Final Exam Babyyy Flashcards

Question

What is Ohm's law>

Answer 1

Voltage = current x resistance

Answer 2

Filtration

Answer 3

Reabsorption

Answer 4

Capillaries

Answer 5

Large arteries

Answer 6

High Vascular resistance in the arterioles & small arteries -- mast majority is arterioles

Answer 7

Arterioles

Answer 8

increased blood flow

Answer 9

reduced blood flow

Answer 10

500 - 700 square meters

Answer 11

1 layer & composed of endothelium cells

Answer 12

No - this is good as there is nothing to hinder nutrient/gas exchange

Answer 13

Arterial end

Answer 14

Venous end

Answer 15

- Hydrostatic pressure in capillaries - Hydrostatic pressure in ISF - Capillary Colloid osmotic pressure (oncotic pressure - Interstitial fluid colloid osmotic pressure

Answer 16

The blood pressure in the capillaries -- also called the hydrostatic pressure -- physical fluid pressure of the blood in the capillaries

Answer 17

The blood pressure outside the capillaries & outside cells - ISF - negative pressure d/t lymphatics pulling extra fluid

Answer 18

Proteins dissolved in blood in capillaries -- creates a pulling force keeping fluid in CV - normal capillary oncotic pressure is 28 mmHg

Answer 19

Proteins in the ISF -- creates a pulling force into ISF

Answer 20

Hemorrhage, liver failure, sepsis & trauma

Answer 21

Not only can proteins escape into ISF but the proteins in the capillaries lose their osmotic pressure -- this is because osmotic pressure is based on a semi-permeable membrane where fluid can move but a dissolved substance cant

Answer 22

Proteoglycan filaments, Hyaluronic acid, & collagen - osmotic pressure of 8mmHg

Answer 23

CV - osmotic pressure produced is 28mmHg

Answer 24

Lymphatic slowly removes extra proteins this takes time -- this process is slowed even more in bedridden patients

Answer 25

The contraction/relaxation of skeletal muscle -- lymphatic uses this to move fluid forward

Answer 26

How permeable the capillary is & how much surface area - the more porous to water the more water will move - the more surface area the more movement (this is secondary to the other forces)

Answer 27

Albumin (Primary), Globulins (2nd most important -- Abx) & Fibrinogen (clotting factor) - total plasma oncotic pressure is 28mmHg

Answer 28

Around capillaries

Answer 29

Retrieving extra fluid from around the interstitial fluid around capillaries and returning it to the CV system

Answer 30

Lymphatic ducts at the top of the thorax dump into "very large veins."

Answer 31

Yes; one way valves, similar to veins. Need muscle contraction for lymph return. This is why bed bound people get swollen.

Answer 32

Passive one way pumping system

Answer 33

Relatively slow

Answer 34

20x; maybe even higher if our activity is enough

Answer 35

Sequential compression devices; helps get venous/lymphatic system moving, possibly more so for lymph *requires intact path to top of thorax

Answer 36

NaCl - small

Answer 37

less permeability we will have

Answer 38

-3mmHg A vacuum; favorable condition for filtration on the arterial side

Answer 39

-7mmHg Not completely favorable for reabsorption. Some fluid is left behind. This requires an intact lymph system to scavenge the remainder of fluid to prevent buildup provided there is not an extreme excess of fluid.

Answer 40

It is 17.3mmHg because capillaries get larger as we go from the arterial side to the venous side, which increases cross sectional area and decreases pressure.

Answer 41

Blood Brain Barrier

Answer 42

....glucose transporters

Answer 43

0mmHg BP drops as it moves through areas of high resistance within the kidney. Energy is removed, so pressure drops

Answer 44

Afferent arteriole

Answer 45

Systemic BP (pressure coming in from renal artery)

Answer 46

High resistance within the afferent arteriole

Answer 47

60mmHg 2x greater than systemic capillary, allowing for high filtration

Answer 48

RBC/Large proteins

Answer 49

DM, lifetime HTN It is okay to have a very low number filtered out per daddy

Answer 50

The renal artery splits into a bunch of smaller arteries, which eventually become the afferent arteriole for a given nephron.

