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Physiology 2 > Exam I Renal > Flashcards

Exam I Renal Flashcards

1
Q

4 components of the urinary system:

A
  1. Kidneys
  2. Ureters
  3. Urinary Bladder
  4. Urethra
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2
Q

Which of the following are functions of the kidney?

a. Maintaining constant ECF
b. Elimination of wastes
c. Acid-Base balance
d. Glucose synthesis
e. Synthesis of hormones
f. All of the above

A

f. all of the above

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3
Q

List the 7 functions of the kidneys:

A
  1. Filtration of blood
  2. Production of urine
  3. Reabsorption of filtered substances
  4. Excretion of metabolic wastes and xenobiotics
  5. Water and acid-base balance
  6. Production of glucose
  7. Endocrine functions
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4
Q

Which of the following clinical signs may be associated with a chronic renal failure?

a. Presence of urine sediments
b. inc. urine specific gravity
c. Pale mucous membranes
d. Polydipsia
e. All of the above

A

c. Pale mucous membrane

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5
Q

What are 3 important hormones produced by the kidney?

A
  1. Calcitriol
  2. Renin
  3. Erythropoietin
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6
Q

What hormone stimulates the production of Calcitriol?

A

PTH

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7
Q

Calcitriol secreted in response to ________

A

Hypocalcemia

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8
Q

Why is renin an important hormone secreted by the kidney?

A

regulation of blood pressure

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9
Q

Why is erythropoietin an important hormone secreted by the kidney?

A

essential for erythropoiesis

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10
Q

What are the 2 types of nephrons?

A
  1. Cortical nephrons

2. Juxtamedullary nephrons

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11
Q

2 characteristics of cortical nephrons:

A
  1. short loops of henle

2. supplied by peritubular capillaries

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12
Q

3 characteristics of juxtamedullary nephrons

A
  1. located near medulla
  2. vasa recta
  3. long loops of henle
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13
Q

Structure of the nephron located in the renal cortex, consists of glomerulus surrounded by bowman’s capsule

A

Malpighian body

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14
Q

The longest part of the nephron, consisting of PCT and a straight part

A

Proximal tubule

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15
Q

What are the 4 limbs of the loop of Henle

A
  1. Thick Descending limb
  2. Thin Descending limb
  3. Thin Ascending limb
  4. Thick Ascending limb
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16
Q

Which portion of the loop of henle extends into the renal medulla?

A

Thick Descending Limb

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17
Q

Which portion of the loop of henle is only found in juxtamedullary nephrons?

A

Thin Ascending Limb

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18
Q

What are the 2 parts of the distal tubule of the nephron?

A

Straight and convoluted part

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19
Q

Structure of the nephron that extends through the renal cortex and medulla

A

Collecting Duct (CD)

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20
Q

What percentage of cardiac output goes into the kidney?

A

25%

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21
Q

The top one cause of death in humans worldwide is:

a. HIV/AIDS
b. Road Traffic Accidents
c. Cancer
d. Myocardial Infarction

A

d. Myocardial Infarction

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22
Q

Interruption of blood supply to a tissue

A

Ischemia

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23
Q

Re-establishment of blood supply to a tissue

A

Reperfusion

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24
Q

What are 4 main causes of renal IR?

A
  1. Organ transplant
  2. Cardiac and vascular surgeries
  3. Acute renal failure
  4. Toxins
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25
Q

Highly reactive molecules that damage DNA, lipids, and proteins

A

Reactive O2 Species (ROS)

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26
Q

What causes an inc. in ROS in the kidneys?

A

Inflammatory response and O2 deprivation

usually ischemia

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27
Q

Which of the following statements concerning the structure of the nephron is NOT correct?

a. The PCT is located in the cortex
b. Thin limbs of Henle’s loop are located in the medulla
c. The collecting Ducts extend through the renal cortex and medulla
d. The Macula Densa is located in the outer medulla

A

d. The Macula Densa is located in the outer medulla

located in the cortex

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28
Q

What are the 4 main processes in the kidneys?

A
  1. Filtration
  2. Re-absorption
  3. Secretion
  4. Excretion
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29
Q

How much of the glomerular filtrate is excreted as urine?

a. 20%
b. 10%
c. 1-5%
d. Less than 1%

A

d. Less than 1%

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30
Q

Which of the following structures is NOT a component of the filtration barrier?

a. Capillary endothelium
b. Bowman’s capsule
c. Podocytes
d. Glomerular BM

A

b. Bowman’s Capsule

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31
Q

What is the 1st step of urine formation?

