Renal, Topnotch + CDB Flashcards
(170 cards)
1
Q
Length of the ureter
A
25-35 cm
2
Q
Origin of the nephron
A
Metanephric blastema
3
Q
Origin of the collecting duct system
A
Ureteric bud
4
Q
pH compatible with life
A
6.8-8.0
5
Q
Stimulus for EPO production by interstitial cells of kidney
A
Hypoxia
6
Q
Form of vitamin D produced in kidneys
A
1,25-hydroxycholecalciferol
7
Q
Enzyme in the kidney that converts vitamin D to its active form
A
1a-hydroxylase
8
Q
Function of kidney during starvation
A
Gluconeogenesis
9
Q
Vertebral level of kidneys
A
T12-L3
10
Q
Weight of 1 kidney
A
150g
11
Q
Part of kidney that is pain sensitive
A
Capsule
12
Q
Organism implicated in staghorn calculi/mg ammonium po4/struvite
A
Proteus mirabilis
13
Q
Renal circulation
A
Renal artery > segmental artery > interlobar artery > arcuate artery > interlobular artery (cortical/radial) > afferent arteriole > glomerular capillaries > efferent arteriole > peritubular capillaries/vasa recta > interlobular vein > arcuate vein > interlobar vein > segmental vein > renal vein
14
Q
Cxs of glomerular capillaries (2)
A
1) Highly fenestrated hence responsible for GFR
2) Only capillaries that leas to arterioles and not venules
15
Q
Hairpin loop-shaped peritubular capillaries of the juxtamedullary nephrons
A
Vasa recta
16
Q
Creates corticopapillary osmotic gradient
A
Countercurrent multipliers
17
Q
Structure known as the countercurrent multiplier
A
Loop of Henle
18
Q
Maintains the corticopapillary osmotic gradient
A
Countercurrent exchangers
19
Q
Structure known as the countercurrent exchanger
A
Vasa recta
20
Q
Substances moved in circles by the countercurrent exchanger (2)
A
1) Na
2) Urea
21
Q
Urge to urinate
A
150 mL
22
Q
Reflex contraction
A
300mL
23
Q
Sense of fullness
A
400mL
24
Q
of nephrons per kidney
A
1M
25
The kidneys undergo compensatory regeneration upon __% damage to nephrons
75%
26
Cortical vs Juxtamedullary nephrons: Percentage
75%, 25%
27
Cortical vs Juxtamedullary nephrons: Loops of Henle
Short-long
28
Cortical vs Juxtamedullary nephrons: Capillary network
Peritubular capillaries-vasa recta
29
Diameter of pores of capillary endothelium
8nm or 80A
30
Vasoactive substances secreted by capillary endothelium
1) NO
| 2) ET-1
31
Form the visceral epithelium in the glomerulus
Podocytes
32
Where filtrations slits are located in kidneys
Podocytes
33
Function of mesangial cells
1) Contractile elements
2) Mediate filtration
3) Take up immune complexes
34
Components of JG apparatus
1) JG cells
2) Macula densa
3) Lacis cells
35
Glomerular cells of the afferent arterioles
JG cells
36
What JG cells secrete
Renin
37
Where macula densa is located
Wall of DCT
38
Function of the macula densa
Monitor Na concentration in the DCT
39
Site of kidneys most susceptible to ischemia
PCT
40
% sodium, K, and H2O reabsorbed in the PCT
66%
41
% glucose and aa reabsorbed in PCT
100%
42
Part of loop of Henle permeable to water but not to solutes
Descending limb
43
Part of loop of Henle permeable to solute but not to water
Ascending limb
44
Substances that kidneys filter only (2)
1) Inulin
| 2) Creatinine
45
Substances that kidneys filter and secrete (2)
1) PAH
| 2) Organic acids and bases
46
GFR is __% lower in females
20-25%
47
Fraction of renal plasma flow that is filtered
Filtration fraction
48
Normal filtration fraction
20%
49
Formulas for filtration fraction
GFR/RPF
50
Substance used to determine RPF (gold std)
PAH
51
Size of substance freely filtered in kidneys
20A or less
52
Size of substance not filtered at all in kidneys
>42
53
Filterability of 1.0
Freely filtered as water
54
Filterability of 0.75
Filtered only 75% as rapidly as water
55
Filterability according to charge
Positive > neutral > negative
56
Portion of renal corpuscle affected by NSAID and mechanism
Afferent arteriole; inhibition of PG (dilates afferent arteriole)
57
Portion of renal corpuscle affected by ACEI and mechanism
Efferent arteriole; inhibition of ATII (constricts efferent arteriole)
58
Glomerular hydrostatic pressure
60 mmHg
59
Net filtration pressure (GFR)
10 mmHg
60
