FINAL Flashcards
1
Q
renin, erythropoietin comes from?
A
kidney
2
Q
Pressure =?
A
flow x resistance
3
Q
velocity of blood flow = ?
A
blood flow/cross sectional area
4
Q
vascular conductance =
A
1/resistance
high conductance = low resistance
5
Q
cross sectional area of aorta
A
2.5 cm^2
6
Q
vena cavae cross sectional area
A
8 cm^2
7
Q
ventricles pressure range
A
2-120mmHg
7
Q
atria pressure?
A
2mmHg
8
Q
Aorta pressure range
A
80-120mmHg
9
Q
aorta or large arteries have wider pulse pressure?
A
large arteries
10
Q
from heart to capillary how much pressure is lost
A
100-30
70mmHg is lost
11
Q
delta P increases = ?
delta P decreases=?
A
delta P increases = more blood flow
11
Q
doubling diameter of vessel increases flow by?
A
16x
12
Q
Poiseuille’s law
A
F=pi * deltaP * r^4/ 8nl
nu= blood viscosity
L= length of tube
r= radius of tube
F, I, Q = flow
13
Q
increasing resistance does what to flow?
A
decreases flow
14
Q
Resistance equation
A
R= delta P/ F
15
Q
conductance is proportional to ?
A
diameter^4
16
Q
total surface area of capillaries
A
500-700 m^2
17
Q
cross sectional area of all capillaries
A
2500 cm^2
18
Q
capillary pressure (hydrostatic pressure) within capillary vasculature
A
30mmHg
pushing fluid out
19
Q
Hydrostatic pressure in ISF , vasculature vessel
A
-3 pushing fluid in
20
Q
plasma colloid osmotic pressure within vasculature vessel
A
28mmHg
keeping fluid in
21
Q
interstitial fluid colloid osmotic pressure ISF vasculature vessel
A
8 pulling fluid out
22
Q
at arteriolar end of capillary what movemet is favored?
A
filtration
23
at venular end of capillary what movement is favored?
reabsorption
24
extra fluid from net filtration pressure on average adds up to ___ per day
2L
scavenged by lymphatic system
24
mean capillary pressure?
17.3mmHg
25
net filtration pressure across entire average capillary
+0.3mmHg
26
NFP positive vs negative
If positive: net loss of fluid, filtration
If negative: net pulling of fluid into capillary, reabsorption
27
makes up 21.8 of total 28 protein oncotic pressure within capillary
albumin
28
2nd largest contributor to capillary oncotic pressure
globulins
29
3rd largest contributor to capillary oncotic pressure?
fibrinogen
30
lymphatic system is able to increase output by ___ due to disease process
20 fold
31
peritubular capillary functions
1) reabsorb fluids
2)provide metabolic requirements for kidney
32
outer part of kidney
cortex
33
next inner layer after cortex
medulla
34
blood vessels that are the peritubular capillaries that descend really deep into the kidney,
those are called vasa recta VR.
35
About 5% of our peritubular capillaries end up being ?
The other 95% are in?
AVR and DVR
The other 95% are in the outer medulla and that's where the bulk of our reabsorption happens.
36
kidneys tucked underneath?
diaphragm
37
if we
38
if we increase amount of blood going through kidney?
Will drive up pressure in other arteries and capillary bed as well
higher pressure is reflected every where
39
adrenal glands where?
on top of kidneys
40
left kidney is ___ than right kidney
higher
41
emptying of bladder is contolled by?
pudendal nerve
42
pudendal nerve sits next to?
prostate in men
43
another name for bowmands capsule
corpuscle
44
after PCT is ?
proximal straight tubule
45
located at first part of DCT
macula densa
46
collecting duct portions
cortical collecting duct
outer medullary collecting duct
inner medullary collecting duct
47
macula densa comes into contact with?
afferent and efferent arteriol
48
For GFR to increase, macula densa has to what?
dilate afferent arterial
49
angiotensin II has what 2 effects
increase resistance on efferent arteriole preferentially and afferent
49
juxtaglomerular cells in response to low Na count from macula densa will do what?
causes renin release
50
if macula densa sees low Na, it will?