A

Filtration through glomerular capillaries into Bowman’s Capsule

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32
Q

Fluid produced by the glomerulus that is nearly identical to the plasma

A

Glomerular Filtrate

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33
Q

The rate the kidney is perfused with blood

A

Renal Plasma Flow (RPF)

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34
Q

The Rate of glomerular filtration depends on ______.

A

RPF

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35
Q

What percentage of blood plasma flowing through the kidney is filtered through the glomeruli?

A

20%

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36
Q

A network of branching and anastomosing capillaries covered by podocytes and encased in bowman’s capsule

A

Glomerulus

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37
Q

The area b/t glomerular capillaries and bowman’s capule

A

Bowman’s space

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38
Q

What are the 3 components of the filtration barrier?

A
  1. Capillary endothelial cells
  2. Glomerular BM
  3. Visceral epithelium (podocytes)
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39
Q

what type of junctions are found b/t capillary endothelial cells?

A

Fenestrated

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40
Q

What are the 3 layers of BM of capillaries?

A
  1. Lamina rara interna
  2. Lamina densa
  3. Lamina rara externa
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41
Q

Which layer of the capillary BM contains the most proteins?

A

middle, Lamina Densa

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42
Q

T/F. Glomerular capillaries are highly permeable to Proteins

A

F. Relatively impermeable

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43
Q

The higher the molecular weight of a substance, the ______ the filterability.

A

Lower

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44
Q

T/F Electrolytes and small organic compounds are filtered as freely as water?

A

T

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45
Q

Filterability through the glomerulus is dependent of what factors:

A
  1. Size
  2. Electrical charge
  3. Plasma protein binding
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46
Q

T/F. Anionic substances are more filtered than Cationic

A

F. Cationic are more filtered

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47
Q

The main driving force for filtration in the glomerulu sis:

a. the oncotic pressure of the blood
b. the hydrostatic pressure of the blood
c. the oncotic pressure in Bowman’s capsule
d. The hydrostatic pressure in Bowman’s Space

A

b. Hydrostatic pressure of the blood

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48
Q

What are the 2 forces opposing filtration ?

A
  1. The hydrostatic pressure in bowman’s space

2. the oncotic pressure of the blood plasma

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49
Q

T/F. the oncotic pressure of the filtrate is nonexistent

A

T

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50
Q

The total volume of fluid filtered by the glomeruli into Bowman’s Space per Kg.

A

GFR

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51
Q

What are the nessecary properties of GFR indicator substances?

A
  1. Must be freely filterable
  2. filtered amt. must not change due to resorption or secretion
  3. must not be metabolized in the kidney
  4. must not alter renal function
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52
Q

the rate the plasma is cleared of a substance, if the substance is free filterable

A

GFR

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53
Q

If creatine in plasma is elevated, then GFR is inc/dec?

A

Dec.

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54
Q

Percentage of the plasma that has been filtered by the glomeruli

A

Fraction of Filtration (FF)

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55
Q

Where is renin produced?

A

in the wall of cells located in the afferent arterioles

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56
Q

What are 2 types of autoregulatory mechanisms for blood flow?

A
  1. Myogenic reflex

2. Tubuloglomerular feedback

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57
Q

What is the myogenic reflex?

A

Detects changes in glomerular perfusion

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58
Q

What is the tubuloglomerular feedback?

A

Detects changes in tubule fluid delivery

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59
Q

T/F. Aldosterone is produced by cells of the renal medulla?

A

F. Adrenal cortex

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60
Q

List the 2 vasodilatory agents from class.

A
  1. No

2. PGE2

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61
Q

List the 3 Constricting factors from class.

A
  1. Endothelin
  2. TXA2
  3. ANG2
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62
Q

If you inc. RBF, GFR will inc/dec.

A

inc

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63
Q

If systemic pressure inc. then GFR will inc/dec.

A

inc

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64
Q

if afferent arteriole tone inc, then GFR will inc/dec.

65
Q

If efferent arteriole tone slightly inc., then GFR will inc/dec.

66
Q

If hydrostatic pressure of bowman’s capsule inc., then GFR will inc/dec.

67
Q

The ultrafiltrate that accumulates inthe capsular space between glomerulus and bowman’s capsule and contains the same conc. of salt and glucose as plasma

A

Primary urine

68
Q

T/F. The proximal tubules are polarized

69
Q

What are the 2 mechanisms of the PT that move tubule fluid back into the blood?

