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Clinical Chemistry (CC 1) > (F) L4: Renal Function (Part 1: Introduction) > Flashcards

(F) L4: Renal Function (Part 1: Introduction) Flashcards

1
Q
  • Paired bean-shaped organs located retroperitoneally on either side of the spinal column below the ribcage
  • Is 4-5 inches in length, 2-3 inches in width, and 3 inches thick
  • Is divided into a cortex and medulla with an outer renal capsule layer
A

Kidneys

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2
Q

Recall the 3 main urine waste products (no choices, recall NPNs in CC):
1. From protein metabolism (ammonia first, then this)
2. From muscle metabolism (a marker for GFR)
3. From purine metabolism

A
  1. Urea
  2. Creatinine
  3. Uric Acid
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3
Q

If NPNs are (elevated/decreased) in blood, one possibility is because of kidney disease

A

Elevated

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4
Q
  • Aka vasopressin
  • Purpose: For water absorption
A

Antidiuretic Hormone (ADH)

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5
Q

Antidiuretic Hormone (ADH)

Hypothalamus vs. Posterior Pituitary Gland
1. Which endocrine gland synthesizes ADH?
2. Which endocrine gland released/secretes ADH?

A
  1. Synthesis - Hypothalamus
  2. Release/Secretion - Posterior Pituitary

Recall in Anaphy/Histo that the pituitary merely STORES hormones produced by the hypothalamus until they are needed

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6
Q

Antidiuretic Hormone (ADH)

The posterior pituitary releases ADH whenever blood volume is (increased/decreased) while blood osmolality is (increased/decreased)

A

Blood volume: Decreased
Blood osmolality: Increased

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7
Q

Antidiuretic Hormone (ADH)

ADH promotes water reabsorption which makes what part of the kidney more permeable to water?

A

Distal Convoluted Tubules (DCT)

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8
Q

Antidiuretic Hormone (ADH)

A deficiency of ADH causes what disease?

A

Diabetes Insipidus (increased frequency of urination)

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9
Q

These 3 electrolytes may be secreted or absorbed depending on the hormones present (e.g. aldosterone)

Note: Where sodium goes, water follows

A
  1. Sodium (Na+)
  2. Potassium (K+)
  3. Chlorine (Cl-)
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10
Q

Aside from sodium, potassium, and chlorine, what are the other 3 electrolytes in the blood?

A
  1. Phosphate
  2. Calcium
  3. Magnesium
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11
Q

What 2 organs are responsible for the maintenance of the acid-base balance?

A
  1. Kidneys
  2. Lungs
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12
Q

The kidneys maintain the acid-base balance by reabsorbing (blank) and excreting (blank)

A
  1. Reabsorption of bicarbonate
  2. Excretion of acids (hydrogen ions)
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13
Q

Endocrine Functions

  • Is released when BP and/or sodium is low
  • There is a vasoconstriction and regulation of osmolarity
  • Part of the RAAS and produced by the juxtaglomerular apparatus
  • This decreases blood volume
A

Renin

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14
Q

Endocrine Functions

  • Is secreted to stimulate the production of RBCs
  • There is a chance of acquiring anemia secondary to chronic kidney disease because of the affected production of this hormone
  • Can cause hypoxia and anemia
A

Erythropoietin (EPO)

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15
Q

Endocrine Functions

  • Aka Calcitriol (active vitamin D)
  • Increased blood calcium levels
A

1,25-dihydroxy vitamin D3

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16
Q

Endocrine Functions

  • A vasodilator
  • Increases permeability, renal blood flow, sodium and H2O secretion and release of renin
A

Prostaglandins

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17
Q
  • The basic functional unit of the kidney
  • Around 1 to 1.5 million of these per kidney
  • Has a glomerulus, renal tubules, and collecting ducts
A

Nephron

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18
Q

What is the number 1 requirement in order to filter metabolic waste products for urine formation?

A

Renal blood flow

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19
Q

Familiarize with the general renal blood flow

A
  1. Renal artery
  2. Afferent arteriole
  3. Glomerulus
  4. Efferent arteriole
  5. Peritubular capillaries
  6. Vasa recta
  7. Renal vein

RAGE-PVR

20
Q

Give the corresponding values for urine formation:
1. Cardiac output in percent?
2. Renal blood flow in mL/min.?
3. Renal plasma flow in mL/min.?
4. Renal filtrate in mL?

