Zoltan's Kidney Failure Flashcards Preview

MBBS1 Abdomen and Pelvis > Zoltan's Kidney Failure > Flashcards

Flashcards in Zoltan's Kidney Failure Deck (149):
1

What is the apex of a medullary pyramid called?

A renal papilla

2

How many nephrons are there in a kidney?

1,000,000 (10^6)

3

Where are erythropoietin producing cells located?

In the renal cortex

4

Are kidneys intrapertioneal or retroperitoneal?

Retroperitoneal

5

Where is the main site of Mg2+ reabsorption?

Thick ascending limb

6

What happens to proteins larger than 70kD at the basal lamina of the glomerulus?

They are excluded and not filtered

7

What do loop diuretics inhibit?

Inhibit Na+-K+-2Cl- pump

8

What is the thin transparent tough capsule surrounding the kidneys?

Renal capsule

9

Why is the collecting tubule negative?

ENac channels

10

What is clearance equal to in terms of urine and plasma concentration and urine volume?

(urine conc. divided by plasma conc.) x urine volume

11

How long is the long axis of a normal kidney?

10 cm

12

Which cells detect [Na]+?

Macula densa cells

13

How is the pH of someone's blood tested?

A sample of arterial blood

14

What is the current preferred term for impaired kidney function with rapid onset?

Acute kidney injury

15

Name a drug that causes K+-sparing diuresis

Spirolactone

16

What causes pressure diuresis?

Prostaglandins and nitric oxide

17

Where do renal arteries usually arise from?

Lateral aspect of the abdominal aorta just below the superior mesenteric artery at L1/2

18

What does ADH cause reabsorption of?

Water and urea

19

What is the retroperitoneal organ lying between the kidneys?

The pancreas

20

What is the fat deep to the renal fascia known as?

Perirenal fat

21

What is Tm for glucose?

380mg/min

22

Where are ENaC channels found?

Late distal tubule and collecting duct principle cells

23

Where do the afferent nerves of the kidney go to?

T10-11 carrying sensory information

24

Does the DCT or PCT contain more urea?

DCT

25

What is the pKa of bicarbonate?

6.1

26

Which receptors and second messengers does ADH work via?

cAMP, V2 receptors and aquaporin-2

27

What muscles do the kidneys come into contact with and how?

Diaphragm is superior to the kidneys
Transversus abdominis is lateral and posterior to the kidneys, quadratus lumborum is middle and posterior and psoas major is medial and posterior

28

Does angiotension II constrict the efferent or afferent arteriole more?

Efferent

29

What kind of muscle surrounds ureters?

Smooth muscle

30

Which part of the Loop of Henle pumps out Na-K-2Cl?

The thick ascending limb

31

Which substance has a clearance most closely reflecting GFR?

Inulin

32

Which cells secrete renin and when?

Juxtaglomerular cells in response to low plasma [Na+] and low blood pressure

33

Which part of the Loop of Henle is impermeable to water?

The whole ascending limb

34

Where is ADH released from?

The posterior pituitary

35

Where do the PCT and afferent arteriole come into contact?

At the juxtaglomerular apparatus

36

How does the vena cava lie at the level of the kidney?

Right and anterior to the aorta

37

When are renal blood flow and glomerular filtration rate increased?

After feeding

38

Where does net H+ secretion occur?

In the collecting duct

39

How does the liver respond to acidaemia?

Producing glutamine from glutamate

40

What does acidosis cause?

Hyperkalemia

41

Where is oncotic pressure higher than hydrostatic pressure

In part of the efferent arteriole and peritubular capillaries

42

What are the three zones of the cortex of the suprarenal glands?

Zona glomerulosa, zona fasciculata and zona reticularis

43

What is the NHE pump?

Na+/H+ antiporter to secrete H+

44

What is the most important buffer in blood?

HCO3-

45

Where are mesangial cells found?

In the glomeralus

46

What does the paracellular pathway allow reabsorption of?

Water and ions

47

What percentage of nephrons have a long loop of Henle?

12%

48

Where do anatomical end-arteries supply in the urinary system?

