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GIR Test 4 > B5-036 Renal Physiology I > Flashcards

B5-036 Renal Physiology I Flashcards

1
Q

blood enters the glomerulus via

A

afferent arteriole

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2
Q

blood exits the glomerulus via

A

efferent arteriole

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3
Q

all the glomeruli are located in the

A

cortex

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4
Q

3 layers of the glomerular filtration membrane

A
  1. endothelial cells
  2. basement membrane
  3. podocytes
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5
Q

space between podocytes

A

slit diaphragm

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6
Q
  • plasma without proteins
  • only ions and small molecules
A

renal ultrafiltrate

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7
Q

is albumin normally able to filter through the membrane?

A

no, too big

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8
Q

the charge of albumin is […] than hemoglobin

A

more negative

this is why hemoglobin can filter and albumin cannot

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9
Q

are positive or negative ions more favorable for filtration?

A

positive

basement membrane is negatively charged

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10
Q

the basement membrane is […] charged

A

negatively

why positively charged ions filter better

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11
Q

infection can cause loss of […] at the basal membrane

A

negative charge

causes leakage of proteins in the urine

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12
Q

damage to the GBM will cause […] decreasing plasma oncotic pressure

A

hypoproteinemia

will cause edema

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13
Q

what is beneficial about the biphasic curve of pressures along the nephron?

A

maintains high hydrostatic pressure for filtration

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14
Q

hydrostatic pressure - oncontic pressure =

A

filtrating pressure

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15
Q

sites of major resistance within nephron

2

A

afferent and efferent arterioles

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16
Q

hydrostatic pressure > oncotic pressure in the glomerular capillaries, thus…

A

filtration

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17
Q

oncotic pressure > hydrostatic pressure in peritubular capillaries, thus…

A

absorption

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18
Q

describe forces involved in ultrafiltration

A

major force: hydrostatic pressure of glomerular capillary bed PGC

opposed by: hydrostatic pressure of tubule PBS
colloid osmotic pressure of blood (PGC)

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19
Q

normal PUF=

A

10 mmHg

PUF= PGC - PBS - IIGC

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20
Q

besides the pressure […] and […] of the GBM are important factors

A

surface area
permeability

together= KUF

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21
Q

normal KUF=

A

12 ml/min/mmHg

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22
Q

GFR=

equation and normal value

A

KUF x PUF

normal about 120

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23
Q

main pressure that can be changed to regulate filtration

A

hydrostatic pressure

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24
Q

increased pressure in glomerulus causes […] filtration

more or less

A

more

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25
Q

obstruction of the renal arteries will […] hydrostatic pressure

A

decrease

cause low GFR

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26
Q

obstruction of the ureter will […] the pressure in the glomerulus

A

increase

decreased GFR due to increased capsule pressure

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27
Q

changes in resistance of afferent and efferent arterioles causes changes in

A

GFR

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28
Q

describe the changes to pressures

afferent constriction
glomerular capillary pressure:
peritubular capillary pressure:
renal blood flow:

A

glomerular capillary pressure: decrease
peritubular capillary pressure: decrease
renal blood flow: decrease

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29
Q

describe the changes to the pressures

afferent dilation
glomerular capillary pressure:
peritubular capillary pressure:
renal blood flow:

A

glomerular capillary pressure: increase
peritubular capillary pressure: increase
renal blood flow: increase

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30
Q

describe the changes to the pressures

efferent constriction
glomerular capillary pressure:
peritubular capillary pressure:
renal blood flow:

A

glomerular capillary pressure: increase
peritubular capillary pressure: decrease
renal blood flow: decrease

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31
Q

describe the changes in the pressures

efferent dilation
glomerular capillary pressure:
peritubular capillary pressure:
renal blood flow:

A

glomerular capillary pressure: decrease
peritubular capillary pressure: increase
renal blood flow: increase

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32
Q

describe the changes in the pressures

afferent-efferent constriction
glomerular capillary pressure:
peritubular capillary pressure:
renal blood flow:

A

glomerular capillary pressure: no change
peritubular capillary pressure: decrease
renal blood flow: decrease

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33
Q

describe the changes in the pressures

afferent-efferent dilation
glomerular capillary pressure:
peritubular capillary pressure:
renal blood flow:

A

glomerular capillary pressure: no change
peritubular capillary pressure: increase
renal blood flow: increase

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34
Q

autoregulation of RBF and GFR is done via

2 mechanisms

A
  • tubuloglomerular feedback
  • myogenic response
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35
Q

if you transplant a kidney, innervation is not maintained but […] is

A

autoregulation

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36
Q

describe the myogenic response

A
  • increase in blood pressure
  • arteriolar smooth muscles stretch
  • arteriolar muscle contraction
  • increases resistance
  • net result: little change in RBF
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37
Q

describe the tubuloglomerular feedback mechanism

A
  1. increase in GFR
  2. increases tubular fluid flow rate
  3. increases Na+ and Cl- delivery to macula densa
  4. increases vasoconstrictor signals (adenosine)
  5. causes afferent arteriolar constriction
38
Q

regulates GFR to prevent overloading of the tubules

A

tubuloglomerular feedback mechanism

39
Q

maintains pressure in the glomerulus

A

myogenic response

40
Q

maintance range for myogenic response and TGF

of arterial pressure

A

about 50-200

41
Q

the glomerular filtration barrier contains [….] charged glycoproteins

A

negatively

prevents the entry of negatively charged molecules (albumin)

FA pg. 605

42
Q

slit diaphragm prevents entry of molecules greater than

size

A

40 nm

FA pg 605

43
Q

how does angiotensin II lead to an increase in blood pressure?

