Osmolar Clearance = __________.

Osmolar Clearance = Vu x Uosm / Posm.

49

Free Water Clearance = ______________

Free Water Clearance = V- Osmolar Clearance

50

Uosm _______ Posm

Free water clearance = 0

No net gain or loss of plasma water

Isosmotic urine

Uosm = Posm

51

Uosm _______ Posm:

Free water clearance +

Net loss of plasma water

Hyposmotic urine

Uosm < Posm

52

Uosm _______ Posm:

Free water clearance -

Net gain of plasma water

Hyperosmotic urine

Uosm > Posm

53

As blood pressure decreases, the concentration of osmolytes in the urine __________.

As blood pressure decreases, the concentration of osmolytes in the urine increases

54

___________ urine = neither excretion nor reabsorption of solute free water and urine flow equals urine 

Isosmotic urine = neither excretion nor reabsorption of solute free water and urine flow equals urine 

55

__________ urine is divided into 2 virtual volumes; once contains solute and is isosmotic to plasma with urine flow rate equal to osmolar clearance and the second is solute free.

Hyposmotic urine is divided into 2 virtual volumes; once contains solute and is isosmotic to plasma with urine flow rate equal to osmolar clearance and the second is solute free.

56

__________ urine represents the volume of solute free water that would have to be added to urine to make it isosmotic to plasma, solute free water reabsorbed by the kidneys.

Hyperosmotic urine represents the volume of solute free water that would have to be added to urine to make it isosmotic to plasma, solute free water reabsorbed by the kidneys.

57

_________: quantifies the actual voluem of solute fre water that is being conserved by the animal over time.

Free water clearance : quantifies the actual voluem of solute fre water that is being conserved by the animal over time.

58

__________: ratio of the density of a volume of solution to the density of an identical volume of water.

Specific Gravity (USG): ratio of the density of a volume of solution to the density of an identical volume of water.

59

Free water has a USG of _______.

Free water has a USG of 1.000.

60

True/False: USG is a precise measure of osmolality

False

61

USG between ________ is the same osmolality as plasma.

USG between 1.018 - 1.020 is the same osmolality as plasma.

62

__________: urine excreted has an osmolality/SG essentially identical to plasma

Isosthenuria: urine excreted has an osmolality/SG essentially identical to plasma

63

________: urine excreted is dilute

Hyposthenuria : urine excreted is dilute

64

_________: urine excreted is concentrated

Hypersthenuria: urine excreted is concentrated

65

Water Deprivation Test

Used to test renal function.  USG is measured as water is deprived over a set amount of time.  In normal animal, expect to see and increase in USG as time continues.

66

__________: accumulation of non protein nitrogen molecules.

Azotemia: accumulation of non protein nitrogen molecules.

67

_______: accumulation of waste products such that toxic effects manifest.

Uremia : accumulation of waste products such that toxic effects manifest.

68

_________ Azotemia is caused by derangements in before the kidney.

Pre-Renal Azotemia is caused by derangements in before the kidney.

69

________ Azotemia is a result of kidney dysfunction.

Renal Azotemia is a result of kidney dysfunction.

70

_______ Azotemia is caused by derangement after the kidney

Post-Renal Azotemia is caused by derangement after the kidney

71

Osmolality increases in the _______

Osmolality increases in the medulla

________________

LoH and Collecting duct

72

2/3 loss of nephrons causes 

2/3 loss of nephrons causes decreased concentrating ability

73

3/4 loss of nephrons causes

3/4 loss of nephrons causes kidney failure

74

Hyperkalemia can be caused by

Increased intake of K+ in diet

Tissue damage

Urinary blockage

75

Most common cause of hyperkalemia is __________.

Most common cause of hyperkalemia is urinary blockage.

76

_________ holds excess K+ until kidney can excrete it.

Skeletal muscle holds excess K+ until kidney can excrete it.

77

2 important non-protein nitrogen (NPN) molecules

Urea and Creatinine

78

Increased [PO42-] = _______ GFR

Increased [PO42-​] = decreased GFR

79

___________ is important in PO42- homeostasis; decreases PO42- reabsorption.

PTH is important in PO42- homeostasis; decreases PO42- reabsorption.

80

___________ is an important site for reabsorption.

Proximal Tubule is an important site for reabsorption.

81

Reabsorption at the ________ is isosmotic.

Reabsorption at the proximal tubule is isosmotic.

82

Major extracellular electrolyte/osmolyte of the proximal tubule is _________.

Major extracellular electrolyte/osmolyte of the proximal tubule is Na+.

83

Mechanisms of Reabsorption include:

Transporters

Solvent Drag

Diffusion

84

Movement of molecules at the proximal tubule are associated with the movement of ______.

Movement of molecules at the proximal tubule are associated with the movement of Na+

85

Na+ gradient is established by the _________.