The kidney lobes but not sections of the ureter

49

Where do arcuate arteries run?

Between renal cortex and renal medulla

50

What does hypokalemia result in?

Neuromuscular depression

51

Where else except the kidney do renal arteries give branches?

A small inferior suprarenal branch to the suprarenal gland and a branch to the ureter

52

How are right and left suprarenal glands shaped?

Right: triangular
Left: crescent shaped

53

How is filtered protein reabsorbed?

Endocytosis

54

What does calcium bind to in DCT epithelial cells?

Calbindin

55

What does the counter-current multipler partially depend on?

Action of ADH on urea transport

56

What is the diameter of a filtration slit?

25-65 nm

57

What happens to the osmolality of fluid as it ascends the loop of Henle?

Decreases osmolality

58

What is a renal pyramid?

A segment of renal medulla ending at the renal papilla

59

What is a medullary ray?

A projection of renal medulla into renal cortex

60

What does the vasa recta supply?

The renal medulla

61

What is normal bicarbonate concentration?

24 mM

62

Where do thiazide diuretics work? What do they inhibit?

DCT. Na+-Cl-

63

Where are the kidneys located in terms of vertebra, costal cartilage and plane?

At vertebra T12- L3, 11-12th costal cartilage in the transpyloric plane

64

How are amino acids reabsorbed?

Via Na+ cotransporter

65

How much K+ is filtered and excreted?

5%

66

How many lobes does a kidney have?

10-18

67

What is the normal range for urine concentration?

60-1400 mOsm

68

What is the autonomic innervation of the kidney?

Sympathetic T10-12 controlling renal perfusion

69

How many litres of plasma do the kidneys filter per day?

180 L

70

Why is the basolateral membrane of the PCT covered in many interdigitations?

For many Na+/K+ATPase transporters

71

How is inulin treated by the kidneys?

Filtered and none reabsorbed

72

Where does ADH increase water reabsorption?

Collecting duct

73

Where are the ureters compressed?

The pelvo-ureteric junction, external iliac artery and uretero-vesical junction

74

What does the macula densa sense and what does it release?

Senses Na+, K+ and Cl-
Releases adenosine

75

What happens to kidneys during chronic kidney disease?

They shrink

76

What do thiazide diuretics inhibit?

Na+-Cl- pump in early DCT

77

What is normal H+ concentration?

40 nM

78

What is normal anion gap metabolic acidosis due to?

Bicarbonate loss

79

How is glomerular filtration rate autoregulated?

Intrinsic constriction of afferent arteriole and tubuloglomerular feedback from DCT

80

Where are macula densa cells found?

In the DCT

81

Which diuretics are often used together?

Furosemide and amiloride

82

What do mesangial cells do?

Carry out phagocytosis

83

What is the normal pH of urine?

3-5

84

What do podocytes share a basal lamina with?

Fenestrated glomerular endothelium

85

How does sodium excretion in kidney determine blood volume?

Indirectly, by altering plasma osmolarity

86

Which side does the renal vein receive the gonadal vein on?

The left

87

How do oncotic and hydrostatic pressures change as you move along the glomerular capillaries?

Hydrostatic remains the same and oncotic pressure goes from low to high

88

What is average glomerular filtration rate?

120ml/min

89

Where are Vitamin-D producing cells located?

In the proximal tubule

90

What does increased H+ conc. do to K+ conc.?

Increases it

91

When does the collecting duct become permeable?

In response to ADH

92

Where does ketoacidosis affect water reabsorption?

In the collecting duct

93

What can cause hyperkalemia?

Renal failure, ACE inhibitors

94

How is HCO3- treated by the kidneys?

Filtered and all reabsorbed

95

Which substance is completely filtered and secreted?

PAH

96

What is the glomerulus?

The ball of capillaries through which blood plasma enters the renal tubule

97

What do ROMK channels facilitate?

K+ efflux into the tubule

98

What is the maximum length of a kidney tubule?

55mm

99

What does renin cause?

Conversion of angiotensinogen to angiotensin

100

What finding may indicate kidney disease?