Answer 51

Glomerular Filtration Rate - Amount of filtration sent into a compartment to process what has been filtered

Answer 52

Increased GFR is typically better

Answer 53

It will relax (dilate) to increase blood flow to glomerulus

Answer 54

It will constrict to decrease blood flow to glomerulus

Answer 55

we lose a lot of fluid due to filtration leading to an increase in concentration in the plasma

Answer 56

The fluid filling up in the tubule generates a physical pressure

Answer 57

0 - if we are healthy we should not be filtering proteins

Answer 58

10 mmHg (60 mmHg - 32 mmHg- 18 mmHg)

Answer 59

Filtration rate = Kf x NFP 125ml/min = 12.5 x 10 mmHg

Answer 60

Filtration coefficient - normal is 12.5

Answer 61

Behind the glomerular capillaries - post glomerulus capillary

Answer 62

constricts or dilates efferent arteriole

Answer 63

Upstream pressure increases --> increases blood pressure --> GFR is increased

Answer 64

Upstream pressure decreases --> decreases blood pressure --> GFR is decreased

Answer 65

18 mmHg (blood pressure drops from 60 to 18 -- 42 mmHg difference)

Answer 66

The efferent arteriole has the highest vascular resistance - efferent drops BP from 60 to 18 -- 42 mmHg difference - afferent drops BP from 100 to 60 -- 40 mmHg difference

Answer 67

Reabsorb 98-99% of stuff that was filtered at the peritubular capillary i.e., afferent arteriole --> Glomerular capillary --> Bowmans capsule --> PCT --> reabsorbed at peritubular capillary

Answer 68

Cells in peritubular capillaries pump stuff out to the proximal convoluted tubule to be excreted

Answer 69

Urine; about 1-2% of what goes through the renal capillaries Filtration - absorption + secretion = excretion

Answer 70

What is filtered is lost as urine, and some stays within the renal vein.

Answer 71

Some filtrate is sent as urine, some stays in the renal vein, and some of the filtrate is reabsorbed back into the peritubular capillaries Sodium; we eat way more than we need, the body chooses to not reabsorb all of this sodium

Answer 72

Will not go to urine - what is filtered gets completely reabsorbed at the peritubular capillaries from the PCT. Glucose in a non-diabetic patient. If glucose is controlled and in normal limits, all glucose is reabsorbed by the PCT.

Answer 73

Elevated glucose (transporters can't reabsorb fast enough; spill over) Something may be wrong with the transport system for glucose reabsorption

Answer 74

A small portion is filtered at the glomerulus (near afferent arteriole), but then is secreted from peritubular capillaries to the PCT. None shows up in the urine.

Answer 75

1/5 or 20% of renal blood flow

Answer 76

4/5, or 80%

Answer 77

Diagnostic compound to estimate renal blood flow; removal from kidney is dependent on how much blood is moving through kidney. If we know how much of this we gave the patient, we can use it to estimate renal blood flow.

Answer 78

Assume all of the blood in the renal artery has Para-aminohippuric acid (PAH) The more removed by the time it gets to the renal vein = higher renal blood flow The less removed by the time it gets to the renal vein = lower renal blood flow

Answer 79

GFR - 125ml/min Reabsorption - 124mL/min Excretion - 1ml/min

Answer 80

We don't really filter proteins normally

Answer 81

Inner - endothelial cells Middle - connective tissue called the basement membrane Outside - epithelial cells

Answer 82

Much more permeable than generic systemic capillaries Have openings in wall called fenestrations

Answer 83

Connective tissue called the basement membrane

Answer 84

Specialized to provide structural support to the capillary bed Podacytes

Answer 85

Astrocytes within the blood brain barrier (support the capillaries of the brain)

Answer 86

Pressure is very high within glomerular capillaries - provides structural support and prevents swelling. They also keep the surface area of the capillaries in check.

