Renal Physiology Flashcards
(110 cards)
1
Q
________ is an enzyme produced by JG cells.
A
Renin is an enzyme produced by JG cells.
1
Q
Inulin
A
Used to calculate GFR
Gold Standard by renal physiologists
Not used in veterinary medicine
Involves urine collection
2
Q
There should never be _________ in the urine.
A
There should never be glucose in the urine.
2
Q
The ____________ receives virtually all blood because it is where filtration and modification occur.
A
The cortex receives virtually all blood because it is where filtration and modification occur.
2
Q
Water is unimpeded by the filtration apparatus thus is said to be __________.
A
Water is unimpeded by the filtration apparatus thus is said to be freely filterable.
2
Q
Steroid effect on prostaglandins
A
Blocks PLA2 enzyme activity
3
Q
Increased Creatinine primarily caused by
A
Decreased H2O in the blood
Decreased filtration by the kidney
4
Q
Parasympathetic nervous system _______ heart rate.
A
Parasympathetic nervous system decreases heart rate.
5
Q
Why do we calculate GFR?
A
- Acute Renal Disease
- Chart progression of Chronic Renal Disease
5
Q
Water is not reabsorbed at the ___________.
A
Water is not reabsorbed at the ascending loop of henle.
6
Q
______________: events in the renal tubules influence the RBF and GFR.
A
Tubuloglomerular Feedback: events in the renal tubules influence the RBF and GFR.
6
Q
Relationship between plasma [creatinine] and GFR
A
Increased plasma [creatinine] = decreased GFR
6
Q
SDMA
A
Used for earlier diagnosis of CKD
Put into blood stream all of the time by all cells during protein degredation
Excreted exclusively by kidney
7
Q
___________: cells of the mascula densa maintain RBF by monitoring [Na+, K+ and Cl-]
A
Humoral Response: cells of the mascula densa maintain RBF by monitoring [Na+, K+ and Cl-]
8
Q
Increased CHP due to systemic pressure = __________ GFR.
A
Increased CHP due to systemic pressure = increased GFR.
8
Q
__________ causes increased PGC, increased GFR and decreased RBF.
A
Constriction of Efferent Arteriole causes increased PGC, increased GFR and decreased RBF.
9
Q
Great increase in CHP due to efferent arteriole tone = ____________ GFR.
A
Great increase in CHP due to efferent arteriole tone = decreased GFR.
_________________
Increase in resistance decreases flow (occlusion)
10
Q
Increased CHP due to afferent arteriole tone = ___________ GFR.
A
Increased CHP due to afferent arteriole tone = increased GFR.
10
Q
Increased [Na+, K+, Cl-] tells the mascula densa that there is _________ GFR.
A
Increased [Na+, K+, Cl-] tells the mascula densa that there is increased GFR.
11
Q
Podocytes are found within the viseral epithelium of ___________.
A
Podocytes are found within the viseral epithelium of Bowman’s Capsule.
11
Q
What are the two types of nephrons in the kidney?
A
Cortical and Juxtamedullary
12
Q
_________ is the most important parameter in determination of normal renal function
A
GFR is the most important parameter in determination of normal renal function
13
Q
Juxtaglomerular (JG) cells are found in the _____________ of the kidney.
A
Juxtaglomerular (JG) cells are found in the afferent arteriole of the kidney.
14
Q
NSAIDs effect on prostaglandins
A
Indescriminant COX blocker
Decrease blood flow to the kidney
Cause GI ulcer
Decrease blood clotting
15
Layers of the "filter"
1. Fenestrations
2. Basement Membrane
3. Filtration slits
16
Under normal conditions ________ is essentially zero.
Under normal conditions **BSCOP** is essentially zero.
18
Amount of plasma in should __________ the amount of plasma out of the kidney (in a normally hydrated animal.)
Amount of plasma in should **equal** the amount of plasma out of the kidney (in a normally hydrated animal.)
19
Describe the stretch reflex
Stimulus \> Afferent Neuron \> Brain \> Preganglionic Neuron \> Postganglionic Neuron \> Effector Organ
20
Urine is produced when
All the time
21
\_\_\_\_\_\_\_\_\_\_\_ responds to decreased [Ca++] to maintain overall Ca++ homeostasis.