Effect on GFR when efferent arteriole is moderately constricted
Increase
61
Effect on GFR when efferent arteriole is severely constricted
Decrease
62
Effect on GFR when ultrafiltration coefficient (Kf) is increased
Increase
63
Causes of decreased Kf
1) DM
2) Htn
3) Renal diseases
64
Cause of increased hydrostatic pressure in the bowman's space
Urinary tract obstruction
65
Glomerular filtration forms
Primitive urine
66
% CO received by kidneys
25%
67
Organs that are sensitive to ischemia
1) Brain
2) Liver
3) Kidney
68
Type of infarct in the kidney
Wedge-shaped white or anemic infarct
69
Renal cortex vs medulla: greater renal blood flow
Renal cortex
70
BP at which renal autoregulation is optimal
80-170 mmHg
71
Massive sympathetic stimulation that results in massive vasoconstriction of kidneys
CNS ischemic response
72
Substances secreted as autoregulatory mechanisms to maintain GFR
1) Adenosine
2) NO
3) ATII
73
Effect of adenosine on kidneys
Afferent arteriole vasoconstriction
74
Effect of nitric oxide on kidneys
Afferent arteriole vasodilation
75
Percentage of solute reabsorbed is held constant
Glomerulotubular balance
76
Concentration at which substance starts to appear in the urine
Renal threshold
77
Concentration at which all excess substance appear in the urine or the limit to the rate at which solute can be transported (reabsorbed)
Renal transport maximum
78
Renal Tmax of glucose
375 mg/dL
79
Renal threshold of glucose
200 mg/dL
80
Filtered load at renal threshold of glucose
250 mg/min
81
Normal filtered load of glucose
125 mg/min
82
Kidney transport mechanism that does not exhibit Tmax and threshold
Gradient-time transport
83
Factors that affect transport of substances that use the gradient-time mechanism (3)
1) Electrochemical gradient
2) Membrane permeability
3) Time
84
Relationship between flow rate and rate of transport in gradient-time transport
Inverse
85
Epithelium of PCT
Low columnar with extensive brush border
86
Osmolarity of PCT
Isosmotic
87
Epithelium of thin segments of loop of Henle
Simple squamous
88
Epithelium of thick segments of loop of Henle
Simple cuboidal
89
% of filtered water reabsorbed in loop of Henle
20%
90
% of filtered Na,K,Cl reabsorbed in loop of Henle
25%
91
Ion channel inhibited by loop diuretics (Furosemide, Bumetanide, Ethacrynic acid)
Na-K-2Cl
92
Epithelial lining of distal tubule
Simple cuboidal
93
Aka Goormatigh or Polkissen cells or agranular cells
Lacis cells
94
Cells found in second part of distal tubule
1) Principal cells
| 2) Intercalated cells
95
Function of principal cells (3)
1) Reabsorb Na
2) Secrete K
3) Reabsorb H2O
96
Function of intercalated cells (2)
1) Reabsorb K
2) Secrete Na
3) HCO3 regulation
97
Transport systems by which intercalated cells secrete H+ (2)
1) Na-H countertransport
| 2) H-ATPase
98
Part of kidney responsive to aldosterone
DT
99
Part of kidney responsive to vasopressin
DT and CD
100
% filtered water reabsorbed in DT
5
101
Part of renal tubules impermeable to urea
DT
102
Part of renal tubules permeable to urea
CD
103
Site for regulation of final urine volume and concentration
CD
104
Effect of aldosterone on kidneys (3)
1) Na reabsorption
2) Water reabsorption
3) K secretion
105
Effect of ATII on kidneys (2)
1) Na reabsorption
| 2) Water reabsorption
106
Effect of ANP and BNP on kidneys
Decrease Na reabsorption
107
Effect of PTH on kidneys
1) Increase Ca reabsorption
2) Decrease PO4 reabsorption
3) Increase 1a-hydroxylase
108
Triggers for ADH secretion and respective sensors
1) Increased osmolarity (Hypothalamus)
2) Decreased BP (atrial stretch receptors)
3) Decreased blood volume (carotid sinus and aortic arch)
109
Effect of alcohol on body fluid regulation of kidneys
Decreases ADH secretion
110
Hormone secreted by DT and CD that acts similar to ANP
Urodilatin
111
Change in osm that triggers ADH secretion
1%
112
Change in blood volume that triggers ADH secretion
10%
113
Stimulus for renin secretion by JG cells
Decrease in BP
114
Effect of renin
Angiotensinogen > angiotensin I in liver
115