Answer 87

Glomerular capillaries swell, fall apart, and lose function

Answer 88

Silt pores Processes are negatively charged and help repel proteins, which are also usually negatively charged. Proteins can't make it through fenestrations because of the charge.

Answer 89

Epithelium (where podacytes are located; silt pores are here)

Answer 90

0mmHg per daddy

Answer 91

Afferent arteriole

Answer 92

Efferent arteriole

Answer 93

Lower pressure; lower GFR Renal blood flow DROPS

Answer 94

Pressure inside of the glomerular capillaries rise, GFR rises Renal blood flow DROPS

Answer 95

Renal blood flow DROPS

Answer 96

Increases renal blood flow

Answer 97

Increase GFR, increase glomerular pressure Increase renal blood flow

Answer 98

Decrease GFR, decrease glomerular pressure Increase renal blood flow

Answer 99

A synthetic sugar; can be larger or smaller based on how many chains are linked together. Used to test filterability in the kidney A positive dextran is more permeable than a negative dextran due to the negative charge of the epithelial layer or the glomerular capillaries. Larger + negative charge = less filterable Smaller + positive charge = more filterable

Answer 100

1.0 - very filterable because they are all small

Answer 101

Can be used to figure out GFR - synthetic, more sensitive than creatinine. Can inject into the patient to determine clearance. Creatinine clearance is variable, and doesn't follow the same kinetics as inulin. Filterability is 1.0, just as filterable as water, sodium, and glucose.

Answer 102

Yes; but we're lazy and use creatinine clearance

Answer 103

no Filterability 0.75

Answer 104

0.005 Very large If we filter it, it adds to oncotic pressure which changes tendency for reabsorption

Answer 105

50mmHg-150mmHg ICU patients will not fare well with a map of 50mmHg in terms of autoregulation

Answer 106

Afferent arterioles ability to dilate

Answer 107

HTN for years Uncontrolled DM Need a higher BP to autoregulate for kidneys to be happy

Answer 108

Over/underperfusion; GFR

Answer 109

GFR fares well - line stays pretty flat, the GFR stays more or less the same with a slight rise. Renal blood flow increases sharply past 150mmHg

Answer 110

Reabsorption goes through the cells or in between the cells that make up the lining of the tubule --> through the renal interstitium--> then cross the wall of the peri-tubular capillaries

Answer 111

In a healthy person, no. GFR is able to hold onto fluid and not let too much go.

Answer 112

Someone without good GFR autoregulation at high BP will have a dramatically increased urine output which could be problematic. Example: CVA resulting in high BP --> Don't want to lose a liter of fluid per hour, this would be bad

Answer 113

Autoregulation in the kidneys is more of a slanted line. As BP goes up, UOP increases As BP goes down, UOP decreases

Answer 114

No - completely independent. Autoregulation is based on pressure. If pressure goes up, favors fluid reduction and reduced pressures.

Answer 115

How much is filtered vs how much makes it through the kidney 20% is normal GFR (125ml/min) divided by renal plasma flow (660ml plasma/min) 125/660 = 0.19

Answer 116

32 mmHg - plasma gets diluted which drops pressure from 36 to 32

Answer 117

1100ml/min

Answer 118

Renal blood flow is 1100ml/min If hct is 0.4, take 40% of 1100ml/min. That will give you RBC volume.

Answer 119

Assuming hct is 0.4. 1-0.4 = 0.6 or 60% Renal blood flow is 1100ml/min 60% of 1100ml/min = 660ml/min renal plasma flow

Answer 120

Proteins would be more concentrated, which would lead to a higher blood colloid osmotic pressure at the end of the glomerulus. Normally occurs if the efferent arteriole constricts. When it constricts, more fluid is filtered.

