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GIR Test 4 > B5-040 Renal Physiology III > Flashcards

B5-040 Renal Physiology III Flashcards

1
Q

plasma minus protein

A

ultrafiltrate

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2
Q

functional unit of kidney

A

nephron

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3
Q

triple layer of glomerulus

A
  1. endothelial cell
  2. basement membrane
  3. podocytes
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4
Q

factors involved in filtration

3

A
  1. size/charge of molecules
  2. properties of membrane (surface area, permeability)
  3. forces (GHP, COP, CHP)
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5
Q

how is GFR regulated?

2 mechanisms

A
  1. autoregulation
  2. extrinsic
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6
Q

main function is reabsorption
all is Na+ dependent

A

proximal tubule

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7
Q

2nd reabsorptive phase
works to concentrate or dilute urine

A

loop of Henle

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8
Q

which part of the tubule is aldosterone regulated?

A

distal tubule

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9
Q

which part of the tubule is ADH regulated?

A

collecting tubule

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10
Q

product of protein metabolism in liver

A

urea

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11
Q

why is BUN more a marker of tubule function?

A

depends on urea transporters

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12
Q

regulation of urea is closely linked with

A

ADH

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13
Q

where can uric acid accumulate?

A

joints –> gout
heart valves –> valve disease
kidneys –> kidney stone

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14
Q

urine output < 50 ml

A

anuria

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15
Q

urine output of 300-500 ml/day

A

oligouria

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16
Q

urine output > 3L/day

A

polyuria

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17
Q

ECF osmolarity depends on

A

Na+ concentration

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18
Q

main regulator of water reabsorption/secretion

hormone

A

ADH

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19
Q

ECF volume depends on

A

total body Na+ content

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20
Q

what part of the pituitary secretes ADH

A

posterior

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21
Q

ADH targets the

A

collecting duct

water reabsorption

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22
Q

ADH effect on urine

A

increased osmolarity
decreased volume

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23
Q

describe the regulation of ECF osmolarity through the hypothalmus

high ECF osmolarity

A
  1. ECF osmolarity increases
  2. triggers osmoreceptors in thirst center of hypothalmus
  3. triggers ADH release from posterior pituitary
  4. ADH acts on collecting tubule to increase water reabsorption
  5. more water enters plasma, decreases osmolarity
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24
Q
  • promotes water reabsorption
  • causes vasoconstriction
A

ADH

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25
Q

the circulating concentration of ADH is directly linked to

A

serum osmolality

slight changes in osmolality effect ADH concentration

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26
Q

[…] changes in pressure are needed to ellicit change in ADH

small or big

A

big

10%

27
Q

ADH binds to […] receptors in the kidney

A

V2

V2 –> cAMP –> PKA –> AQ2

28
Q

ADH stimulates phosphorylation of […] to apical membrane

A

AQ2

water enters cell –> more water in plasma

29
Q

AQ2 allows water into the cells, increasing the concentration of water in the

serum or urine

A

serum

30
Q

Anti-diuresis requires what two factors?

A
  • ADH to increase renal tubular permeability
  • a gradient that will favor water reabsorption
31
Q

creates the gradient needed for ADH action later

A

loop of Henle

32
Q

transporter that is always basolateral

A

NaKATPase

33
Q

transporters in ascending loop of Henle

A

basolateral: NaKATPase
apical: NKCC

bring salt from tubule into interstitium

34
Q

salt from the ascending loop of Henle will accumulate in the interstitium and then move into

A

descending loop of Henle

salt is slowly added to fluid as it moves through descending loop, water

water out

35
Q

salt is slowly added to fluid as it moves through the […] loop of Henle

A

descending

salt in, water out

36
Q

what part of the loop of Henle is impermeable to water?

A

ascending

37
Q

osmolarity […] in the descending loop of Henle

A

increases

salt coming in, water going out

38
Q

osmolarity […] in the ascending loop of Henle

A

decreases

salt out, water stays same

39
Q

reduces the osmolarity of fluid in the tubule

what part of tubule

A

loop of Henle

creates gradient for reabsorption in collecting duct

40
Q

unless ADH is present, the walls of the collecting duct are […] to water

A

impermeable

41
Q

diluting segment of the loop of Henle

A

ascending

42
Q

ADH […] the osmolarity of fluid in the collecting tubule

A

increases

water reabsorbed

43
Q

how would the absence of ADH affect urine concentration?

A

low osmolarity
high volume

44
Q

what part of the kidney has the highest salt concentration?

A

medulla

45
Q

what structure protects the countercurrent mechansim and supplies nutrients to the cell?

A

vasa recta

46
Q

the juxtaglomerular nephrons have longer loops of Henle and participate in

A

concentrating the urine

47
Q

the nephrons in the cortex with very short loop of Henles are mainly for

A

filtration

48
Q

why does blood flow through the vasa recta have to be slow?

A

when increased, more salt is reabsorbed from the interstitium which decreases the countercurrent effects

49
Q

low protein diets decrease urea. How would that effect the countercurrent mechanism?

A

decreases countercurrent mechanism

high urea concentrations favor the countercurrent mech.

50
Q

furosemide inhibits

A

NKCC

inhibit Na+ reabsorption, more urine production

51
Q

acute ECF volume expansion trigger the release of

A

atrial natriuretic peptide

52
Q

decreases renal tubular sodium and fluid reabsorption

A

atrial natriuretic peptide

53
Q

released due to distension of the atria

A

atrial natriuretic peptide

54
Q

after a prolonged period without water intake, ECF decreases and the […] is activated

A

sympathetic nervous system

alpha-1-adrenoreceptors

55
Q

causes systemic vasoconstriction, including the glomerular afferent arteriole

A

alpha 1 adrenoreceptors

56
Q

increases the permeability of distal and collecting tubules causing water to be reabsorbed

A

ADH

57
Q

effectiveness of the countercurrent mechanism requires:

3

A
  1. ADH
  2. urea in the kidney medulla
  3. salt reabsorption in the loop of Henle
58
Q

an increase in blood flow through the vasa recta will cause

A

salt in the renal medulla to be washed away

decrease effectiveness of countercurrent mech.

59
Q

a decrease in salt delivery to the macula densa will trigger the release of

A

renin

60
Q

aldosterone activates

2

A

NaKATPase
ENaC

61
Q

activates NaKATPase at the basolateral membrane of the principal cells of the collecting tubules

A

aldosterone

62
Q

a negative value for the UAG indicates

A

kidneys are producing and excreting NH4+

63
Q

what conditions cause hyperkalemia?

shifting K out of cell

A

Digoxin
hyperOsmolarity
Lysis of cells
Acidosis
B-blockers
high blood Sugar (insulin deficiency)
Succinylcholine

DO LABSS

64
Q

what conditions cause hypokalemia?

shifting K+ into cell

A

hypo osmolarity
alkalosis
B agonist
insulin

insulin shifts K+ INto cells

GIR Test 4 (18 decks)

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