Where and angiotensin I is converted to angiotensin II and enzyme responsible
Lungs and kidneys via ACE
116
CKD with normal size
1) SLE
2) HIV
3) PTB
4) Amyloidosis
5) Sarcoidosis
117
All tubular capillaries are derived from
Efferent arterioles
118
Onion-skinning or fibrinoid necrosis is seen in what renal disease
Malignant nephrosclerosis
119
Most common site of abdominal aneurysm
Infrarenal/before bifurcation of abdominal aorta
120
Symptom of abdominal aneurysm
Abdominal bruit
121
Most common type of htn
Essential/idiopathic
122
Most common cause of secondary htn
Renovascular dse
123
Most common renovascular disease
Renal artery stenosis
124
Filtration rate - reabsorption rate + secretion rate
Excretion rate
125
How many times is plasma volume filtered in a day
60x
126
% water reabsorbed from filtered volume
99%
127
% phenol reabsorbed from filtered volume
0%
128
Regulation of urine concentration (2)
1) Medullary countercurrent system
| 2) Vasopressin
129
High permeability of thin descending limb to water is via
Aquaporin-1
130
Nodular sclerosis of glomerular membrane is seen in what disease
DM
131
Microscopic finding in kidneys with DM
Kimmelsteil-Wilson Lesions
132
Microscopic finding in kidneys with minimal change disease
Effacement of podocytes
133
Combined blood flow through both kidneys in an average adult
1100mL/min
134
Renal vessels with greatest resistance (4)
1) Interlobar artery
2) Interlobular artery
3) Afferent arteriole
4) Efferent arteriole
135
Formula for renal blood flow
(R artery pressure-R vein pressure)/Total renal vascular resistance
136
Drug that causes diabetes insipidus by interfering with ADH receptors on DT
Lithium
137
Major ion secreted into tubules coupled with sodium entry
Hydrogen
138
Forces that propel the urine along the ureter
1) Gravity
| 2) Peristaltic contractions
139
Treatment for post-operative bladder atony
Bethanechol
140
Where EPO is produced
Interstitial peritubular cells
141
Usual daily urine output
700-1400mL
142
Why ACEI exacerbates cough
ACE inhibits bradykinin
143
Normal venous pH
7.35
144
Normal interstitial fluid pH
7.35
145
Body fluid buffer systems (3)
1) Bicarbonate
2) Phosphate
3) Intracellular proteins
146
The respiratory buffer responds to
H+ levels
147
Respiratory regulation of acid-base balance is __% effective in returning pH back to normal
50-75%
148
Respiratory regulation returns pH back to normal within ___ minutes
3-12
149
Mechanisms of renal regulation of acid-base balance (3)
1) Excess H+ secretion
2) HCO3 reabsorption
3) Production of new HCO3 using ammonia and phosphate buffers
150
Normal HCO3
22-26 mmol/L
151
Normal pCO2
35-45 mmHg
152
Acid-base imbalance due to conditions resulting in decreased ventilation
Respiratory acidosis
153
Acid-base imbalance due to conditions resulting in increased ventilation
Respiratory alkalosis
154
Respi acid vs alka: Airway obstruction
Respi acid
155
Respi acid vs alka: Pneumonia
Respi alka
156
Respi acid vs alka: ARDS
Respi acid
157
Respi acid vs alka: Pulmonary embolus
Respi alka
158
Respi acid vs alka: COPD
Respi acid
159
Respi acid vs alka: High altitude
Respi alka
160
Respi acid vs alka: Psychogenic
Respi alka
161
Respi acid vs alka: Salicylate intoxication
Respi alka
162
Formula for plasma anion gap
Na - (HCO3 + Cl-)
163
Met acidosis where there is excess organic anions to maintain electroneutrality
HAGMA
164
Met acidosis where there is increased chloride to maintain electroneutrality
NAGMA
165
HAGMA (11)
MUDPILES
Methanol, uremia, DKA, paraldehyde, propylene glycol, iron, isoniazid, idiopathic acidosis, lactic acidosis, ethylene glycol, ethanol, salicylic acid
166
NAGMA (6)
HARD UP
| Hyperalimentation, acetazolamide, RTA, diarrhea, ureteroenteric fistula, pancreaticoduodenal fistula
167
Conditions resulting in metabolic alkalosis (5)
1) Loop diuretics
2) Thiazide diuretics
3) Vomiting
4) Hyperaldosteronism
5) Ingestion of alkaline drugs
168
Osmolarity of medullary interstitium
1200-1400
169
Segment of tubules that is virtually impermeable to water
TALH
170
Most important cause of high medullary osmolarity
TALH
