Renal - Urinary System

Question 1

How much blood goes from the aorta to the kidneys?

Answer 1

20% of blood goes to the kidneys through the renal arteries

Question 2

Kidney anatomy

Answer 2

Renal vein, renal artery, kidneys (renal capsule, cortex, renal columns between the renal pyramids, renal papillae at the apex of the pyramid, minor renal calyx, renal major calyx, pelvis) ureter

Question 3

Vasa recta

Answer 3

Peritubular capillaries - efferent arteriole

Question 4

What is the afferent arteriole sensitive to?

What is the efferent arteriole sensitive to?

Answer 4

Epinephrine

Angiotensin 2

Question 5

What does epinephrine do to the afferent arteriole?

Answer 5

Epinephrine constricts the arteriole decreasing glomerular filtration rate (GFR)

Question 6

Remember

Answer 6

At the glomerulus, there is one physiological physical activity.
Pure filtration. Pressure, fluid, and pore size.

Question 7

Osmoregulation

Answer 7

Receptors are in the hypothalamus.

Hyperosmorality results in thirst and ADH release to dilute solutes more, trying to thing the blood out.

Question 8

Volume regulation

Answer 8

baroreceptors in the macula densa.

When there is blood loss, then there is sympathetic activation and renin release from JGA

Question 9

Where are most of the sodium reabsorbed in the kidney?

Answer 9

67% in the proximal tubule, 25% in the thick ascending loop of Henle

Question 10

Is glucose, amino acid, bicarbonate reabsorbed into the bloodstream?
How much of it?

Answer 10

Almost all of the glucose, amino acid, and bicarbonate are reabsorbed in the proximal tubule

Question 11

Where is calcium mostly reabsorbed?

Answer 11

It is reabsorbed throughout the whole nephron, but primarily in the proximal convoluted tubule

Question 12

Where do you find the tri-cotransporter?

Answer 12

The NA-K-Cl transporter is found in the thick ascending loop of Henle

Question 13

How does the potassium (K) reabsorption behave in the nephron?

Answer 13

Same as Sodium with the exception that in the distal convoluted tubule, it can be reabsorbed or excreted depending on the level of potassium in the blood

Question 14

Remember

Answer 14

The liver produces angiotensinogen.

Question 15

What is angiotensinogen cleaved to? by what?

Answer 15

Angiotensinogen is cleaved to angiotensin-I by renin

Question 16

Who releases renin?

Answer 16

juxtaglomerular cells

Question 17

What is ACE and what releases it?

Answer 17

The lung releases ACE. It stands for Angiotensin Converting Enzyme. It converts angiotensin I to Angiotensin II

Question 18

What are the two activities of angiotensin 2?

Answer 18

Glomerular efferent arteriole constriction thus increasing GFR
and
ZOna glomerulosa activation of Aldosterone. It goes to the distal tubule and causes sodium reabsorption and potassium excretion.

Question 19

Why do I want reabsorption of sodium?

Answer 19

Water follows sodium thus increasing the blood volume

Question 20

When you drink water, what happens?

Answer 20

Decreases plasma osmolarity
Inhibits osmoreceptors in the anterior pituitary
Decreases secretion of ADH from the posterior pituitary
Decreases water permeability of late distal tubule and collecting duct

Question 21

What organ does most transamination?

Answer 21

Liver, but the kidneys are also responsible for transamination

Question 22

What is transamination?

Answer 22

Transamination is the process by which amino groups are removed from amino acids and transferred to acceptor keto-acids to generate the amino acid version of the keto-acid and the keto-acid version of the original amino acid

Question 23

What do the transaminases use?

Answer 23

Vitamin B6

Question 24

Urea cycle

Known this

Answer 24

where does it occur? Liver cell
What does it do? A way the liver takes two very dangerous metabolites (carbon dioxide and ammonia) combines them together forming urea that can go out into the blood and be filtered out from the tubular system

Question 25

What part of the Urea Cycle happens in the mitochondria?