**Parathyroid Hormone (PTH)** responds to decreased [Ca++] to maintain overall Ca++ homeostasis.
22
Describe the vascular network of the nephron
Afferent Arteriole → Glomerulus → Efferent Arteriole → 1. Peritubular Capillaries or 2. Vasa Recta
24
Regulation and maintenance of plasma concentration within homeostatic norms is acheived by
Filtration
Secretion
Reabsorption
Excretion
24
Kidney produces ________ to combat the constant influence of vasoconstrictors.
Kidney produces **prostaglandins** to combat the constant influence of vasoconstrictors.
25
The urinary system is composed of \_\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_\_\_\_, and \_\_\_\_\_\_\_\_.
The urinary system is composed of **kidneys**, **Ureters**, **Urinary bladder**, and **Urethra**.
25
Describe the synthesis of creatine
1. Kidney: AA1 + AA2 = Dipeptide
2. Dipeptide released into bloodstream
3. Taken up by Liver: Dipeptide + AA3 = Creatine
4. Creatine released into the blood stream
5. Taken up by Skeletal Muscle: Creatine + Phosphate = Creatine-P
6. Creatine-P spontaneously falls apart to form Creatinine (waste molecule)
26
Iohexol
Contrasting agent that can be used to calcualte GFR
Single injection (and a few timed blood draws)
Take plotted results and calculate AUC
28
25 hydroxycholecalciferol is converted to 1,25 dihydroxycholecalciferol (calcitriol) by the enzyme \_\_\_\_\_\_\_\_\_\_\_\_\_.
25 hydroxycholecalciferol is converted to 1,25 dihydroxycholecalciferol (calcitriol) by the enzyme **1 alpha hydroxylase**.
29
Renal Autoregulation mechanisms
Direct Myogenic Response
Humoral Response
30
Increased blood pressure is due to:
1. Vasoconstriction
2. Stroke Volume
3. Heart Rate
4. Volume of Fluid
31
\_\_\_\_\_\_ is virtually unchanged in the glomerulus, has an overal higher pressure than other capillaries.
**CHP** is virtually unchanged in the glomerulus, has an overal higher pressure than other capillaries.
32
Freely filterable substances have a filterability coefficient of \_\_\_\_\_\_\_.
Freely filterable substances have a filterability coefficient of **1.0**.
33
When skeletal muscle is at rest what happens to creatine?
ATP is invested into creatinine for "storage" forming creatine-P
34
Functions of the kidney
Regulate and maintain plasma concentration
Regulate and maintain blood volume and pressure
Calcitriol
Catabolism
Gluconeogenesis
Synthesis of Erythropoietin
Synthesis of Creatine
35
Effects of decreased blood pressure on vessels includes
Vasoconstriction where needed
36
Effects of decreased blood pressure on the kidney include
Decreased GFR
Increased Reabsorption of H2O
Decreased urine flow
Increased Renin (thus vasoconstriction)
38
Effects of decreased blood pressure on the heart include
Increased heart rate
Increased stroke volume
39
\_\_\_\_\_\_\_\_\_\_\_ is the maintenance of a relatively constant renal blood flow and GFR despite changes in systemic blood pressure.
**Renal Autoregulation** is the maintenance of a relatively constant renal blood flow and GFR despite changes in systemic blood pressure.
40
Oncotic pressures push water \_\_\_\_\_\_\_\_.
Oncotic pressures push water **toward**
40
Requirements for a substance to be used to calculate GFR
Freely filterable
Not secreted
Not reabsorbed
Not metabolized
41
\_\_\_\_\_\_\_\_\_\_\_\_ is a hormone that influences RBC production in the bone marrow.
**Erythropoietin** is a hormone that influences RBC production in the bone marrow.
42
Slight increase in CHP due to efferent arteriole tone = _________ GFR.
Slight increase in CHP due to efferent arteriole tone = **increased** GFR.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Increase in resistance causes increased CHP to compensate for decreased flow
44
\_\_\_\_\_\_\_\_\_\_ is the most important regulator of homeostatic norms (according to Dr. Reich)
**Filtration** is the most important regulator of homeostatic norms (according to Dr. Reich)
44
Mascula densa are cells of the \_\_\_\_\_\_\_\_.
Mascula densa are cells of the **distal tubule**.
45
\_\_\_\_\_\_\_\_\_\_\_\_\_: stretch stimulus received and responded to by the afferent arteriole.
**Direct Myogenic Response**: stretch stimulus received and responded to by the afferent arteriole.
46
Most protein in plasma is produced by the \_\_\_\_\_\_\_.
Most protein in plasma is produced by the **liver**.
46
Prostaglandins are produced by _________ enzyme.
