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MT6328 : AUBF > 1.1 : Renal Function > Flashcards

1.1 : Renal Function Flashcards

1
Q

What are the 4 main components of the Urinary system

A
  • kidney
  • ureters
  • bladder
  • urethra
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2
Q

The urinary bladder is made up of what tissue?

A

Transitional epithelium

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3
Q

What is the functional unit of the kidney

A

Nephron

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4
Q

What are the two types of nephron of the kidney

A
  • cortical (85%)
  • juxtamedullary (15%)
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5
Q

This type of nephron, which make up approximately 85% of nephrons, are situated primarily in the cortex of the kidney

A

Cortical nephrons

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6
Q

This type of nephron responsible primarily for removal of waste products and reabsorption of nutrients

A

Cortical nephrons

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7
Q

This type of nephron have longer loops of Henle that extend deep into the medulla of the kidney

A

Juxtamedullary nephron

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8
Q

The primary function of this type of nephron is focused on the concentration of the urine

A

Juxtamedullary nephron

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9
Q

This is responsible for clearing waste products selectively from the blood and simultaneously maintaining the body’s essential water and electrolyte balances

A

Nephrons

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10
Q

What are the renal functions under the nephron?

A
  • renal blood flow
  • glomerular filtration
  • tubular reabsorption
  • tubular secretion
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11
Q

The renal blood flow begins by __________

A

(Blood) enters the nephron via afferent arteriole

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12
Q

In the renal blood flow, the blood enters the nephron via the _______ arteriole

A

Afferent

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13
Q

In the renal blood flow, after the blood passes through the afferent arteriole, it flows through the ________ via _______

A

Glomerulus ; efferent arteriole

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14
Q

In the renal blood flow, blood from the efferent arterioles enters the __________ capillaries and _________ (for immediate reabsorption)

A

Peritubular capillaries ; Vasa recta

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15
Q

Based on the average size, what is total renal blood flow? (mL/min)

A

1200 mL/min

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16
Q

Based on the average size, what is total renal plasma flow? (mL/min)

A

600-700 mL/min

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17
Q

The peritubular capillaries surround the _______ and ______ consulates tubules providing for the immediate reabsorption of essential substances from the fluid in the ______________ and final adjustment of the urinary composition in the __________

A

proximal ; distal

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18
Q

The vasa recta are located adjacent to the ______________ in ______________

A

ascending & descending loops of Henle ; juxtamedullary nephrons

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19
Q

The major exchanges of water and salts take place between the blood and the _______________

A

medullary interstitium

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20
Q

The major exchanges of water and salts that take place between the blood and medullary interstitium maintains the ___________ ( necessary for renal conc.)

A

Osmotic gradient

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21
Q

The ___________ consists of a coil of approximately eight capillary lobes, the walls of which are referred to as the glomerular filtration barrier

A

Glomerulus

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22
Q

The walls of the glomerulus is referred to as the ________

A

Glomerular filtration barrier

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23
Q

Where is the glomerulus located at?

A

Bowman capsule

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24
Q

What are the factors influencing the filtration process?

A
  • cellular structure of the glomerulus
  • hydrostatic pressure
  • oncotic pressure
  • feedback mechanism of RAAS
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25
Q

What is the meaning of RAAS

A

Renin-Angiotensin-Aldosterone-System

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26
Q

In the cellular structure of the glomerulus, the plasma filtrate must pass through three glomerular filtration barrier cellular layers

A
  • capillary walk membrane
  • basement membrane (basal lamina)
  • visceral epithelium of the Bowman capsule
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27
Q

How does the endothelial cells of the capillary wall of the glomerular differ from other capillaries?

A

It contains pores aka fenestrated endothelium

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28
Q

T or F

The poorest of the endothelial cells of the capillary wall of the glomerular increases capillary permeability, but do not allow the passage of large molecules in blood cells

A

True

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29
Q

Besides the capillary wall of the glomerulus, the basement membrane also does not allow the passage of large molecules and passes through thin membrane, covering the filtration slits formed by intertwining foot processes called the _____________

A

Podocytes

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30
Q

The glomerular filtration barrier also contains a ____________ that repels molecules with a negative charge even though they are small enough to pass through the three layers of the barrier

A

shield of negativity

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31
Q

What is the primary protein associated with renal disease that is repelled by the shield of negativity?

A

Albumin

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32
Q

This results from the smaller size of the efferent arterial and the glomerular capillaries, which then enhances filtration.

