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Renal > Renal Physiology > Flashcards

Renal Physiology Flashcards

1
Q

clearance equation

A

Clearance + UV/P

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2
Q

Normal GFR

A

90-120, <15=AKI/ESRD

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3
Q

FENa equation

A

(U/P)Na/(U/P)Cr

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4
Q

Normal FENa

A

1-2%, lower means volume depletion, higher means overload

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5
Q

water deficit equation

A

(140TBW)normal=([Na]TBW)currently

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6
Q

water deficit equation correct at

A

0.5 mEq/L or less

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7
Q

flux equals

A

Permeability * area * driving force

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8
Q

afferent constriction effect on RPF

A

decrease

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9
Q

afferent constriction effect on GFR

A

decrease

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10
Q

afferent constriction effect on FF (GFR/RPF)

A

none

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11
Q

afferent constriction effect on H2O reabsorptions

A

increase

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12
Q

afferent constriction: example

A

NE

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13
Q

efferent constriction effect on RPF

A

decrease

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14
Q

efferent constriction effect on GFR

A

increase

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15
Q

efferent constriction effect on FF (GFR/RPF)

A

increase

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16
Q

efferent constriction effect on H2O reabsorption

A

increase

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17
Q

efferent constriction: example

A

low level AngII

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18
Q

Afferent + efferent constriction effect on RPF

A

decrease

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19
Q

Afferent + efferent constriction effect on GFR

A

none

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20
Q

Afferent + efferent constriction effect on FF (GFR/RPF)

A

increase

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21
Q

Afferent + efferent constriction effect on H20 reabsorption

A

increase

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22
Q

Afferent + efferent constriction example

A

high level AngII

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23
Q

afferent dilation effect on RPF

A

increase

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24
Q

afferent dilation effect on GFR

A

increase

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25
Q

afferent dilation effect on FF (GFR/RPF)

A

none

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26
Q

afferent dilation effect on H2O reabsorption

A

decrease

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27
Q

afferent dilation example

A

ANP

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28
Q

efferent dilation effect on RPF

A

none

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29
Q

efferent dilation effect on GFR

A

decrease

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30
Q

efferent dilation effect on FF (GFR/RPF)

A

decrease

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31
Q

efferent dilation effect on H2O reabsorption

A

none

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32
Q

increased plasma protein effect on RPF

A

none

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33
Q

increased plasma protein effect on GFR

A

decrease

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34
Q

increased plasma protein effect on FF (GFR/RPF)

A

decrease

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35
Q

increased plasma protein effect on H2O reabsorption

A

increase

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36
Q

decreased plasma protein effect on RPF

A

none

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37
Q

decreased plasma protein effect on GFR

A

increase

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38
Q

decreased plasma protein effect on FF (GFR/RPF)

A

increase

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39
Q

decreased plasma protein effect on (H2O reabsorption)

A

decrease

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40
Q

isoosmotic volume depletion

A

diarrhea

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41
Q

isoosmotic volume overload

A

IV normal saline, or high salt+water intake

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42
Q

hyperosmotic volume depletion

A

water deprivation

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43
Q

hyperosmotic volume overload

A

high salt intake

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44
Q

hypoosmotic volume depletion

A

adrenal insufficiency

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45
Q

hypoosmotic volume overload

A

SIADH (syndrome of inappropriate ADH)

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46
Q

signs of volume depletion

A

lightheaded, weak, orthostatic, cold extremities, weight loss

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47
Q

signs of volume overload

A

edema, SOB, HTN, weight gain

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48
Q

labs of volume depletion

A

Increased BUN/Cr, decreased FENa, decreased U/O, increased urine osmolarity

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49
Q

labs of volume overload

A

increased FENa and U/O

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50
Q

regulation of volume depletion

A

ATII, Aldo, ADH, NE (as a last resort)

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51
Q

regulation of volume overload

A

ANP

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52
Q

ATII acts where, does what?