Prostaglandins are produced by **COX-1** enzyme.
47
Ultrafiltration results in a filtrate free of
Cells, large molecules and large anions
48
\_\_\_\_\_\_\_\_\_ is nearly freely filterable and used as the gold standard indicator substance to calculate GFR.
**Inulin** is nearly freely filterable and used as the gold standard indicator substance to calculate GFR.
50
Major target of PTH is the \_\_\_\_\_\_\_\_\_.
Major target of PTH is the **proximal tubule**.
51
Reabsorption Pressures
Bowman's Space Hydrostatic Pressure (BSHP)
Plasma Colloid Oncotic Pressure (PCOP)
51
Cells of the mascula densa secrete ________ substances.
Cells of the mascula densa secrete **vasoconstriction** substances.
52
Increased renal blood flow = ________ GFR.
Increased renal blood flow = **increased** GFR.
53
At the afferent arteriole the GFR is net _________ wherease at the efferent arteriole the GFR is net ________ due to change in [Protein].
At the afferent arteriole the GFR is net **filtration** wherease at the efferent arteriole the GFR is net **reabsorption** due to change in [Protein].
54
\_\_\_\_\_\_\_\_\_\_\_ causes increased PGC, increased GFR and increased RBF.
**Dilation of Efferent Arteriole** causes increased PGC, increased GFR and increased RBF.
56
\_\_\_\_\_\_\_\_\_ nephrons have a LoH that is entirely in the cortex.
**Cortical** nephrons have a LoH that is entirely in the cortex.
57
Driving force for filtration of plasma at the glomerulus is \_\_\_\_\_\_\_\_\_\_\_\_\_.
Driving force for filtration of plasma at the glomerulus is **hydrostatic pressure**.
58
Calculation of GFR when using Iohexol
Amount of Iohexol injected (mg) / AUC (mg x time/mL)
59
\_\_\_\_\_\_\_\_\_\_\_ causes decreased PGC, decreased GFR and increased RBF.
**Dilation of Afferent Arteriole** causes decreased PGC, decreased GFR and increased RBF.
60
When there is skeletal muscle damage it is common to see elevated _______ and ________ in blood sample. You do not see elevated _________ and \_\_\_\_\_\_\_\_\_.
When there is skeletal muscle damage it is common to see elevated **myoglobin** and **creatine** in blood sample. You do not see elevated **creatinine** and **creatine-p**.
61
Angiotension II causes _______ of the afferent and efferent arterioles.
Angiotension II causes **vasoconstriction** of the afferent and efferent arterioles.
63
When skeletal muscle is active what happens to the creatine?
Creatine-P releases its phosphate to ADP to make ATP quickly
64
Atrial Naturetic Polypeptide (ANP) causes \_\_\_\_\_\_, ________ GFR and _______ reabsorption.
Atrial Naturetic Polypeptide (ANP) causes **vasodilation**, **increased** GFR and **decreased** reabsorption.
65
Increased [Protein] in bowman's space causes increased \_\_\_\_\_\_\_.
Increased [Protein] in bowman's space causes increased **BSCOP**.
67
\_\_\_\_\_\_\_\_\_\_ is the most abundant protein in plasma.
**Albumin** is the most abundant protein in plasma.
69
Nephrons receive ______ of renal blood flow.
Nephrons receive **90%** of renal blood flow.
71
\_\_\_\_\_\_\_\_\_\_\_ is important in the homeostatic regulation of calcium.
**Calcitriol** is important in the homeostatic regulation of calcium.
72
Erythropoietin is produced in response to \_\_\_\_\_\_\_\_.
Erythropoietin is produced in response to **anemia**.
73
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ causes decreased PGC, decreased GFR, and decreased RBF.
**Constriction of Afferent Arteriole** causes decreased PGC, decreased GFR, and decreased RBF.
75
Filtration pressures
Capillary Hydrostatic Pressure (CHP)
Bowman's Space Colloid Oncotic Pressure (BSCOP)
76
Hydrostatic pressures push water \_\_\_\_\_\_\_.
Hydrostatic pressures push water **away**.
77
Renal components of volume and pressure homeostasis.
JG cells
Mesangial cells
Podocytes
Renin
Mascula densa
78
\_\_\_\_\_\_\_\_\_\_\_ receptors respond to epinephrine and norepinephrine.
**Androgenic** receptors respond to epinephrine and norepinephrine.
79
Coxhib effect on prostaglandin
Blocks COX 2 better than COX 1
81
\_\_\_\_\_\_\_, ________ and ________ store urine but do little to change its volume or composition.