think GFR is low
dilate afferent arteriol
cause renin release
51
renal blood flow
1100 ml/min
52
renal plasma flow
660 ml/min
53
filtration fraction
125/660
19%
54
GFR mls and dls
125ml/min = 1.25 dL/min
55
where does body choose to fine-tune the GFR
efferent arterioles
56
glomerular cap hydrostatic BP vs peritubular cap BP
60 in glomer vs 13 in peritubular
57
filtered load equation and units?
plasma concentration x GFR (convert to dL/min)
answer in mg/min
58
renal clearance
(urine flow rate x urinary conc)/ plasma conc
59
excretion = ?
filtration - reabsorption + secretion
60
secretion of organic compounds happens where?
proximal tubule
61
how much creatinine is being actively secreted?
0.10 - 0.15mg
62
most accurate guess of creatinine clearance
1.35 - 1.4mg/min but 1.25mg/min is close enough
63
inulin
A compound that is more accurate than creatinine
o Synthetic compound, can be injected IV,
Advantage: inulin is not secreted at all by peritubular capillaries and tubules
63
PAH stands for and used for?
para amino hippuric acid
estimating renal plasma flow
64
urinary conc after nephrectomy at steady state
0.625mg/ml
3 weeks out: 1.25mg/ml
65
Podocytes
similar structure to astrocytes in brain
outermost strucutre of glomerular capillaries
part of epithelial cells
66
slit pores do what?
keep proteins out of area
has lots of negative charges to repel, but doesnt repel ions
67
layers of glomerular capillary
epithelium
basement membrane
endothelium
68
normal urine output
1 mL/min
69
net filtration pressure equation
glomerular hydrostatic pressure - bowmans capsule pressure - glomerular oncotic pressure
70
bowmans capsule pressure
18 mmHg
71
glomerular colloid osmotic pressure
32
72
capillary colloid osmotic pressure beginning of glomerular capillary vs end
28 to 32 to 26
73
filtration coefficient unit
Kf (ml/min/mmHg)
12.5 ml/min/mmHg
74
factors that affect the filtration coefficient
extreme infection (swiss cheese)
2nd: capillaries become larger, more surface area
75
polycationic dextran filterability
positive charges on the dextran make it easier for that dextran to be filtered
76
filtration rate is____ to urine output
directly proportional
77
most BP drugs affect resistance of?
afferent arteriole
78
constricting afferent arteriole does what to renal blood flow
decreases renal blood flow
79
cardiac bp meds that dilate will do what to urine output?
increase urine output, dilates afferent arteriole
80
clearance rate units
ml/min
dl/min
81
organic anions and cations filtered where?
PT
82
proteins are not filterable bc of 2 things
size and negative charge
83
which is more efficient: autoregulation of GFR or renal blood flow
GFR
at higher pressures
84
all fluid filtered by 2 million nephrons
125ml/min
84
massive reabsorption in proximal tubule
bulk flow
85
sodium and chloride concentration across length of proximal tubule
doesnt change
85
n the tubular lumen side of proximal tubules, they have these infoldings here that increase the surface area that the proximal tubule has to use as a reabsorption point or a pumping area
brush border
86
by end of proximal tubule we've reabsorbed how much water
65%
87
anhydrase enzyme is pulling?
water out of something
88
glucose and amino acid reabsorbed where?
PT
89
carbonic anhydrase active where? and associated with?
everywhere, but mostly in PT
associated with brush border
90
transporter for amino acids located where?
PT on tubular side
co transported with Na
91
SGLT 2 transporters reabsorb how much of filter load of glucose?
ratio?
capactiy?
90%
1:1 reabsorption ratio
high capacity, low affinity
92
SGLT 1 transporters reabsorb how much of filter load of glucose?
ratio?
capactiy?
10 to 35%
2:1
low capacity, high affinity
93
glutamine splits into?
2 bicarb and 2 ammonium
93
ammonia
Nh3
94
ammonium
NH4
95
angiotensin II effects on proximal tubule
speeds up
NaK pump
sodium proton exchanger
-bicarb sodium pump
95
buffers in proximal tubule
phosphate, ammonium, bicarb
96
aniotensin II increases amount of ______ reabsorbing at proximal tubules
salt and water
97
when Ang II receptors on adrenal gland get hit...
aldo is released from adrenal glands
98
PTH 3 things:
increase Ca intestinal absorption through vitamin D activation
increase renal Ca reabsorption
increase Ca release from bones
99
bicarb 3 main places
mainly PT, TAL, DT
99
PTH 3 main places
PT, TAL, DT
100
how much water is filtered in a descending loop of Henle
20%
101
PTH on osteoblast/clast
stimulates osteoclasts
inhibits osteoblasts
102
which segment requires the most energy, 2nd?
