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Renal Exam 1 > Extra > Flashcards

Extra Flashcards

1
Q

Angiotensin II.

What does it do

to PGC, GFR, RBF and FF, Pertitubular oncotic pressure

A

Causes vasoconstriction of the efferent arteriole

–> Increase PGC–> increase GFR, but decrease RBF

Filtration fraction will thus, increase because the amount of protein in the plasma increases–> increasing your peritubular oncotic pressure

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2
Q

L –> dL

A

1L= 10dL

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3
Q

L to mL

A

1L= 1000 mL

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4
Q

Rate of rate of urine (K+) excretion

A

Ux * V (flow)

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5
Q

TGF goal:

  1. Maintain a constant GFR
  2. Maintain constant NaCl delivery to DCT

How does this work>

A
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6
Q

Adenosine acts on what part of the GC?

A

Vasoconstriction of the afferent arteriole

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7
Q

How do MESENGIAL CELLS ALTER GFR?

A

Alter SA of K+

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8
Q

How does constriction of the afferent arteriole alter of FF?

A

No change

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9
Q

How does constriction of the efferent arteriole alter of FF?

A

increase

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10
Q

Why do our kidneys use 2x rate of O2 than the brain?

A

Increase reabsorption of Na+ occurs linearly

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11
Q

What happens when we sweat?

A

Think of sweat as losing water:

Hyperosmotic volume contraction

When we sweat

    1. Decrease in ECF volume*
    1. Increase in ECF osmolarity*
  • —creates a concentration gradient: water wants to move from ICF–> ECF—-*
    1. Decrease in ICF volume*
    1. Increase in ICF osmolarity*
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12
Q

A child is diagnosed with SIADH. What happens to ECF, ICF and osmolarity.

A

Same thing as excessive water intake: hypoosmotic volume expansion

— Increase ECF volume—-

Decrease osmolarity of ECF and ICF

—– Increase in ICF volume—–

  • Plasma protein levels decrease bc increase in ECF volume.

Hematocri- stays same bc water goes into RBC, increasing volume and offesting dilution

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13
Q

What happens when we have diarreah?

A

isoosmotic volume contraction

  1. ECF volume will decrease; no change in osmolarity, so ICF volume does not change.
  2. Plasma protein levels increase and hemotocrit increase because decrease ECF increases them. RBC do not shrink or swell
  3. BP will decrease d/t decrease in ECF volume
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14
Q

What happens when lost in a desert?

A

Sweat

(hyperosmostic volume contraction)

  1. Decrease in ECF volume: Increase in ECF osmolarity--> water moves from [ICF–> ECF–> decrease in ICF volume–> incrrease in ICF osmolarity
  2. Plasma protein levels increase
  3. Hemotocrit: stays the same bc water is moving out
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15
Q

What happens when during adrenal insufficiency

A

Adrenal insufficiency–> loss of NaCl

  • Hypo-osmotic volume contraction
    1. Decrease ECF osmolarity because aldosterone insufficiency, leading to decreased reabsorption and the kidneys excrete more NaCl> water.
  • ECF volume decrease:
  • ICF volume increases
  • ICF osmolarity decreases
  1. Plasma protein concentration increases
  2. Hematocrit will increase d/t decreased ECF volume and the RBC swell
  3. BP decreases
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16
Q

What happens during infusion of isotonic NaCl

  • Plasma protein concentration
  • hematocrit
  • BP
A

isoosmotic volume expansion

  1. ECF volume decreases; but there is not change in osmarity.
    * BECAUSE THERE IS NO CHANGE IN OSMOLARITY, water cannot move bc the NaCl distributed evenly in both.
  2. Plasma protein concentration decreases and hematocrit decreases bc it dilutres. RBCs do not shrink or swell bc no change in osmolarity.
  3. BP increases
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17
Q

What happens when during excessive NaCl intake

A
  • hyperosmotic volume expansion
  • Increase in ECF osmolarity
  • Cause water to move from the ICF–> ECF: ECF increases and ICF decreases
  • Increase in ICF osmolarity
  • plasma protein concentration decreases
  • hemotocrit decreases
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18
Q

A 40 y/o Caucasian female presents with a 3 week cc of “weird urine problems” She says the urine is extremely clear and doesn’t seem to be as yellow as she thinks it should be. You decide to perform a test that assesses the bodies ability to concentrate the urine. What is the name of this test?
.

