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Phys III > Dr. Rice Renal Final > Flashcards

Dr. Rice Renal Final Flashcards

1
Q

Transport maximum =

A

Tubular reabsorption

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2
Q

The limit to the rate at which a solute can be transported during active reabsorption or secretion is which type of tubular reabsorption?

A

Transport maximum

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3
Q

The type of tubular reabsorption that depends on the electrochemical gradient, permeability and time is called:

A

Gradient-time transport

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4
Q

True/False: Gradient-time transport can exhibit both passive and active elements.

A

True

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5
Q

What is osmosis?

A

The net diffusion of water across a selectively permeable membrane from a region of high water concentration to one of a lower water concentration

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6
Q

Osmosis involves the diffusion of water from _____ to _____ water concentrations.

A

High to low

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7
Q

What effects does capillary hydrostatic pressure have on arterial pressure?

A

As arterial pressure increases, GFR increases

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8
Q

Constriction of afferent arterioles leads to _____, while dilation of afferent arterioles leads to _____.

A

Decreased glomerular CHP and decreased GFR

Increased glomerular CHP and increased GFR

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9
Q

If the blood pressure arriving at the kidney was increased, what would happen to the amount of urine being produced?

A

Increased amount

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10
Q

Constriction of efferent arterioles would have what effects on glomerular CHP and GFR?

A

Increased glomerular CHP and increased GFR (slightly)

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11
Q

Which hormone causes increased water permeability?

A

ADH/Vasopressin

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12
Q

ADH causes increased water permeability where?

A

Distal tubule, collecting tubule and collecting duct

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13
Q

Osmoreceptor cells fire and stimulate the _____ to release ADH.

A

Posterior pituitary

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14
Q

What region is responsible for signaling the posterior pituitary to release ADH?

A

AV3V region

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15
Q

How much does sodium content increase when there is a desire to ingest fluid (thirst)?

A

Increases 2mEq/L above normal

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16
Q

GFR =

A

RPF x FF

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17
Q

Normal GFR is:

A

110 ml/min

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18
Q

How can GFR be increased?

A

Alter the RPF (increase cardiac output/dilate afferent arterioles) or alter the FF (contract efferent arterioles, increasing glomerular pressure)

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19
Q

How are glomerular capillaries different than others in the body?

A

They have 3 layers instead of 2 (endothelium, basement membrane and epithelial cell layer)

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20
Q

The filtration fraction is best defined as:

A

The proportion of the fluid reaching the kidneys which passes into the renal tubules

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21
Q

What separates glomerular and peritubular capillary beds?

A

Efferent arterioles

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22
Q

Which sodium glucose co-transporter transports the most filtered glucose?

A

SGLT-2 (90%, SGLT-1 is 10%)

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23
Q

Sodium reabsorption occurs where?

A

Proximal tubule

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24
Q

Which molecules are rapidly absorbed in the first half of the proximal tubule?

A

Sodium, glucose, amino acids and water

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25
Q

Which molecule is left in high concentrations in the second half of the proximal tubule?

A

Chloride ions

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26
Q

Kidney damage involves:

A

Impaired sodium excretion

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27
Q

What is the trade off that occurs when there is damage to the kidneys?

A

Increase blood pressure (helps maintain normal sodium excretion); harmful long-term though

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28
Q

What are principal cells?

A

Specialized epithelial cells in the late distal and collecting tubules that secrete potassium for excretion

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29
Q

What factors control potassium secretion by the principal cells?

A

Activity of Na/K ATPase pump, electrochemical gradient and K+ permeability

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30
Q

Which hormone stimulates active secretion of potassium via principal cells?

A

Aldosterone

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31
Q

A pH below 7.4 indicates:

A

Acidosis

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32
Q

A pH above 7.4 indicates:

A

Alkalosis

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33
Q

Describe the flow of urine.

A

Nephrons, collecting ducts, renal calyces, ureters and then the bladder

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34
Q

Sodium excretion in the urine describes pressure _____, while water excretion to regulate BP describes pressure _____.

A

Natriuresis; Diuresis

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35
Q

Hypokalemia is caused by excess _____ in the system.

A

Aldosterone (Conn’s syndrome)

36
Q

Excess aldosterone in the system causes:

A

Hypokalemia

37
Q

True/False: In a healthy adult, the glomerular filtrate should contain proteins and cellular elements.

A

FALSE; It shouldn’t contain ANY cellular elements

38
Q

Which three things have an impact on extracellular fluid volume of H+ concentration?

A

Secretion of H+, reabsorption of filtered HCO3- and production of new HCO3-

39
Q

The bladder is innervated by:

A

S2 and S3 nerves

40
Q

The external anal sphincter is controlled by which nerve?

A

Pudendal nerve

41
Q

The first line of defense against changes in H+ concentration.

A

Acid-base buffering system (seconds)

42
Q

Reabsorption of sodium and secretion of potassium are both controlled by:

A

Aldosterone

43
Q

The second line of defense against changes in H+ concentration.