Answer 25

Carbon dioxide and ammonia are put together to form carbamoyl phosphate inside the mitochondria by carbamoyl phosphate synthase. Carbamoyl synthase and L-ornithine is converted into L-citrulline by ornithine transcarbamoylase

Question 26

What happens in the cytosol?

Answer 26

L-citrulline is converted into argininosuccinate and then into L-arginine and then arginase and then finally into urea.

Question 27

Acute nephritis | Inflammation

Answer 27

Red cell casts, 1-2 weeks after recovery from sore throat, children 6-10 years, moderate proteinuria

Question 28

IgA Nephropathy

Answer 28

Abnormal IgA Damage to the cells in the glomerulus allowing blood to come in causes hematuria Chronic GN Usually in adults

Question 29

Henoch-Schonlein Purpura

Answer 29

Purpuric skin lesion on the exterior surface of extremities and buttock IgA precipitation after a respiratory infection, kids 3-8 years Hematuria recurrences for years

Question 30

Goodpasture's syndrome

Answer 30

Rapid GN with auto-antibodies to the basement membrane Young men who smoke Death due to renal failure or lung hemorrhage Type II antibody attack on the base membrane of glomerulus and alveoli so u have hematuria and hemoptysis together

Question 31

Nephrotic syndrome

Answer 31

Heavy proteinuria, hypoalbuminemia, severe edema, hyperlipidemia Kids due to primary kidney disease Adults > SLE DM, amyloidosis, membranous GN most common cause More in men, Immune complexes in the basement membrane, food allergy

Question 32

Pyelonephritis | deadly

Answer 32

Affects tubules or interstitium Ascending fecal flora, females, pregnancy, BPH, secondary to stasis or urine) It is in the renal pelvis, infectious It can kill you by seeding the blood and bacteria or by shutting your kidneys down. Fever, dysuria, deadly

Question 33

Hydronephrosis | finding

Answer 33

Dilation of the renal pelvis and calyces associates with progressive atrophy of the kidney due to obstruction of urine outflow

Question 34

Urolithiasis

Answer 34

75% Ca oxalate, radiopaque (showup on x-ray) 25% radiolucent (no X-ray) Proteus or Staph infection causes alkaline urine. increase crystal formation Staghorn calculi = large obstructive stones in pelvis

Question 35

Intrinsic causes of obstruction

Answer 35

renal calculi, strictures tumors, blood clots

Question 36

Extrinsic causes of obstruction

Answer 36

Pregnancy, periureteral inflammation/salpingitis/peritonitis, tumors of the rectum, bladder prostate, ovaries, uterus

Question 37

Cystitis

Answer 37

Bladder inflammation is usually due to infectious reasons E.coli, urethral trauma, bacterial contamination Can lead to Pyelonephritis, chronic cystitis

Question 38

Interstitial cystitis

Answer 38

autoimmune disease Usually women, chronic cystitis, inflammation of all layers of blader normal urinalysis Suprapubic pain when the bladder is full which is relieved by voiding

Question 39

Adenocarcinoma/Hyperphrenoma

Answer 39

Cigarette, pipe, and cigar smokers, upper kidney pole solitary, unilateral Metastasize to lung and bone before sx appear Painless hematuria

Question 40

Wilm's tumor | Nephroblastoma

Answer 40

Most common malignant kidney tumor in children Large abdominal mass, painless hematuria, good prognosis with tx aka nephroblastoma Kidney disease of children

Question 41

Rememeber

Answer 41

Painless hematuria is cancer until proven otherwise. | Most hematuria are painful

Question 42

Benign Ureteric tumors

Answer 42

Polyps. May be too small to cause obstruction

Question 43

Tumors of bladder

Answer 43

Risk factors; industrial solvents, cigarette smoking Transitional cell tumors, benign papilloma; 90% transitional cell carcinoma, squamous cell carcinoma Painless hematuria, HCG in urine is marker of aggressive tumor