PT
second most: TAL
103
which pump and where does lasix work, what ions are transported thru pump
sodium K 2 Cl transporter
4 ions
Na exits through NaK pump
Cl exits through simple Cl channel
on tubular side
on TAL
104
which segment has K channels on both sides
TAL, makes tubule section +8mV
drives reabsorption of other cations (mg, ca, na, K) through tight junctions
105
glutamine needs to have __________ to produce bicarb
sodium proton exchanger
106
lasix does what to renal interstitium
dilutes it
107
source for renal inst concentration
TAL
108
thought of as diluting segment
distal tubule
dilution comes from sodium and chloride pumping
109
thin ascending limb has which pump
Na Cl co transporter
from tubule to interstitum
110
40-50% of dissolved stuff in interstitium
urea
111
urea tends to be reabsorbed from __________ via stimulation of ____
medullary collecting duct via ADH/AVP
112
regulation of body fluid osmolarity is via ___
ADH
113
ADH is released from posterior pituitary gland which effects _____ in the _______
efects principal and intercalated cells in the late DCT, but primarily in collecting duct
114
2 urea transporters in distal tubule and cortical medullary duct
UT -A1 and UT-A3
115
decreased GFR or RBF results in?
decreased UO
116
which calcium pump ensures bulk of calcium reabsorption
Na Ca exchanger
117
where are calcium pumps in distal tubule
interstitial side
simple Calcium channel on tubule side
118
which channels do PTH stimulate
calcium channels on tubular side
119
2 actions of thiazide diuretics
inhibit Na Cl pump (tubular side)
speed up sodium calcium exchanger (on interstitial side)
in distal tubule
120
chronically low calcium and chronically high PTH?
osteroporosis
121
when aldo is high?
sodium is reabsorbed and Potassium is excreted
122
aldosterone antagonist
spironolactone
123
Na channel blockers
Amiloride
Triamterene
124
2 parts that ar aldo sensitive
are the sodium/potassium pump speed
- ALDO also determines how many sodium channels we have on the tubular side of the cell wall.
125
aldo needs sufficient supply of ___
cholesterol
126
adrenal medulla produces?
catecholamines
127
fasciulata and reticularis produces?
cortisol and androgens
128
potassium wasting effect comes from which cell
principal cell in distal tubule
through sodium channels in tubular lumen
128
that's a compound that specifically destroys cortisol or cortisol like steroids, but tends to not act at all on the Aldo
11 beta-HSD. So 11 beta hydroxy steroid dehydrogenase,
129
dont give potassium sparing diuretic to ?
massive hearat failure with tons of arrhythmias
130
as K increase, aldo__
increases
130
too high cortisol effects include?
HTN and problem maintaining potassium balance
131
ADH acts on what receptor?
V2 receptor
132
V2 receptor type?
GPCR
increase cAMP, increases PKA, phosphorylates AQP-2, moves to tubular side of cell
133
AQP 3 and 4
water is allowed out back of cell
134
final determinant of urinary osmolarity
cortical & medullary collecting duct
135
produces 5/6 ADH
supraoptic neuron
136
produces 1/6 ADH
periventricular nuclei
137
lack of release of ADH disease
central DI
138
failure of kidney to repond normally to ADH
nephrogenic DI
139
nephrogenic DI cause
high dose lithium
infection, drugs, genetics
140
ADH half life
20 min
141
high free water clearance is from?
no adh
142
low free water clearance is from?
ADH around
143
decreasing thirst (decrease ADH)
alcohol clonidine
haldol
143
range of K intake
30-120 mEq/day
144
increasing thirst drugs (increase adh)
nausea
morphin
nicotine
145
blocking aldo has not that much effect on?
plasma Na concentrations
146
common cause for essential HTN
stenotic renal artery
147
148
149
150