Answer 121

13 mmHg (end of the peri-tubular capillaries should be lower -- he didnt give a number)

Answer 122

Would not be as high as normal. Normally occurs if the efferent arteriole relaxes, which makes it easier for blood to get by. This decreases the amount of fluid filtered.

Answer 123

Net filtration pressure = - 10mmHg Net reabsorption pressure = 10 mmHg

Answer 124

10% or 1/5th

Answer 125

Ureters & fills into bladder

Answer 126

Excretion?

Answer 127

Excretion = filtration - reabsorption + secretion

Answer 128

The body can actively pump things it doesn't want into the tubule -- works the opposite of reabsorption -- things are pumped out of the peri-tubular capillaries into the renal intersitium --> then cross the cells that make up the walls of the tubule & gets dumped into tubule

Answer 129

Volume or Quantities (quantity of substance dissolved in a volume)

Answer 130

- long term BP regulator - long term pH regulator - Long term RBC regulator - long term electrolyte regulator - long term vitamin D regulator - long term glucose regulator - Drug clearance - long term metabolic waste disposal - Osmolarity regulator

Answer 131

Determines how much volume we have in the CV system

Answer 132

Regulates acid/base balance - dictates how much bicarb we reabsorb & can produce its own bicarb - gets rid of excess protons

Answer 133

short term - lungs -- can get rid of excess CO2 but not protons Long term - kidneys -- through getting rid of protons & keeping/producing bicarb

Answer 134

In the deep medullary kidney, there are sensors that measure blood oxygen levels -- if oxygen is low the kidney releases erythropoietin which stimulates the bone marrow to produce more RBCs

Answer 135

determines how much we reabsorb & can determine how much we absorb through Vitamin D -- Activation of Vitamin D is controlled by kidney --

Answer 136

Normally the more we filter the more we reabsorb - once reabsorption max is reached glucose will be excreted via in high blood glucose levels (blow off valve)

Answer 137

it can transport drugs from the blood stream to the tubule to be excreted via urine (secretory process)

Answer 138

Determines how much water we reabsorb second to salt reabsorption -- kidney can choose to get rid of salts or be selective of how much water we reabsorb --> the kidney can differentiate between the two & choose what to keep or get rid of

Answer 139

ADH (by osmoreceptors in brain)

Answer 140

Maintaining GFR - auto regulation is important

Answer 141

Renal artery --> Segmental arteries --> Interlobar arteries --> arcuate arteries --> interlobular arteries --> afferent arterioles --> Glomerular capillaries --> efferent arterioles --> Peri-tubular capillaries --> interlobular veins --> arcuate veins --> interlobar veins --> segmental veins --> renal veins

Answer 142

The basic functional unit of the kidney - a nephron consists of the Afferent/efferent arteriole, the glomerular/peri-tubular capillary, & the tubule/collecting duct

Answer 143

1 million per kidney (2 milli total) - at age 40

Answer 144

Superficial cortical - make up 90-95% of nephrons Deep medullary nephrons -- make up 5-10%

Answer 145

This slows blood velocity going up the ascending limb - this helps prevent the washing out of the renal interstitium by maintaining a normal level of solutes in the deep medulla

Answer 146

Vesa Recta

Answer 147

The deep medullary nephrons as there are so few (5-10%) ischemia would most affect here

Answer 148

Mesenteric artery

Answer 149

Adrenal glands

Answer 150

Gastric surface (stomach)

Answer 151

Cancer spreading - Cancer of the kidney itself is very rare as it doesnt really generate new nephrons -- most cancer of kidney is due to infiltration

Answer 152

The larger the prostate the more is squeezes the urethra & makes it difficult to empty the bladder (us men have it so difficult :( )

Answer 153

SNS & PNS - example -- if we are nervous we may lose control of bladder or have inability to empty bladder

