Renal Physiology I

Question 1

TBW is ___% of total body weight (kg). What indicators are linked to this compartment?

Answer 1

Question 2

ICF is ___% of total body weight? What indicators predict this compartment?

Answer 2

Question 3

ECF is ___% of total body weight? What indicators predict this compartment?

Answer 3

Question 4

ECF is composed of?

Answer 4

Question 5

How do you calculate total blood volume?

Answer 5

Question 6

How do you calculate interstitial fluid?

Answer 6

Question 7

How do you calculate intravascular plasma? What are the indicators for that compartment?

Answer 7

Question 8

Adipocytes contain how much fluid?

Answer 8

Question 9

How would you estimate TBW of an obese individual?

Answer 9

Question 10

What percentages of total body water (TBW) make up ECF and ICF?

Answer 10

Question 11

How do the kidneys regulate Na⁺ homeostasis?

Answer 11

Question 12

What happens if the kidneys are unable to maintain normal ECF volume?

Answer 12

Question 13

What are the key ideas of this graph?

Answer 13

Question 14

What are the three steps you should take when analyzing a Darrow-Yannet diagram?

Answer 14

Question 15

What happens if you infuse 2 L Isotonic Saline?

Answer 15

Question 16

What happens if you are lost in the desert?

Answer 16

Question 17

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Question 18

What is insensible water loss?

Answer 18

Water loss that we are not consciously aware of, even though it occurs continually in all living humans.

• 700mL/day through respiratory evaporation
• 300-400mL/day through the skin
• 300-400mL/day through respiratory tract
• 100mL/day through sweat
• 100mL/day through feces

Question 19

What are the major triggers of AVP/ADH (Agrinine Vasopressin/Anti-Diuretic Hormone), and what do they do?

Answer 19

Question 20

What is the major trigger of RAAS activation, what is it’s effect?

Answer 20

Question 21

What are the two ways that the body responds to decreases in ECFV and increases in plasma Osmolarity?

Answer 21

Question 22

3 Factors that Effect Filtration:

Answer 22

Question 23

Explain the anatomy of the nephron and how blood flow is organized

Answer 23

Question 24

Normal GFR per day (both kidneys)?

Answer 24

Question 25

How many times is plasma volume (~3L) filtered/day?

Answer 25

Question 26

Normal urine volume/day?

Answer 26

Question 27

What are dextrans?

Answer 27

Question 28

How does charge and size affect filterability?

Answer 28

Question 29

How does the quality of the glomerular membrane affect filtration?

Answer 29

Question 30

How does net filtration pressure (NFP) affect filtration?

Answer 30

Question 31

Calculate the NFP using values below.

Answer 31

Question 32

What does the glomerular filtrate look like compared to plasma?

Answer 32

Question 33

Clinically, the glomerular filtration rate (GFR) comes down to 2 factors…

Answer 33

Question 34

Clinically it’s impractical to measure GFR by Kf or NFP! What is the basic theory of renal clearance?

Answer 34

Question 35

What is clearance?

Answer 35

Question 36

How do you calculate clearance?

Answer 36

Question 37

What is the benefit of using inulin to calculate clearance?

Answer 37

Renal Clearance: Inulin (Gold Standard of GFR)

Question 38

What is the benefit of using creatinine to estimate GFR?

Answer 38

Renal Clearance: Creatinine (~GFR Estimate)

Question 39

How is plasma creatinine related to GFR?

Answer 39

Renal Clearance: Plasma Cr inversely related to GFR!

Question 40

MDRD Study Equation:

Answer 40

Question 41

Cockcroft-Gault Equation:

Answer 41

Question 42

What would make the plasma Cr rise?

Answer 42

Question 43

Board review:

Answer 43

Question 44

Renal clearance:

Answer 44

Question 45

Why is GFR clinically useful?

Answer 45

Question 46

How can we filter so much plasma?

Answer 46

Question 47

What is normal renal blood flow?

Answer 47

Question 48

What is filtration fraction?

Answer 48

Question 49

Why is PAH an ideal marker of plasma renal blood flow?

Answer 49

Question 50

Board reveiw:

Answer 50

Question 51

Board review:

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Question 52

Board review:

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Question 53

Board review:

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Question 54

What happens when you contrict only the afferent arteriole?

Answer 54

Question 55

What happens when you constrict only the efferent arteriole?

Answer 55

Question 56

The kidney protects RBF & GFR from changes in MAP. How?

Answer 56

Question 57

What are the following neuroendocrine influence on RBF?

Answer 57

Question 58

Explain the myogenic mechanism of the renal arterioles

Answer 58

Question 59

Tubuloglomerular Feedback (TGF): What happens when you decrease tubule flow?

Answer 59

Question 60

Tubuloglomerular Feedback (TGF): What happens when you increase tubule flow?

Answer 60

Question 61

Explain Tubuloglomerular Feedback (TGF)

Answer 61

Question 62

What will happen to GFR if there is: A decrease in AA resistance?

Answer 62

Question 63

What will happen to GFR if there is: Constriction of the AA?

Answer 63

Question 64

What will happen to GFR if there is: A decrease in EA resistance?

Answer 64

Question 65

What will happen to GFR if there is: Constriction of the EA?

Answer 65

Question 66

What will happen to GFR if there is: A lack of protein in the diet?

Answer 66

Question 67

What will happen to GFR if there is: Acute obstruction (kidney stone, enlarged prostate)?

Answer 67

Question 68

What will happen to GFR if there is: If your protein makes it past the filter?

Answer 68

Question 69

What will happen to GFR if there is: Diabetes induced reduction in glomerular surface area?

Answer 69

Question 70

Introduction to Body Fluid: 60-40-20 Rule

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Question 71

Practice question:

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Question 72

Practice question:

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Question 73

Practice question:

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Question 74

Practice question:

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Question 75

Practice question:

Answer 75

Question 76

Practice problems: ICF/ECF Osmotic Relationships If you have a loss of blood volume or severe adult diarrhea?

Answer 76

Question 77

Practice problems: ICF/ECF Osmotic Relationships If you infuse excessive isotonic saline?

Answer 77

Question 78

Practice problems: ICF/ECF Osmotic Relationships What happens if you have Addison’s disease and you can’t retain sodium?

Answer 78

Question 79

Practice problems: ICF/ECF Osmotic Relationships You get lost in Mojave Desert in June where temps sore above 120 °F…

Answer 79

Question 80

Practice problems: ICF/ECF Osmotic Relationships A person eats a generous portion of NaCl

Answer 80

Question 81

Practice problems: ICF/ECF Osmotic Relationships A person rides the Hotter’N Hell 100 mile bicycle race in Wichita Falls, TX in August, while only drinking pure water…

Answer 81

Question 82

Practice problems: ICF/ECF Osmotic Relationships A patient case...

Answer 82