A

Specific gravity- used to assess the concentrating ability of rthe kidney.

19
Q

Constriction of the afferent arteriole occurs via _____ and does what

A

sympathetic

  • decrease GFR
  • decrease RBF
  • no change on filtration fraction
20
Q

Constriction of efferent artioles occurs via _____ and does what?

A

Angiotensin II

Increase GFR

Decrease RBF

Incerase filtration fraction

21
Q

Increase plasam protein does to GFR, RBF, filtration fraction

A

Decrease GFR

no change in RBF

-decrease FF

22
Q

Uretal stone does what to GFR, RBF, FF

A

Decrease GFR d/t increase hydrostatic pressure in BC

  • no change in RBF
  • decrease FF

-

23
Q

What is invluded in the renal sinus

A

Renal pelvis

renal calyces

BV

nerves

fat

24
Q

Cells in PCT

A

Simple cuboidal–> simple columnar with alot of microvillus, creating a brush boarder

-has TONs of Na/K ATpases

25
Q

LoH cells

A

Thin limb- permeable simple squamous cells

Thick ascending- simple cuboidal epithelium with microvillus, but no BB

26
Q

Why is the LoH so important?

A

SUPER important for concentrating the filtrate passing through, creating a HYPEROSMOTIC gradient.

27
Q

How do we maintain a water concentration gradient in medulla?

A

Vasa recta take the water away

28
Q

DCT cells and big player

A

Cells: simple cuboidal with few microvillus, having a smoother surface than the thick ascending limb

Angiotensin II influences Na+ reabsorption

29
Q

CD

Cells:

A

Simple cuboidal–> simple columnar at the end

Job: concentrate urine by reabsorping water

ADH works here via type 2 aquaporin channels

Aldosterone

30
Q

Types of collecting tubule cells

A
  1. Light cells (intercalated)–> H+ and bicarb transport
  2. Dark cells (principle cells)- aldosterone hits and increases Na+ reabsorption via Enac and K secretion
31
Q

Remember, the concentration of Na+ in the tubular lumen will be the same as extracellular fluid (145meq). Intracellular Na+ is about 15 meq. This creates a concentration gradient.

A
32
Q

The regulation of K/Na in the distal tubule is controlled by _______\_

A

aldosterone

33
Q

How does aldosterone back on principle cells in the DCT?

A

Hold onto Na+, get rid if K.

Increase Na+ reabsorption,

Increase K+ secretion

34
Q

As we go from CTX–> medulla: osmolarity increases.

What does this allow?

A

concentrate urine.

35
Q

Water is freely filtered.

Regulated where?

A

Distal tubule and collecting ducts

36
Q

Ascending thick limb reabsorbs Na, 2Cl and K. How does this affect the osmolarity?

A

Decreases; thus the thick ascending limb will always be hyposmotic and hypotonic.

37
Q

What does ANP doe

A

Vasodilate afferent arterioles- and to a lesser extend; vasoconstrict efferent

ANP, overall increases RBF

38
Q

Vasoconstriction of arteriols

A

Vasconstriction–> decrease in RBF

Occurs by activating [sympathetic NS and angiotensin II]

  • Angiotensin II constricts efferent artioles and increases GFR.
39
Q

What do ACE-inhibtors do?

A

dilate efferent arterioles and decrease GFR;

reduce hyperfiltartion

40
Q

What does vasodilation do?

A

Increases RBF;

producted by PGE2, PGI2, NO, DA, bradykinin, ANP

41
Q

Summary of tubulogomerular feedback

A

increased renal arterial pressure–> increased fluid delivery to macula densa

MD senses and constricts afferent arterioles, increasing resistance to maintain constant BF.

42
Q

GFR decreases with age, although serum [creatinine] remains _____ because of

decreased muscle mass.

A

constant

43
Q
A

Renal Exam 1 (10 decks)

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