A
  1. Transcellular Pathway

2. Paracellular Pathway

70
Q

How does the transcellular pathway work?

A

carrier-mediated transports substances across the apical memb, cytoplasm, and basolateral PM into interstitial fluid

71
Q

How does the paracellular pathway work?

A

tubule fluids pass through the epithelium across the tight junctions.

72
Q

How is transport across the PT classified?

A

according to source of energy

73
Q

What is the difference b/t primary and secondary active transport?

A

P: fueled directly by ATP consumption

S: driven by electrochemical gradient produced by the primary active transporter

74
Q

What is tertiary active transport?

A

The carrier is driven by the gradient generated by a secondary active transporter.

75
Q

How are low molecular wr. proteins reabsorbed in the PT?

A

receptor mediated endocytosis

76
Q

protein in the urine

A

proteinuria

77
Q

What are the 3 types of proteinuria?

A
  1. pre-renal
  2. intrarenal
  3. post-renal
78
Q

When is proteinuria classified as pre-renal?

A

when the conc. of free-filterable proteins in the blood is inc.

79
Q

When is proteinuria classified as intrarenal?

A

If the glomerular filter is damaged

80
Q

When is proteinuria classified as post-renal

A

when there is tubular loss of proteins

81
Q

What are the 2 carbonic anhydrases in the kidney?

A
  1. one membrane associated

2. one located in cytosol of PT cells

82
Q

The major driving force favoring filtration across the glomerular capillary wall is the :

a. oncotic pressure of the plasma
b. oncotic pressure of the glomerular filtrate
c. hydrostatic pressure of the blood
d. hydrostatic pressure of the glomerular filtrate
e. ultrafiltration coeficient

A

c. hydrostatic presssure fo the blood

83
Q

What is glomerular filtration rate?

A

volume of glomerular filtrate formed by the kidneys per minute per kilogram of body weight

84
Q

In clinical practice the GFR is often estimated by determining the rate of creatinie clearance. the rate of creatinine clearance is the _____.

A

Volume of plasma cleared of creatinine per minute per kilogram of body wt.

85
Q

the two major characteristics that determine whether a blood component is filtered or retained in the capillary lumen are its:

a. molecular radius and molecular wt.
b. molecular radius and lipid solubility
c. molecular radius and plasma conc.
d. molecular radius and electrical charge
e. molecular wt. and lenght

86
Q

the GFR is inc. by:

a. A low-protein meal
b. Afferent arteriolar consideration
c. Tubuloglomerular feedback
d. Release of atria natriuretic peptide
e. Activation of the renin- angiotensin-aldosterone system

87
Q

T/F. Organic ions that are protein bound are freely filterable by the glomerulus.

A

F. poorly filterable

88
Q

How is glucose reabsorbed?

A

the Sodium-dependent transporter Sodium glucose transporter SGLT

89
Q

What are the 2 types of SGLTs?

A
  1. low affinity located in pars convoluta (SGLT2)

2. High affinity located in pars recta (SGLT1)

90
Q

What happens when the glucose carriers are saturated?

A

less re-absorption, and glucose is secreted in urine

91
Q

If plasm glucose is greater than _____ than glucosuria develops.

A

10-15 mmol/L

92
Q

What is glucosuria

A

presence of glucose in the urine

93
Q

The minor component of a solution which is regarded as having been dissolved by solvent

94
Q

A liquid or solid phase containing more than one substance, contains a solvent and solute

95
Q

concentration of all osmotically active particles in a solution expressed as osmoles per liter of solution

A

osmolarity

96
Q

more suitable for living organisms b/c osmolarity is temperature dependent

A

osmolality

97
Q

What are the 4 segments of the loop of henle

A
  1. thick descending
  2. thin descending
  3. thin ascending
  4. thick ascending
98
Q

What is another name for the thick ascending loop of henle?

A

Medullary Thick Ascending Limb (mTAL)

99
Q

Which segment of the loop of henle do cortical nephrons lack?

A

thin ascending limb

100
Q

T/F. Cortical nephrons are important for urine concentration

A

F. Juxtamedullary

101
Q

What is the thin descending limb of the loop of henle especially permeable to? Impermeable?

A

Permeable: Water
impermeable: Na, Cl, Urea

102
Q

If Water is being removed and NaCl remains there. . . What happens with the tubular fluid?

a. It becomes less concentrated
b. It becomes more concentrated
c. It remains unchanged

A

b. it becomes more concentrated

103
Q

The _____ limb of the loop of henle helps concentrating the tubule fluid

A

Thin descending

104
Q

T/F. both the thick and thin ascending limbs of the loop of henle are impermeable to water.