A

Hydrostatic pressure

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33
Q

This is necessary to overcome the opposition of pressures from the fluid within the Bowman capsule and the oncotic pressure of unfiltered plasma proteins

A

Glomerular pressure

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34
Q

This results from increasing or decreasing the size of the afferent and efferent arterioles and occurs within the juxtaglomerular apparatus which maintains the glomerulus blood pressure

A

Autoregulatory mechanism

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35
Q

_________ of the afferent arterioles and __________ of the efferent arterioles when blood pressure drops prevent a marked decrease in blood flowing through the kidney = preventing an increase in the blood level of toxic waste products

A

Dilation ; constriction

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36
Q

An increase in blood pressure result in ___________ of the afferent arterioles to prevent overfiltration or dames to the glomerulus

A

Constriction

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37
Q

Enumerate the steps in the Renal blood flow

A
  1. Enters the Renal artery
  2. Passes through the afferent arteriole
  3. Flows thru the glomerulus
  4. Goes into the efferent arteriole
  5. Enters the peritubular capillaries
  6. Enters the vasa recta
  7. Back to the renal vein
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38
Q

Enumerate the steps in the Urinary filtrate flow

A
  1. Bowman capsule
  2. Proximal convoluted tubule
  3. Descending loop of Henle
  4. Ascending loop of Henle
  5. Distal convoluted tubule
  6. Collecting duct
  7. Renal calyces
  8. Ureter
  9. Bladder
  10. Urethra
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39
Q

This regulates the flow of blood to and within the glomerulus

A

RAAS

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40
Q

This responds to changes in blood pressure and plasma sodium content that are monitored by the juxtaglomerular apparatus

A

RAAS

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41
Q

Juxtaglomerular apparatus consists of the:

A
  • juxtaglomerular cells (afferent arteriole)
  • macula densa (distal convoluted tubule)
42
Q

Low plasma sodium content decreases water retention within the circulatory system —> decreased overall blood volume, which results to:

A

decrease in blood pressure

43
Q

It is an enzyme produced by the juxtaglomerular cells, which is secreted and reacts with Angiotensinogen to produce Angiotensin I

44
Q

What produces renin?

A

Juxtaglomerular cells

45
Q

What converts Angiotensin I to its active form Angiotensin II

A

Angiotensin-converting enzyme (ACE)

46
Q

What are the ways on how Angiotensin II corrects the renal blood flow?

A
  • vasodilation of AA, constriction of EA
  • reabsorption of water (CD) and sodium in the PCT & DCT)
  • release of Aldosterone by adrenal cortex to stimulate sodium reabsorption & potassium excretion (DCT)
  • release of Antidiureti hormone (ADH) by the hypothalamus to stimulate water reabsorption by (CD)
47
Q

As systemic blood pressure and plasma sodium content increases, renin __________

48
Q

What are the substances reabsorbed through the active transport?

A
  • glucose, amino acids, salts (PCT)
  • chloride (PCT)
  • sodium (LCT & DCT)
49
Q

What are the substances reabsorbed through the passive transport?

A
  • water (PCT, DLoH, CD)
  • urea (PCT, ALoH)
  • sodium (ALoH)
50
Q

Renal concentration begins where?

A

Descending and Ascending Loop of Henle

51
Q

In tubular concentration, water is removed by _________ in the __________

A

Osmosis ; DLoH

52
Q

In tubular concentration, sodium (Na) and chloride (Cl) are reabsorbed in the _________

53
Q

What are the cellular mechanisms involved in tubular reabsorption?

A
  • active transport
  • passive transport
54
Q

This cellular mechanism requires to be combined with a carrier protein in order for the substance to be reabsorbed

A

Active transport

55
Q

This cellular mechanism is movement of molecules across a membrane as a result of differences in their concentration (gradient) or electrical potential on opposite sides of the membrane

A

Passive transport

56
Q

Passive reabsorption of water takes place in all parts of the nephron except the ________

A

ALoH (walls are impermeable to water)

57
Q

When the plasma concentration of a substance that is normally completely reabsorbed reaches a level that is abnormally high, the filtrate concentration exceeds _________

A

maximal reabsorptive capacity (Tm)

58
Q

The plasma concentration at which active transport stops is termed as the _________

A

Renal threshold

59
Q

What is the plasma renal threshold for glucose?

A

160 - 180 mg/dL

60
Q

T or F

Glucose appearing in the urine of a person with a normal blood glucose level is the result of tubular damage and not diabetes mellitus.

