Session 3 Flashcards

1
Q

Through what artery does blood enter the glomerulus?

Describe structure of glomerulus

What are podocytes?

A

Renal afferent arterioles

Fenestrated capillaries with a specialised selective 1 cell thick BM

Specialised epithelium again aiding specificity in filtration. They use foot processes then the gaps between adjacent form a slit diaphragm.

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2
Q

Name of artery leaving the glomerulus?

Structure and function of bowman capsule?

Role of mesangium?

A

Renal efferent arterioles

Layer of epithelial cells, gelatinous, glycoproteins and negatively charged draining blood into proximal tubule

Full of mesangial cells that support the glomerulus capillaries by forming a basement membrane like matrix.

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3
Q

Body fluid compartment distribution?

Predominant cations and anion in ECF?

A

60% water. 2/3 intracellular. 1/3 extra cellular.
Of ECF- 75%interstitial and 25% intravascular.

Sodium and chlorine

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4
Q

What causes the hydrostatic pressure inside the glomeruli?

4 things filtered through fenstrations?

A

The diameter of the afferent arterioles is greater than the efferent.

Water, urea, glucose, salts

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5
Q

Define ultra-filtrate and how much produced per day?

What happens if NaCl concentration in filtrate decreases?

A

Plasma without the cells and large organic molecules. 180L per day.

Macula Densa is sensitive to the decrease,it increases renin secretion from juxtaglomerular cells.

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6
Q

What happens to the ultra-filtrate once it enters the kidney nephron tubules?

A

99% of water urea glucose AA’s are reabsorbed back into circulating plasma.

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7
Q

Describe reabsorption in the proximal convoluted tubule

A

All the glucose and some water is reabsorbed. Sodium also moves out through the cells in the PCT, using symporters on the apical membrane. Symporters are dependent on the 3Na-2K-ATPase transporter on the basolateral membrane. After solute movement majority of water then moves out my osmosis.

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8
Q

Describe and role of tubular secretion?

A

H+,K+,NH4+ etc secreted by epithelial cells and added to ultra-filtrate to maintain the optimum pH.

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9
Q

Why is auto regulation important?

A

Maintains GFR allowing optimum solute plasma/ultrafiltrate concentration.

Protects glomeruli from increased perfusion pressure causing structural damage.

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10
Q

Describe the myogenic autoregulation response

A

Afferent arterioles response to changes in pressure, the smooth muscle has non-selective cat ion channels in vascular smooth muscle. Upon depolarisation ca2+ will rush in causing contraction.
Contraction will decrease GFR as less blood available to be filtered.

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11
Q

Describe the tubuloglomerular feedback system

A

Macula densa cells in ascending limb sense change in salinity (increase in GFR) causing a contraction of the afferent arterioles thus reducing GFR.

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12
Q

Normal GFR?

Normal total glomerular filtrate per day?

Define renal clearance

A

90-120ml/min

180L/day

Volume of plasma cleared of a substance per unit time.

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13
Q

Clearance equation?

Work out clearance if substrate at conc in urine at 100 mg/ml and urine flow rate of 1ml/min. And plasma conc is 1 ml/min.

A

Cx= Ax/Px
Ax= amount of substance eliminated from plasma.
Px=plasma conc of substance.

100(1)=100 (Ax)
100%1=100ml/min

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14
Q

Hat must be the case to measure renal clearance?

If all true relationship between amount excreted to urine compared to amount filtered by kidney?

A

Freely filtered by glomerulus
No secretion/reabsorption at renal tubule.

They are the same.

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15
Q

Why is insulin a surrogate for GFR?

Why dont we use insulin?

Alternative?

A

It’s exogenous, not secreted absorbed at renal tubule and freely filtered.

Catheter and constant IV drip.

51 Cr EDTA

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16
Q

Best endogenous source for measuring insulin and why?

What measurements are taken for creatinine clearance measurement?

Why is GFR usually a 10-15% overestimate?

A

Creatinine as freely filtered and on,y a bit secreted at renal tubule however changes in people depending on age/ethnicity and diet so can vary a bit.

Urine collection every 24 hours and a plasma collection.

Due to some secretion into the renal tubule.

17
Q

What happens to plasma creatinine levels as kidney function falls?

A

They increase in creatine is filtered and excreted by the healthy kidney.

18
Q

Serum creatinine in US =Mg/dl
In England=umol/L

Convert to Mg/ml

A

Mg/dl= umol/l % 88.4

Mg/ml= Mg/dl % 100