3 mechanisms

A
  • Na+ reabsorption in proximal tubules
  • Na+ retention
  • vasoconstriction
44
Q

the clearance of […] is most commonly used to measure GFR

A

creatinine

45
Q

the excretion of […] provides the most accurate measure of GFR

46
Q

GFR values differ with […] and […]

A

age and gender

depends greatly on muscle mass

47
Q

main parts of juxtaglomerular apparatus

A
  • mesangial cells
  • JG cells
  • macula densa
48
Q

sense decreased NaCl in distal convoluted tubule and stimulate the release of renin

A

macula densa

49
Q

the GBM is […] charged and facillitates the filtrations of […] charged molecules

A

negative
positively

50
Q

can glucose filter through the glomerulus?

51
Q

changes in the […] of the GBM lead to proteinuria

52
Q

changes in the glomerular membrane effect its

53
Q

prevents increases in blood pressure from producing significant changes in RBF and GFR

A

autoregulation

54
Q

arterioles constrict in responce to stretch produced by increased hydrostatic pressure

A

myogenic response

55
Q

causes constriction of the glomerular afferent arterioles

A

tubuloglomerular feedback mechanism

56
Q

dilation of both the afferent and efferent glomerular arteries will increase

57
Q

constriction of the glomerular afferent and efferent arteriole will cause

A

decreased RBF and GFR

58
Q

constriction of the afferent arteriole alone will cause

A

decrease in RBF and GFR

59
Q

a post renal obstruction will cause the net glomerular ultrafiltrating pressure to

60
Q

how does autoregulation effect GFR and RBF?

A

remains constant

61
Q

an ACE inhibitor blocks the conversion of

A

angiotensin I to angiotensin II

decreases total aldosterone

62
Q

main physiological factor involved in the regulation of GFR

A

constriction of afferent and efferent arterioles

increases hydrostatic pressure

63
Q

the GBM is extremely negatively charged due to

A

heparin sulfates

64
Q

the lamina densa is made of type […] collagen

65
Q

spaces between podocytes

A

filtration slit

66
Q

bridge slits between podocytes

A

slit diaphragms

67
Q

slit diaphrams are made of

what protein

68
Q

what electrolytes can get through the GBM?

A
  • K+
  • Na+
  • Cl+
  • Mg2+
  • Ca2+
  • H2O
  • HCO3-
69
Q

what molecules can get through the glomerulus?

A
  • glucose
  • amino acids
  • lipids
  • urea
  • creatinine
  • vitamins
70
Q

phagocytose and remove trapped molecules from the slit diaphrams

A

mesangial cells

71
Q

produce renin

72
Q

have baroreceptors and are important in the maintenance of blood pressure

73
Q

any fluctuations in the […] or […] effect GFR

A

net filtration pressure (NFP)
filtration coefficient (KF)

74
Q

force that pushes plasma out of glomerular capsule into Bowman’s space

75
Q

what glomerular force is directly dependent on systolic bp?

A

GHP

increases as BP increases, decreases as BP decreases

76
Q

what force is exerted by plasma proteins (like albumin)?

A

colloid osmotic pressure (COP)

77
Q

how does multiple myeloma effect COP?

A

increases

increased plasma protein

78
Q

how does hypoproteinemia affect COP?

A

decreases

common cause: diarrhea

79
Q

which force pushes fluid back into the capillary bed as fluid is being filtered out?

pressure build up in Bowman’s

A

capsular hydrostatic pressure

80
Q

how do renal calculi effect CHP?

81
Q

how does hydronephrosis effect CHP?

82
Q

how does afferent arteriole constriction effect:
GFR:
RPF:
FF:

A

GFR: decreases
RPF: decreases
FF: -

83
Q

how does efferent arteriole constriction effect:
GFR:
RPF:
FF:

A

GFR: increases
RPF: decreases
FF: increases

84
Q

how does increased plasma protein concentration effect:
GFR:
RPF:
FF:

A

GFR: decreases
RPF: -
FF: decreases

85
Q

how does decreased plasma protein effect:
GFR:
RPF:
FF:

A

GFR: increased
RPF: -
FF: increased

86
Q

how does constriction of the ureter effect:
GFR:
RPF:
FF:

A

GFR: decreased
RPF: –
FF: decreased

87
Q

how does dehyration effect:
GFR:
RPF:
FF:

A

GFR: decreased
RPF: way decreased
FF: increased

88
Q

why does diabetic nephropathy decrease GFR?

A

protein deposits decrease glomerular surface area, decreasing GFR

89
Q

why does glomerulonephritis cause a high GFR?

A

makes basement membrane very porous –> higher GFR

lose more protein

90
Q

what two factors effect the filtration coefficient?

A

surface area
permeability of the glomerulus

91
Q

what factors effect the NFP?

3

A

glomerular hydrostatic pressure (GHP)
colloid osmotic pressure (COP)
capsular hydrostatic pressure (CHP)

GIR Test 4 (18 decks)

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