Na+ gradient is established by the Na+ - K+ ATPase.

86

Proteins are _____________ by proximal tubule cells.

Proteins are endocytosed and hydrolyzed by proximal tubule cells.

87

[Urea] _________ in the filtrate as it courses through the proximal tubule.

[Urea] increases in the filtrate as it courses through the proximal tubule.

88

Secretion at the proximal tubule requires_________.

Secretion at the proximal tubule requires membrane bound proteins.

89

_________ of total remains of Na+, water and osmoles after reabsorption at the proximal tubule.

1/3 of total remains of Na+, water and osmoles after reabsorption at the proximal tubule.

90

_______ of wanted electrolytes are reabsorbed at the proximal tubule.

2/3 of wanted electrolytes are reabsorbed at the proximal tubule.

91

CO2 + H2O ⇔ H2CO3 is catalyzed by what enzyme.

Carbonic Anhydrase

92

"Leakiness" of tight junctions _________ along the length of the nephron.

"Leakiness" of tight junctions decreases along the length of the nephron.

93

Reabsorptive force attributable to ____________ pressure.

Reabsorptive force attributable to plasma colloid oncotic pressure.

94

____________: direct relationship betwen volume of fluid filtered at the glomerulus and volume of fluid reabsorbed at the proximal tubule.

Glomertubular Balance: direct relationship betwen volume of fluid filtered at the glomerulus and volume of fluid reabsorbed at the proximal tubule.

95

_______ is the most important extracellular anion in the proximal tubule.

Cl- is the most important extracellular anion in the proximal tubule.

96

Reabsorption of _________ occures only in the first half of the proximal tubule.

Reabsorption of organic molecules occures only in the first half of the proximal tubule.

97

Reabsorption of __________ occures the entire length of the nephron.

Reabsorption of electrolytes occures the entire length of the nephron.

98

True/False: At the proximal tubule the Na+-Bicarb symport is important in maintaining acid base.

False, there is no such thing as a Na+-Bicarb symport

99

Bicarb pumped into the plasma makes plasma _______ and the filtrate __________.

Bicarb pumped into the plasma makes plasma alkaline and the filtrate acidic.

100

Na+-K+ ATPase is stimulated by

Norepinephrine

Epinephrine

Angiotension II

101

It is more common for an animal to become more (acidic/alkaline).

It is more common for an animal to become more (acidic/alkaline).

102

True/False: Bicarb is freely filterable

True

103

Reabsorption at the LoH is not ______osmotic.

Reabsorption at the LoH is not isososmotic.

104

Water is reabsorbed ________ in the dLoH.

Water is reabsorbed passively in the dLoH.

105

Solute is reabsorbed by _________ in the aLoH

Solute is reabsorbed by active transport in the aLoH

106

Due to H2O reabsorption in the dLoH filtrate becomes ________osmotic.

Due to H2O reabsorption in the dLoH filtrate becomes hyperosmotic.

107

Due to solute reabsorption in the aLoH filtrate becomes _______osmotic.

Due to solute reabsorption in the aLoH filtrate becomes hyposmotic.

108

_________: protein secreted by the LoH to decrease the likelihood of bacterial attachment to urinary epithelium

Uromodulin: protein secreted by the LoH to decrease the likelihood of bacterial attachment to urinary epithelium

109

__________ is the most abundent protein found in urine.

Uromodulin is the most abundent protein found in urine.

110

________ takes solute out of the medullary interstitium all the time.

Vasa Recta takes solute out of the medullary interstitium all the time.

111

Filtrate should be _____osmotic and interstitium should be _____osmotic.

Filtrate should be hyposmotic and interstitium should be hyperosmotic.

112

Transport of urea into and out of the medullary interstitium is dependent on __________.

Transport of urea into and out of the medullary interstitium is dependent on urea transporters.

113

The aLoH is net reabsorptive of _____.

The aLoH is net reabsorptive of K+.

114

_______________: medullary interstitium is all hyperosmotic, however it gets increasingly more hyperosmotic as it gets deeper into the medulla.

Counter-Current Mechanism: medullary interstitium is all hyperosmotic, however it gets increasingly more hyperosmotic as it gets deeper into the medulla.

115

________: a drug used to block 2Cl- - Na+K+ symports; overdose can lead to dehydration.

Lasix: a drug used to block 2Cl- - Na+K+ symports; overdose can lead to dehydration.

116

____________ increases urea permeability  in the collecting duct by increasing the number/density of urea transporters.

ADH increases urea permeability  in the collecting duct by increasing the number/density of urea transporters.

117

________ symport found in the aLoH is electroneutral.

2Cl- - Na+K+ symport found in the aLoH is electroneutral.