A

proximal tubule, increases Na reabsorption, / H excretion (which is coupled with bicarb reabsorption)

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53
Q

ADH acts where, does what?

A

thick limb, increases NKCC (NaCl reabsorption?), collecting duct, increased water reabsorption

54
Q

Aldo acts where, does what?

A

collecting duct, Na reabsorption, K excretion

55
Q

prerenal AKI urine osmolarity

A

High, >500

56
Q

prerenal AKI urine Na

A

Looow, <10

57
Q

prerenal AKI FENa

A

Low, <1%

58
Q

prerenal AKI serum BUN/Cr

A

Hiiiigh, >20

59
Q

cause of low intake hypokalemia

A

prolonged vomitting/diarrhea

60
Q

causes of distribution hypokalemia 4

A

Insulin, beta agonists (Albuterol), alkalosis, hyperosmolarity

61
Q

causes of high excretion hypokalemia 3

A

high aldo, alkalosis, thiazide/lopp diuretics

62
Q

causes of high intake hyperkalemia

A

packed RBC transfusions

63
Q

causes of distribution hyperkalemia 5

A

insulin deficiency (DM), beta blockers, exercise, acidosis, cell lysis, hyperosmolarity

64
Q

causes of low excretion hyperkalemia 3

A

low aldo, acidosis, K sparing diueretics

65
Q

urinalysis: RBC casts 3

A

glomerulonephritis, ischemia, malignant HTN

66
Q

urinalysis: abnormal RBCs 3

A

HUS, TTP, GN

67
Q

urinalysis: pyuria/WBC casts 2

A

UTI, acute pyelo

68
Q

urinalysis: sterile pyuria 2

A

AIN, papillary necrosis

69
Q

urinalysis: granular casts, muddy brown

A

ATN

70
Q

urinalysis: waxy casts

A

CKD

71
Q

urinalysis: hyaline casts

A

benign, nonspecific

72
Q

three causes of metabolic alkalosis

A

decreased H+, increased bicarb, volume contraction

73
Q

H+ depletion alkalosis causes

A

vomiting, hyperaldosteronism

74
Q

increased bicarb alkalosis cause

A

ingesting a ton of bicarb

75
Q

volume contraction alkalosis cause

A

loop or thiazide diuretics

76
Q

loss of gastric H+ and K+ w/o bicarb loss

A

vomiting

77
Q

increased H+ secretion, decreased K+

A

hyperaldosteronism

78
Q

in the setting of renal failure, causes metabolic acidosis

A

ingesting a ton of bicarb

79
Q

increased bicarb reapsorption via increased RAAS

A

loop or thiazide diuretics

80
Q

correct metabolic alkalosis

A

hyPOventilation, bicarb excretion

81
Q

two causes of respiratory alkalosis

A

increased respiratory drive and hypoxemia

82
Q

two causes of increased respiratory drive alkalosis

A

hyperventilation (pain, anxiety) or neurodisorders

83
Q

four causes of hypoxemia alkalosis

A

pneumonia, PE, anemia, liver disease

84
Q

correct respiratory alkalosis

A

decrease bicarb reabsorption

85
Q

3 causes of metabolic acidosis

A

increase H+, decrease bicarb, decrease H+ secretion

86
Q

three causes of increased H+ (big anion gap) metabolic acidosis

A

diabetic ketoacidosis, lactic acidosis, salicylate/methanol/ethylene glycol

87
Q

two causes of decreased bicarb (normal anion gap, hyperchloremia) metabolic acidosis

A

diarrhea, type II RTA (proximal)

88
Q

two causes of decreased H+ secretion (normal anion gap, metabolic acidosis

A

type I RTA (distal), type IV RTA (decreased ammoniogenesis)

89
Q

loss of bicarb via GI

A

diarrhea

90
Q

renal loss of bicarb (failure to reabsorb)

A

type II RTA (proximal)

91
Q

defect in H+ ATPase, can’t acidify urine

A

Type I RTA (distal)