105
Q

What is the mTAL of the loop of henle especially permeable to?

A

Na, Cl, K, Ca, Mg, HCO3

106
Q

If NaCl is being reabsorbed and water cannot follow. . . What happens now with the tubular fluid?

a. It becomes more diluted
b. It becomes more concentrated
c. It remains unchanged

A

b. It becomes more concentrated

107
Q

The ____ limb of the loop of henle is known as the diluting segment

A

Thick ascending

108
Q

What does the descending thin limb of the loop of henle reabsorb?

109
Q

What does the thin ascending limb of the loop of henle reabsorb?

110
Q

What Three transporters are located in the mTAL

A
  1. NKCC
  2. Cl- channels
  3. ROMK
111
Q

Are NKCC primary active transport or secondary active transport?

112
Q

What are NKCC inhibited by

A

Furosemide

113
Q

What is reabsorbed in the DCT?

A

Ions such as: Na, K, Cl, Ca, Mg

114
Q

What 5 transporters are located in the DCT?

A
  1. Ca channels (TRPV)
  2. NA/Cl cotransporters (NCC)
  3. Cl channels
  4. K channels
  5. Ca/Na exchanger (NCX)
115
Q

What inhibits NCX?

116
Q

What is reabsorbed in the DCT and CD?

117
Q

If ADH levels are high, then there will be an inc/dec in water reabsorption in the DCT and CD.

118
Q

What are the 2 main cell types of the CD?

A
  1. Principal cells

2. intercalated cells

119
Q

Which type of principle cell is responsible for mantaining acid base homeostasis?

A

Intercalated

120
Q

Which type of CD cell has few mitochondria and few intracytoplasmic vesicles

A

Principal cells

121
Q

Which type of CD cell has basolateral PM infoldings?

122
Q

Which type of CD cell has numerous mitochondria?

A

Intercalated

123
Q

What are the 2 transport systems of principle cells of CD

A
  1. NaCL reabsorption by ENaC

2. K secretion by ROMK

124
Q

What are the two types of intercalated cells?

A
  1. Type A

2. Type B

125
Q

What is the transport system of Type A intercalated cells?

A

Secretes H and reabsorbs HCO3-

126
Q

What is the transport system of Type B intercalated cells?

A

Reabsorbs H and Secretes HCO3-

127
Q

Which segment of the nephron is responsable for the reabsorption of the bulk of filtered solutes?

a. Proximal Tubule
b. Thin limbs of Henle’s loop
c. Thick ascending limb of henle’s loop
d. Distal convoluted tubule
e. Collecting duct

A

a. Proximal tubule

128
Q

What transporters are located on the apical surface of the PCT?

A
  1. Na/H antiport

2. Na dependent Symport carriers

129
Q

What transporters are located on the Basolateral surface of PCT?

A
  1. Na, K ATPase

2. Na,HCO3 symport

130
Q

What transporters are located on the apical surface of the loop of henle?

A
  1. K symport

2. paracellular Cl (NKCC)

131
Q

What transporters are located on the basolateral surface of the loop of henle?

A
  1. Na, K ATPase
132
Q

What transporters are located on the apical surface of the DCT and CD?

A
  1. Na, Cl Symport

2. Na Channels (ENaC)

133
Q

What transporters are located on the basolateral surface of the DCT and CD?

A
  1. Na, K ATPase

2. Na, Ca exchanger

134
Q

Which hormone increases Na reabsorption in the PT, TAL and DCT?

A

Angiotensin II

135
Q

Which hormone stimulates Na Reabsorption in the CD?

A

Aldosterone

136
Q

Which hormone stimulates NKCC in the TAL

137
Q

Which 3 hormones stimulate solute reabsorption?

A
  1. Angiotensin II
  2. Aldosterone
  3. ADH
138
Q

Which 3 hormones inhibit solute reabsorption

A
  1. NO
  2. Endothelin-1
  3. ANP
139
Q

Which hormones increases Na excretion through inhibition of NHE3, NA, K-ATPase, NKCC, and ENaC

A

NO, Endothelin-1

140
Q

Which hormone inhibits aldosterone and renin release and inc. Na excretion?