A

Respiratory center (minutes)

44
Q

The last line of defense against H+ concentration changes.

A

KIdney via acidic/basic urine (hours-days) –> most powerful mechanism

45
Q

Renal blood flow accounts for what percentage of cardiac output?

A

22%

46
Q

True/False: Kidneys consume more oxygen and blood than the brain.

A

True; 2x more oxygen, 7x more blood flow

47
Q

How are glomerular and peritubular capillary beds different?

A

Glomerular- High hydrostatic pressure, rapid fluid filtration

Peritubular- Low hydrostatic pressure, rapid fluid reabsorption

48
Q

Foamy urine is a sign of _____ in the urine, indicative of which disease?

A

Protein; Nephrotic syndrome

49
Q

If osmolarities stay equal throughout the structure:

A

Isotonic

50
Q

If osmolarities increase throughout the structure:

A

Hypertonic

51
Q

If osmolarities decrease throughout the structure:

A

Hypotonic

52
Q

Overhydration results when there is overly high secretion of:

A

ADH (over retention of water; hyponatremia) and aldosterone (excess NaCl; hypernatremia)

53
Q

Intracellular edema is the result of:

A

Hyponatremia, metabolic depression and poor nutrition

54
Q

Extracellular edema is the result of:

A

Fluid leakage and lymphatic failure (lymphedema)

55
Q

When voluntary urination is desired, the micturition reflex is excited and the _____ signals for voluntary external urethral sphincter relaxation.

A

Pudendal nerve

56
Q

The transport of sodium from the tubular cells into the interstitial fluid during reabsorption requires:

A

Potassium

57
Q

A person who is sweating profusely is at risk for:

A

Hypernatremia

58
Q

Someone with hyponatremia has very low levels of _____ in their blood.

A

Sodium

59
Q

Juxtamedullary nephrons are distinct from cortical nephrons in that they have:

A

Significantly longer loops of Henle

60
Q

If a patient is in a standing/upright position, where should the kidneys be located (approximately)?

A

Between L1-L4

61
Q

Name the muscle responsible for contraction of the bladder.

A

Detrusor

62
Q

A person experiencing flank pain and blood in their urine is likely going to be diagnosed with:

A

Polycystic kidney disease/Nephrolithiasis

63
Q

This messed up kidney is showing signs of severe:

A

Polycystic kidney disease

64
Q

Which of the following is a symptom of pyelonephritis?

A

Bilateral loin pain

65
Q

Colloidal osmotic pressure in the glomerulus is proportional to the concentration of:

A

Proteins in the blood

66
Q

Both norepinephrine and epinephrine have what effects on GFR?

A

Inhibitory

67
Q

When arterial pressure is increased, some blood vessels have the ability to resist stretching. This is called:

A

Myogenic mechanism

68
Q

Kidneys consume twice as much oxygen as the brain due to the high rate of _____ in the renal tubules.

A

Active sodium reabsorption

69
Q

Angiotensin II is a powerful renal:

A

Vasoconstrictor

70
Q

True/False: The renal cortex receives significantly less of the blood arriving at the kidneys than the renal medulla.

A

FALSE, the renal medulla receives less than the renal cortex

71
Q

The kidneys can autoregulate, which means that even if arterial pressure varies greatly, there will be little net change in:

A

GFR

72
Q

Glomerular filtration is _____, and tubular reabsorption is _____.

A

Non-selective; highly selective

73
Q

Before a solute can be reabsorbed into the renal blood supply, it must first be:

A

Transported into the interstitial fluid

74
Q

True/False: Secondary active transport is coupled directly to solute gradients.

A

FALSE, coupled INDIRECTLY

75
Q

What is represented by the yellow colored portion of this diagram?

A

Filtrate

76
Q

Where is energy (ATP) expended during glucose reabsorption in the kidneys?

A

By the Na/K ATPase transporters

77
Q

The limit to the rate at which a solute can be transported during active reabsorption or secretion is called the:

A

Transport maximum

78
Q

Osmosis causes a:

A

Solvent drag

79
Q

Which segment of the Loop of Henle is impermeable to water? Which one is highly permeable to water?

A

Thick ascending segment is impermeable; Thin descending is highly permeable

80
Q

The specialized principal cells of the kidneys are located in the:

A

Distal tubule

81
Q

The presence of a high concentration of ADH in the cortical collecting tubule will make the membrane:

A

Permeable to water

82
Q

Filtrate that has passed through the proximal tubule stays _____ relative to the blood plasma.

A

Isotonic

83
Q

Which mechanism is driven by sodium movement in the proximal tubule and the thick ascending loop of Henle?

A

Countercurrent mechanism

84
Q

True/False: The same urea may be secreted back into the nephron and recirculate multiple times.

A

True

85
Q

One of the first systemic adjustments the body will make if the kidneys aren’t maintaining fluid balance is to:

A

Change blood pressure

Phys III (3 decks)

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