92
Q

decreased RAAS, decreased ammoniogenesis, increased K+

A

type IV RTA (decreased ammoniogenesis)

93
Q

correct metabolic acidosis

A

hyPERventilation, increased bicarb reabsorption

94
Q

four causes of respiratory acidosis

A

decreased respiratory drive, respiratory muscle disorders, airway obstruction gas exchange

95
Q

four causes of decreased respiratory drive acidosis

A

opiates, barbituates, obesity, anesthesia

96
Q

5 causes of respiratory muscle disorder acidosis

A

Guillain-Barre, polio, ALS, MS, fatiguw

97
Q

2 causes of obstruction acidosis

A

aspiration, sleep apnea

98
Q

four causes of gas exchange problem acidosis

A

ARDS, COPD, pneumonia, pulmonary edema

99
Q

correct respiratory acidosis

A

increased bicarb reabsorption

100
Q

renin source

A

low BP (JGA)

101
Q

renin primary effect

A

angiotensinogen to ang I

102
Q

AII source

A

AngI (liver) +ACE (lung)

103
Q

AII primary effect

A

increase vasoconstriction, Efferent vasoconstriction, aldo, ADH, Na/H

104
Q

Aldo source

A

AngII (zona glomerulosa)

105
Q

Aldo primary effect

A

increase EnaC, Na/K, K+and H+ excretion

106
Q

ADH source

A

high BP (>decreased Osm), post. Pituitary

107
Q

ADH primary effect

A

increase aquaporins, thirst

108
Q

NE primary effect

A

increases RAAS

109
Q

ANP source

A

increased BP, atria

110
Q

ANP primary effect

A

decrease RAAS, afferent vasodilation, increased GFR, decreased renin

111
Q

PTH source

A

low Ca, high P, low VitD, parathyroid

112
Q

PTH primary effect

A

increases Ca and P GI absorption and renal reabsorption, increases VitD, osteoclasts

113
Q

everyone increases volume except

A

ANP (decrease), PTH (no effect)

114
Q

Isoosmotic H2O +solute reabsorption

A

early and late proximal tubule

115
Q

NaCl reabsorbed by Cl gradient

A

late proximal tubule

116
Q

NaCl absorptions (sans water), dilution of tubular fluid, countercurrent multiplication, Ca and Mg reabsorption

A

thick ascending limb

117
Q

NaCl absorption (sans water), dilution of fluid

A

early distal tubule

118
Q

K+ reabsorption, H+ secretion

A

Alpha-intercalated cells

119
Q

Na+ reabsorption, K+ secretion, H20 reabsorption

A

principal cells

120
Q

Na/gluc, Na/AA, Na/P cotrans (decreased by PTH)

A

early proximal tubule

121
Q

Na/H exchange (ATII increases)

A

early proximal tubule

122
Q

NKCC co-transport (ADH increases)

A

thick ascending limb

123
Q

Na/Cl co-trans (PTH increases)

A

early distal tubule

124
Q

H/K ATPase

A

alpha-intercalated cells

125
Q

H+ ATPase (aldo increases)

A

alpha-intercalated cells

126
Q

EnaC channels, K+ channels (aldo increases)

A

principal cells

127
Q

Aquaporins (ADH increases)

A

principal cells

128
Q

4 responses to increased Na intake

A

decreased sympathetic activity, increased ANP, decreased plasma oncotic pressure, decreased RAAS

129
Q

decreased sympathetic activity effect

A

dilation of afferent arterioles to increase GFR, decreased Na reabsoprtion (PT)

130
Q

increased ANP effect

A

constriction of efferent arterioles to increase GFR, decrease Na reabsorption (collecting duct)

131
Q

decreased plasma oncotic pressure effect

A

decreases Na reabsorption (PT)

132
Q

decreased RAAS effect

A

decrease Na reabsorption (PT and collecting ducts)

Renal (11 decks)

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