141
Q

The ultimate rate of K+ excretion is determined by the

a. CD, which reabsorbs or excretes K depending on the need of the body
b. PT, which reabsorbs or secretes K
c. TAL, which reabsorbs K, Na, and Cl

142
Q

The kidneys are responsible for maintaining a constant composition of the following body fluids:

a. the plasma
b. the interstitial fluid
c. the intracellular fluid
d. a and b
e. all of the above

143
Q

In a patient with an acute renal vein thrombosis. . .

a. the surface area available for filtration is dramatically reduced
b. the GFR is reduced
c. The filtration barrier permeability is inc.
d. a and b

144
Q

T/F. After a damage to a nephron, tubular cells cannot be regenerated

145
Q

Which of the following structures is not a component of the filtration barrier?

a. Capillary Endothelium
b. Bowman’s capsule
c. Podocytes
d. Glomerular BM

146
Q

The main driving force for filtration in the glomerulus is

a. the oncotic pressure of the blood
b. hydrostatic pressure of the blood
c. the oncotic pressure in bowman’s space
d. the hydrostatic pressure in bowman’s space

147
Q

The glomerular filtrate:

a. Is the total volume of fluid entering the glomerulus
b. Is the total volume of fluid enterin bowman’s space

148
Q

Which renal parameter can be calculated dividing GFR by RPF?

a. renal blood flow
b. Fractional excretion
c. Fractional Filtration

149
Q

Which of the following is not an effect of angiotensin II?

a. stimulation of fluid intake
b. Arteriolar contraction
c. Renal excretion of sodium
d. Stimulation of aldosterone release

150
Q

The main mechanism by which some drugs and toxins are excreted in the kidney is

a. Glomerular filtration
b. Active transport in the PT
c. Passive transport in the PT
d. Exocytosis in the PT

151
Q

T/F. Magnesium is mainly reabsorbed in the TAL

152
Q

Which segment of the nephron is responsible for reabsorption of most of the Ca.

a. DCT
b. CD
c. Loop of Henle
d. PT

153
Q

What do glucose and AA transport have in common?

a. both processes take place in the PT
b. Both processes can be saturated
c. Both are reabsorbed with sodium
d. A and C
e. All of the above

154
Q

Which of the following could be a cause of glucosuria?

a. inc. blood levels of glucose
b. An inflammation of the urinary system
c. reduced capacity in the PT
d. A and C
e. B and C

155
Q 
Which segment of the renal tubule is responsible for the reabsorption of the bulk of filtered solutes?
a. PT
b. Thin limbs of Henle's loop
c. TAL
d. DCT
e CD
156
Q

The main driving force for the reabsorption of solutes from the tubule fluid is

a. active transport of solutes across the apical PM
b. Secondary active transport of solutes across the apical PM
c. Active transport of Na from the tubule epithelial cell across the basolateral PM by the electrogenic Na channel
d. Active transport of Na from the tubule epithelial cell across the basolateral PM by the Na,k-ATPase
e. Passive diffusion of solutes through paracellular pathway

157
Q

Glucose is found in the urine of an animal when:

a. Glucose transport in the PT are inhibited by furosemide
b. Glucose secretion in the PTis stimulated by angiotensin 2
c. Glomerular filtration barrier is defectiv casing increased glucose in the tubule fluid
d. plasma glucose is elevated, inc. glucose conc. in the tubule fluid above the pt transport capacity
e. elevated plasma glucose stimulates pt glucose secreation

158
Q

The ultimate rate of excretion of K in the urine is determined by the

a. conc. of K in the glomerular filtrate
b. PT, which reabsorbs or secretes K to meet the physiological requiremnts of the animals
c. TAL, where K secretion is enhanced by high plasma K conc.
d. DCT, which has the K pumps that are inserted in the apical or basolateral PM, depending on the need for reabsorption or secretion of K
e. CD, where the principle cells are capable of K secretion, and the intercalated cells are capable of K reabsorption

159
Q

Which of the following are effects of aldosterone on Na tranport in the connecting segment and collecting duct?

a. Enhances the permeability of Na channels in th eapical PM, thereby enhancing Na reabsorption
b. stimulates Na,K-ATPase activity in the basolateral PM, thereby enhancing Na reabsorption
c. reduces Na permeability of the apical PM, thereby inhibiting Na reabsorption
d. Reduces Na,K-ATPase activity in the basolateral PM, thereby inhibiting Na reabsorption
e. Reduces the K permeability of the apical PM, thereby inhibiting K reabsorption

Physiology 2 (19 decks)

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