Renal Structure And Glomerular Filtration Flashcards Preview

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Flashcards in Renal Structure And Glomerular Filtration Deck (31):
1

What are the Primary Functions of the Kidney?

1. Excretion of waste products: urea, uric acid, creatinine
2. Water and electrolyte balance
3. Avid/base balance
4. EPO and renin secretion
5. 1,25-dehydroxi-Vit D

2

This part of the kidney is more susceptible to isquemia and is due to slow blood flow (⬇️PO2) ?

1. Medulla

3

What are the 4 renal processes of the kidney?

1. Filtration
2. Reabsorption
3. Secretion
4. Excretion

4

Where is plasma filtrated in the kidney?

Renal corpuscle

5

Through what transport mechanism does secretion usually occur?

1. Active Transport

6

How do you calculate the excretion rate (Er)?

Er = (Filtration - Reabsorption) + Secretion

7

Nerve necessary for bladder filling phase ?

1. Hypogastric nerve.
2. Sympathetic NS
3. B3–> detrusor relaxation
4. Alpha-1: internal sphincter contraction

8

Filling of the bladder activates and deactivates the following systems?

1. ⬇️Sympathetic
2. ⬆️Parasympathetic (Pelvic nerve) —> M3 receptor —> Detrusor contraction

9

How is the external sphincter controlled, for contraction ?

1. Pudendal Motor Nerve (Nicotinic)
2. Void—> it’s inhibited

10

2 mechanisms by which the kidney auto regulates ?

1. Myogenic response: ⬆️compliance—> ⬆️contraction
2. Tubuloglomerular feedback (TGF)

11

TGF: what happens to RBF and GFR with ⬆️MAP?

1. ⬆️⬆️

12

TGF: what happens to RBF and GFR with ⬆️Na delivery to the macula densa ?

1. ⬆️Vasoconstriction
2. ⬇️RBF and GFR

13

TGF: what happens to RBF and GFR with ⬇️Na delivery in macula densa ?

1. Vasodilation
2 ⬆️RBF and GFR

14

In order to maintain an ⬆️GFR, what will be the afferent/efferent interactions?

1. Afferent vasodilation (⬆️downstream pressure )
2. Efferent vasoconstriction (⬆️upstream pressure )

15

Relationships between afferent/efferent arterioles to ⬇️GFR?

1. Afferent vasoconstriction (⬇️downstream pressure )
2. Efferent vasodilation (⬇️upstream pressure )

16

What renal capillaries have ⬇️ hydrostatic pressure ?

Peritubular capillaries

17

Normal GFR?

1. 120 ml/min
2. 180L/day

18

Main starling force for GFR?

1. Glomerular Capillary Hydrostatic Pressure

19

Main starling force that drives reabsorption in the tubules ?

1. Tubular capillary Oncotic Pressure

20

Both capillary endothelial cells and GBM have this property that repels protein filtration?

1. Negatively (-) charged proteins and particles

21

Plasma concentration/filtered concentration ratio for a substance freely filtered by kidney?

1.0

22

How do you calculate filtration fraction ?

FF= GFR/RPF

FF= (120ml/min)/(600ml/min)

FF= .20 or 20%

23

What does an ⬆️FF do to the peritubular capillary oncotic pressure?

1. ⬆️⬆️
2. ⬆️⬆️Reabsorption

24

What does a ⬇️FF due to peritubular capillary oncotic pressure ?

1. ⬇️⬇️Oncotic pressure
2. ⬇️⬇️Reabsorption

25

What does an ⬆️ in sympathetic function produce in renal function tests?

1. Vasoconstriction of AA>EA
2. ⬇️GFR < ⬇️⬇️RPF
3. ⬆️FF
4. ⬆️peritubular capillary oncotic pressure
5. ⬆️tubular reabsorption
6. ⬇️Glomerular capillary hydrostatic
7. ⬇️peritubular capillary hydrostatic

26

What does angiotensin II cause to the renal function tests?

1. AA ⬆️< EA ⬆️⬆️ vasoconstriction
2. ⬆️GFR / ⬇️RPF
3. ⬆️FF
4. ⬆️Hydrostatic Capillary Pressure
5. ⬆️Peritubular Oncotic Pressure
6. ⬇️Peritubular Hydrostatic Pressure
7. ⬆️Peritubular reabsorption

27

What does a combination of both sympathetic and angiotensin II do to kidney function?

1. ⬇️GFR/ ⬇️⬇️RPF
2. ⬆️FF
3. ⬆️Peritubular Oncotic Pressure

IN A FEW WORDS:

⬇️GFR and ⬆️reabsorption

28

Endogenous substances that protect kidney from ischemia during stress?

1. PGD’s —> protect kidneys countering sympathetic vasoconstriction in AA

29

Uses of ACE inhibitors and ARB in kidney conditions?

1. CKD
2. Nephrotic Syndrome

⬇️GFR

30

ACE inhibitors and ARB contraindications?

1. AKF (⬇️GFR) -> 😵
2. Bilateral Renal Stenosis
(⬇️⬇️GFR) —> death
GFR depends on EA vasoconstriction. If you inhibit ACE or AII—> 😵

31

ACE inhibitors and ARB can cause this type of Renal Tubular Acidosis?

1. Type IV
2. ⬇️Hypoaldosteronism
3. ⬆️Hyperkalemia