A GFR below 60 ml/min

101

Where is fluid hypotonic in the absence of ADH?

DCT and collecting duct

102

What does the clearance of a substance which is completely filtered and secreted equal?

Renal plasma flow

103

How much water and NaCl is absorbed in the PCT?

50% of both

104

What does the zona reticularis do?

Secretes precursors of steroid sex hormones

105

Where do osmotic diuretics work? What do they inhibit?

Entire tubule, none

106

Where does active reabsorption of NaCl take place?

In the thick ascending limb, distal tubule and collecting duct

107

Where do loop diuretics work? What do they inhibit?

Thick ascending limb. Na+-K+-Cl-

108

When will the clearance of a substance equal GFR?

When it is filtered, not secreted and not reabsorbed

109

What does aldosterone do to K+ and Na+?

Causes K+ excretion and Na+ reabsorption

110

Where does the suprarenal vein drain into on the right and left?

The vena cava on the right and the renal vein on the left

111

What are the resistances of afferent and efferent arterioles in the glomerulus?

Both high

112

How can diuretics cause hypokalemia?

K+ secretion in collecting duct

113

How is PAH treated by the kidneys?

Filtered, not reabsorbed, and secreted

114

Where does the ureter enter the bladder?

Obliquely into the base of the bladder at the apices of the trigone

115

Where does ADH work?

The principal cells of the collecting duct

116

How do renal arteries divide after they enter the hilum of the kidney?

Into 5 segmental arteries then into interlobar, arcuate and cortical radiate arteries before forming the afferent arteries for the glomeruli

117

How much Mg2+ is reabsorbed in the PCT?

30%

118

What is the consequence of segmental arteries being end arteries?

If they are tied off or blocked then the section of kidney that is supplied by that artery will die (become ischemic)

119

What is anuria?

Daily urine production of up to 50ml

120

What is hydrostatic pressure in Bowman's space?

10 mmHg

121

What are the main urinary buffers?

HPO42- and NH3

122

What is the diaphragm between podocyte foot processes called?

A filtration slit

123

What is the half life of ADH?

15 min

124

How small must a molecule be for filtration of it to be unselective?

10kD

125

When is anion gap relevant?

In metabolic acidosis

126

Which part of the colon does the left kidney lie next to?

The splenic flexure, posteriorly

127

Which kidney does the duodenum lie next to?

Right kidney

128

What happens to H+ and HCO3- in type A intercalated cells of the collecting duct?

H+ is secreted and HCO3- synthesised

129

What can hyperkalemia result in?

Cardiac arrest

130

What does hyperkalemia cause?

Acidosis

131

What is the anion gap?

[measured plasma cations] - [measured plasma anions]

132

How does ANP work?

Inhibiting renin-angiotensin system and ENaC channels

133

Which cells detect blood pressure?

Juxtaglomerular cells

134

What substances does the sodium gradient in the PCT help recover?

Amino acids and glucose

135

What does the zona glomerulosa do?

Controls salt and water balance

136

Where are osmoreceptors located?

Hypothalamus

137

Where does the left kidney reach, posteriorly?

11th rib and L2-3

138

What kind of epithelium has thickened plaques of membrane which can be internalised?

Transitional epithlium

139

What does the zona fasciculata do?

Regulates body carbohydrates

140

What is minimum urine production a day?

400ml

141

What is a nephron composed of?

A renal corpuscle and a renal tubule

142

Where do K+-sparing diuretics work? What do they inhibit?

Collecting tubule. ENaC and ROMK

143

At what concentration will glucose appear in the urine?

11mM

144

What is normal GFR?

125ml/min

145

What is the main pump on the basolateral membrane of the PCT?

Na+-K+ATPase

146

What does the medulla of the suprarenal glands do?

Has chromaffin cells that augment the sympathetic nervous system by secreting adrenaline and noradrenaline

147

Which substance decreases in concentration along the length of the PCT?

HCO3-

148

Which physiological cation is secreted the most?

H+

149

What does Tm apply to?

Reabsorption and secretion