61
Q

Excessive reabsorption of water as the filtrate passes through the highly concentrated medulla is prevented by the _________

A

Water-impermeable walls of ALoH

62
Q

This is the selective reabsorption process of preventing excessive water reabsorption through the aid of the water-impermeable walls of ALoH

A

Countercurrent mechanism

63
Q

Maintenance of the osmotic gradient is essential for the final concentration of the filtrate when it reaches the _______________

A

collecting duct

64
Q

This serves to maintain the osmotic gradient of the medulla

A

Concurrent mechanism

65
Q

This serves to maintain the osmotic gradient of the medulla

A

Concurrent mechanism

66
Q

Reabsorption depends on __________ in the medulla and the hormone _________ that is released by the posterior pituitary gland when the amount of water in the body decreases

A

Osmotic gradient ; vasopressin (Antidiuretic hormone / ADH)

67
Q

A high level of ADH results in:

A
  • increases permeability
  • increased reabsorption of water
  • low-volume conc urine
68
Q

Absence of ADH results in:

A
  • renders the walls impermeable to water
  • large volume of dilute urine
69
Q

The production of aldosterone is controlled by the ___________

A

body’s sodium concentration

70
Q

The production of ADH is determined by the state of ___________

A

Body hydration

71
Q

What is the final determinant or urine volume and concentration?

A

Chemical balance in the body

72
Q

What will happen to ADH and urine volume if there is an increase in body hydration?

A
  • decreased ADH
  • increased urine volume
73
Q

What will happen to ADH and urine volume if there is an **decrease* in body hydration?

A
  • increased ADH
  • decreased urine volume
74
Q

This involves the passage of substances from the blood in the peritubular capillaries to the tubular filtrate

A

Tubular secretion

75
Q

This renal function serves the following two major functions:

  • Elimination of waste products not filtered by the Glomerulus
  • Regulation of acid base balance through secretion of H ions
A

Tubular secretion

76
Q

This renal function serves the following two major functions:

  • Elimination of waste products not filtered by the Glomerulus
  • Regulation of acid base balance through secretion of H ions
A

Tubular secretion

77
Q

These are standard tests used to measure the filtering capacity of the glomeruli

A

Clearance tests

78
Q

It measures the rate in mL/min at which the kidneys are able to remove (to clear) a filterable substance from the blood

A

Clearance tests

79
Q

What are the primary substances used in clearance tests?

A
  • creatinine
  • beta 2-microglobulin (B2M)
  • cystatin C
  • radiotopes
80
Q

T or F
Based on the characteristics of substance to be tested:

Should not be reabsorbed or secreted by the tubules

81
Q

Based on the characteristics of substance to be tested:

Substance must be stable for ________ hrs

82
Q

Based on the characteristics of substance to be tested:

Plasma level should be ________

83
Q

The earliest glomerular filtration tests measured __________ because of its presence in all urine specimens, as well as the existence of routinely used methods of chemical analysis

84
Q

How many percent of urea is reabsorbed?

85
Q

It is a polymer of fructose that is an extremely stable substance that is neither reabsorbed nor secreted by the tubules

86
Q

It is a test that requires an infused substance

A

Exogenous procedure

87
Q

It is a suitable test substance is already present in the body

A

Endogenous procedure

88
Q

The urea clearance test requires a ________ sample

A

2-hr sample

89
Q

What is the earliest clearance test?

A

Urea clearance test

90
Q

What is the problem / cons of the urea clearance test?

A

It is reabsorbed by the tubule

91
Q

The advantage of this test is that it is extremely stable and not reabsorbed

A

Inulin clearance test

92
Q

The advantage of this test is that it is extremely stable and not reabsorbed

A

Inulin clearance test

93
Q

The disadvantage of this test is that it is infused at a constant rate

A

Inulin clearance test

94
Q

The creatinine clearance test requires a ________ hr sample

A

24 hr sample

95
Q

It is the endogenous procedure for evaluating glomerular filtration

A

Creatinine clearance test

96
Q

One of the disadvantages of the creatinine clearance test is that some creatinine are secreted by ____

97
Q

T or F

Diet can also influence the test results of the creatinine clearance test

98
Q

Create clearance test is not reliable when the patient is/has:

A
  • muscle-wasting diseases
  • heavy exercises
  • supplementing with creatine
99
Q

What is the sample required for renal function tests

A

Midstream cleancatch urine

100
Q

What is the reference range for creatinine clearance for male?

A

107-139 mL/min

101
Q

What is the reference range for creatinine clearance for female?

A

87-107 mL/min

MT6328 : AUBF (4 decks)

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