**Ureters**, **Urethra** and **Urinary Bladder** store urine but do little to change its volume or composition.
82
Increased BSCOP= _________ GFR.
Increased BSCOP= **increased** GFR.
84
\_\_\_\_\_\_\_\_\_ nephrons have LoH in the medulla because they are responsible for urine concentrating.
**Juxtamedullary** nephrons have LoH in the medulla because they are responsible for urine concentrating.
85
Gluconeogenesis occurs in
Kidney (proximal tubule)
Liver
86
The kidney receives _______ of cardiac output.
The kidney receives **20%** of cardiac output.
87
Obstruction and edema are causes of increased \_\_\_\_\_\_\_\_\_\_.
Obstruction and edema are causes of increased **BSHP**.
88
\_\_\_\_\_\_\_\_\_\_ causes vasoconstriction, increased reabsorption of of water and decreased GFR
**ADH (Vasopressin)** causes vasoconstriction, increased reabsorption of of water and decreased GFR
89
Animal can lose ______ of nephrons before increased [creatinine] in plasma.
Animal can lose **75%** of nephrons before increased [creatinine] in plasma.
91
Stored glycogen lasts for less than \_\_\_\_\_\_\_\_\_.
Stored glycogen lasts for less than **24 hours**.
93
\_\_\_\_\_\_\_\_\_\_\_: "Capillary Tuft"- Capillary bed in the nephron which is invested with a specialized basement membrane and surrounding space lined by viseral epithelium of podocytes and parietal epithelium that merges with proximal tubule.
**Glomerulus:**"Capillary Tuft"- Capillary bed in the nephron which is invested with a specialized basement membrane and surrounding space lined by viseral epithelium of podocytes and parietal epithelium that merges with proximal tubule.
94
Increased PCOP = _____ GFR
Increased PCOP = **decreased** GFR
95
There should always be _________ in the urine.
There should always be **protein** in the urine.
96
Practitioners rely on __________ as the indicator of filtering ability of the kidney
Practitioners rely on **[creatinine]** as the indicator of filtering ability of the kidney
97
Any substance that is freely filterable exists at the same concentration in _______ and in \_\_\_\_\_\_\_\_\_.
Any substance that is freely filterable exists at the same concentration in **plasma** and in **bowmans space**.
98
Gluconeogenesis
Making glucose from a non-carbohydrate source
99
Glomerular Filtration Rate = \_\_\_\_\_\_\_\_\_\_\_\_
Glomerular Filtration Rate =
## Footnote
**Kf (CHP + BSCOP) - (BSHP + PCOP)**
**Kf (Sum Filtration) - (Sum Reabsorption)**
100
Sympathetic nervous system ______ heart rate.
Sympathetic nervous system **increases** heart rate.
101
Creatine ⇔ Creatine-P is catalyzed by \_\_\_\_\_\_\_\_\_\_\_.
Creatine ⇔ Creatine-P is catalyzed by **Creatine Kinase**.
102
Synthesis of creatine requires normal function of the _________ and \_\_\_\_\_\_\_\_.
Synthesis of creatine requires normal function of the **liver** and **kidney**.
102
Methods of evaluating GFR
1. [Creatinine] in plasma
2. Inulin
3. Iohexol
4. SDMA (coming in 2015!)
104
Renal Clearance = \_\_\_\_\_\_\_
Renal Clearance = **GFR**
105
Single Nephron GFR
Loss of nephron may be masked to some extent by increased filtration at remaining nephrons
106
Increased blood flow = _______ blood pressure
Increased blood flow = **increased** blood pressure
107
\_\_\_\_\_\_\_\_\_ allows the kidney to fight sympathetic stimulation during times of decreased blood pressure.
**Autoregulation** allows the kidney to fight sympathetic stimulation during times of decreased blood pressure.
108
\_\_\_\_\_\_\_\_ increases significantly from afferent arteriole to efferent arteriole ends of the glomerular capillary.
**PCOP** increases significantly from afferent arteriole to efferent arteriole ends of the glomerular capillary.
109
Increased BSHP = _______ GFR.
Increased BSHP = **decreased** GFR.
110
GFR(mL/min) = \_\_\_\_\_\_\_\_\_\_\_\_\_\_
GFR(mL/min) =
**_Urine Flow (mL/min) [X] Urine (mg/mL)_**
**_[_****X] plasma (mg/mL)**