A. 600-700
B. 21-25
C. 1,200
D. 130

A
  1. Cardiac: 21-25%
  2. Blood flow: 1,200 mL/min.
  3. Plasma flow: 600-700 mL/min.
  4. Renal filtrate: 130 mL/min.
21
Q

Give the 3 major steps of urine formation

A
  1. Glomerular filtration
  2. Tubular reabsorption
  3. Tubular secretion
22
Q

Filtration

This acts as a non-selective sieve/filter

A

Glomerulus

23
Q

Filtration

  • Aka basal lamina
  • Substances with a MW of < 70k (or 66k) can pass through this
  • Cells and large molecules are not able to pass here
A

Glomerular Basement Membrane

24
Q

Filtration

Passage through the GBM, possible or not?
1. Water, Glucose, Amino Acids, Low MW proteins, and Waste products (creatinine and urea)
2. Cells, plasma proteins, and conjugated proteins (lipoproteins and bilirubin)
3. Albumin

A
  1. Possible
  2. Not possible
  3. Not possible
25
Q

Filtration

Albumin cannot pass through the GBM despite its MW being only 69k because the glomerulus has what?

A

Shield of negativity (will only pass through if the glomerulus is damaged)

Note: Albumin is (-) charged; like signs repel

26
Q

Reabsorption

  • This receives the glomerular filtrate
  • The major site of reabsorption of important substances
A

Proximal Convoluted Tubule (PCT)

27
Q

Reabsorption (important substances)

  • Reabsorbed by BOTH PCT and DCT
  • Aldosterone is responsible for regulating this substance
A

Sodium (Na+)

28
Q

Reabsorption (important substances)

  • Reabsorbed by the PCT, DCT, and Collecting Ducts
  • This gets reabsorbed because of ADH/vasopressin (effective towards the collecting duct)
29
Q

Reabsorption (important substances)

  • Has a threshold of 180 mg/dL
  • Once it surpasses the threshold, it will now be present in the urine
30
Q

Reabsorption (important substances)

Is not commonly used anymore for Clearance Tests because of the tendency of tubules to reabsorb it

31
Q

Reabsorption

Reabsorbed by BOTH PCT and DCT
A. Water
B. Sodium
C. Both
D. Neither

32
Q

Reabsorption

Reabsorbed by the collecting duct only
A. Water
B. Sodium
C. Both
D. Neither

33
Q

Reabsorption

This portion regulates the osmolarity of the interstitial fluid from the renal medulla

A

Loop of Henle

34
Q

Reabsorption (Loop of Henle: Countercurrent Multiplier System)

  • Impermeable to water
  • Sodium (Na+) and Chloride (Cl-) are reabsorbed
35
Q

Reabsorption (Loop of Henle: Countercurrent Multiplier System)

Highly reabsorbs water (passive movement)

A

Descending

36
Q

Secretion

  • The major site of secretion
  • Able to eliminate waste products such as creatinine and urea
  • Regulates sodium and potassium and releases vasopressin
A

Distal Convoluted Tubule (DCT)

37
Q

Secretion

What are the 3 secreted hydrogen ions for acid-base balance?

A
  1. Ammonium ions
  2. Dihydrogen phosphate
  3. Weak organic acids

Specimen: Urine

38
Q

Secretion

The final site of urine concentration and/or dilution

A

Collecting Ducts

39
Q

Secretion

Aldosterone, RAAS, and ADH act on what 2 parts of the kidney?

A
  1. Distal convoluted tubule (DCT)
  2. Collecting duct
40
Q

Familiarize yourself with the pathway of urine formation

A
  1. Kidneys
  2. Renal pelvis
  3. Ureter
  4. Urinary bladder
  5. Urethra
  6. Excretion
41
Q

Glomerular Filtration (can be filtered)
A. Cells
B. Large Molecules
C. Both
D. Neither

A

D. Neither (these CANNOT be filtered)

42
Q

Tubular Reabsorption
A. Distal Convoluted Tubule
B. Loop of Henle
C. Both
D. Neither

A

B. Loop of Henle (the DCT is for tubular secretion, PCT is for reabsorption)

43
Q

Tubular Reabsorption
A. Countercurrent Multiplier System
B. Amino acids and Vitamins
C. Both
D. Neither

44
Q

Loop of Henle: Countercurrent Multiplier System (Ascending)
A. Permeable to water
B. Potassium is reabsorbed
C. Both
D. Neither

A

D. Neither (is IMPERMEABLE to water and it is SODIUM and CHLORINE that get reabsorbed)

45
Q

Loop of Henle: Countercurrent Multiplier System (Descending)
A. Passive reabsorption of water
B. Active reabsorption of water
C. Both
D. Neither

A

A. Passive only

46
Q

Tubular Secretion
A. Distal Convoluted Tubule
B. Waste product recycling
C. Both
D. Neither

A

A. DCT only (waste products are to be eliminated, not recirculated back to the system)

Clinical Chemistry (CC 1) (33 decks)

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