118

_______ stimulates the addition of aquaporins in the MCD.

ADH stimulates the addition of aquaporins in the MCD.

119

__________ shut down urea transporters in the MCD.

Cortisol shut down urea transporters in the MCD.

120

__________ increase activity of Na+-K+ ATPase in the DCT, CCD, MCD.

Aldosterone increase activity of Na+-K+ ATPase in the DCT, CCD, MCD.

121

________ decreases Na+ and H2O reabsorption at the MCD.

ANP decreases Na+ and H2O reabsorption at the MCD.

122

____________

Na+ - K+ ATPase

Na+ 

Na+ - Glucose/AA/PO4-

Na+ - Cl- Symport

Na+ - H+ Antiport

Proximal Tubule

Na+ - K+ ATPase

Na+ 

Na+ - Glucose/AA/PO4-

Na+ - Cl- Symport

Na+ - H+ Antiport

123

_______________

Aquaporins

Urea Transporters

dLoH and MCD

Aquaporins

Urea Transporters

124

____________

Na+ - K+ ATPase

2Cl- -Na+K+ Symport

aLoH

Na+ - K+ ATPase

2Cl- -Na+K+ Symport

125

___________

Aquaporins

H+

H+ - K+ Antiport

HCO3- - Cl- Antiport

DCT/ CCD

Aquaporins

H+

H+ - K+ Antiport

HCO3- - Cl- Antiport

126

[Glucose] _____ at the PCT

[Glucose] decreases at the PCT

127

[Na+]/[Cl-] _______ at the PCT.

[Na+]/[Cl-] decreases at the PCT.

128

[Na+]/[Cl-] _______ at the dLoH.

[Na+]/[Cl-] remains constant at the dLoH.

129

[Na+]/[Cl-] _______ at the aLoH.

[Na+]/[Cl-] decreases at the aLoH.

130

[Na+]/[Cl-] _______ at the DT/CD.

[Na+]/[Cl-] decreases at the DT/CD.

131

[H2O] ________ from PCT to CD

[H2O] decreases from PCT to CD

132

[Urea] ______ at the PCT.

[Urea] decreases at the PCT.

133

[Urea] ______ at the dLoH.

[Urea] increases at the dLoH.

134

[Urea] ______ at the aLoH.

[Urea] remains constant at the aLoH.

135

[Urea] ______ from the DT to CD.

[Urea] decreases from the DT to CD.

136

[CREA] _______ at the PCT.

[CREA] increases at the PCT.

137

[CREA] _______ from dLoH to CD.

[CREA] remains constant from dLoH to CD.

138

A deficiency in _________ results in loss of solute and large volumes of water in dilute urine leading to the disease state of _________.

A deficiency in ADH results in loss of solute and large volumes of water in dilute urine leading to the disease state of Diabetes Insipidus.

139

Diabetes Insipidus can be a result of 

Dysfunction of hypothalamus or neurohypophysis

or

Deficient/ dysfunctional ADH receptrors in the kidney

140

_________ Diabetes Insipidus is due to a dysfunction of the hypothalmus or neurohypophysis

Central / Primary Diabetes Insipidus is due to a dysfunction of the hypothalmus or neurohypophysis

141

________ Diabetes Insipidus is caused by deficient or dysfunctional ADH receptors in the kidney.

Nephrogenic Diabetes Insipidus is caused by deficient or dysfunctional ADH receptors in the kidney.

142

__________ polydipsia occurs when the animals drinks too much.

Primary polydipsia occurs when the animals drinks too much.

143

________ polydipsia is due to a problem in the kidney.

Secondary polydipsia is due to a problem in the kidney.

144

The ALoH is constantly putting solute into the interstititium because

The ALoH is constantly putting solute into the interstititium because the vasa recta is constantly taking it out.

145

____________: Condition in which Na+ and Cl- are not constantly resupplied to the interstitium leading to a persistant slight loss of osmolyte to vasa recta.

Medullary Washout: Condition in which Na+ and Cl- are not constantly resupplied to the interstitium leading to a persistant slight loss of osmolyte to vasa recta.

146

Medullary Washout occurs due to:

ALoH not putting solute into the intersitium (Lack of hormone vs receptor)

Liver Disease (decreased Urea)

147

Hyperadrenocorticism is also called ________.

Hyperadrenocorticism is also called Cushings Disease

148

Hypoadrenocorticism is also called ________.

Hypoadrenocorticism is also called Addisons Disease.

149

Hyperadrenocorticism is due to an increase in ____________.

Hyperadrenocorticism is due to an increase in cortisol.

150

Hypoadrenocorticism is due to a decrease in _________.

Hypoadrenocorticism is due to a decrease in Aldosterone.

151

Diseases typically associated with Nephrogenic Diabetes Insipidus

Hypercalcemia

Hypokalemia

Glucosuria