Answer 154

Pudendal nerve - comes from S2,S3, & S4

Answer 155

Bowman's capsule (Corpuscle) --> Proximal tubule --> proximal straight tubule --> Descending thin limb --> Ascending thin limb --> Ascending thick limb --> Distal convoluted tubule --> Cortical collecting duct --> Medullary collecting duct --> empties into papillary duct

Answer 156

Descending thin limb, Ascending thin limb & Ascending thick limb

Answer 157

Thick Ascending limb

Answer 158

Tells the kidney how much is being filtered - monitors filtration rate by acting like a speedometer - is in contact with Afferent & Efferent Arterioles

Answer 159

The Juxtaglomerular cells connected to the afferent/efferent arterioles release renin --> renin eventually gets converted to Angiotensin II --> this constricts the Efferent Arteriole --> increases pressure in glomerulus --> filtration is increased

Answer 160

Renin production is reduced --> leads to dilation of efferent arterioles

Answer 161

Chemist who had prostate cancer for 25years - there is a correlation between cancer and antioxidants, such as vitamin C -Antioxidants help prevent free radical oxidative stress

Answer 162

Quantity of plasma that is cleared of a substance per time (ml fluid/min)

Answer 163

No - it will only ever be mL/min

Answer 164

Hepatic clearance

Answer 165

Urinary flow rate (1ml/min) x urinary concentration of the compound = excretion rate

Answer 166

(Urinary flow rate x concentration of the compound)/Plasma = Renal clearance

Answer 167

1,000,000 (one million PER kidney)

Answer 168

2,000,000 (two million)

Answer 169

124ml/min (99% of what is filtered, leaving 1ml/min of urine)

Answer 170

v̇ Note: can also be v̇u̇, but not commonly

Answer 171

volume per unit of time

Answer 172

Easy Roughly the same composition EARLY in Bowmans capsule

Answer 173

2/3 of everything

Answer 174

No clearance at all at normal glucose levels

Answer 175

No - will have some spill over into the urine which would result in a non-zero clearance.

Answer 176

124ml, and none of the compound.

Answer 177

It would stay within the proximal convoluted tubule and make its way to the bladder.

Answer 178

Early on in the PCT the concentration would be the same as it was in the glomerulus. Later in the PCT, after 124ml plasma is reabsorbed at the peritubular capillaries, the 1ml of urine will become more concentrated with the substance as it flows to the bladder.

Answer 179

GFR; 124ml/min

Answer 180

It becomes dilute as it heads to the renal vein. This is due to reabsorption of 124ml/min of fluid. The fluid dilutes what fluid is there.

Answer 181

No Peritubular capillaries are more concentrated than the renal vein.

Answer 182

Multiply by the reciprocal of the denominator

Answer 183

The amount filtered is the same amount that goes to the urine.

Answer 184

125mL --> 1.25dL 1.25dL/min x 1mg = 1.25mg/min

Answer 185

1.25mg/ml of urine Excretion is 1.25mg/min

Answer 186

Quantity of stuff lost in the urine over a minute

Answer 187

Inulin Two (measure two minutes after administration, then another time after another two minutes)

Answer 188

Freely filtered, not reabsorbed or secreted. Great to find GFR. Exogenous.

Answer 189

Creatinine clearance. Creatinine is endogenously produced, some is released continuously as it is a byproduct of skeletal muscle. This leads to artificially high GFR readings.

Answer 190

Low GFR/creatinine clearance would be low due to lack of creatinine. Use inulin to get accurate measure of kidney function.

Answer 191

Very high Renal plasma flow None in the renal vein

Answer 192

It has massive amounts of transporters at the peritubular capillaries that secrete it back into the PCT. The clearance rate is very high, and the renal plasma flow is equal to the clearance rate.

Answer 193

No; heavily/totally secreted into the PCT.

Answer 194

Daddy said please

Answer 195

Clearance rate of Para-aminohippuric acid (PAH) is equal to the renal plasma flow. Divide renal plasma flow (RPF) by (1 minus HCT level) --> will give renal blood flow

Answer 196

90% of Para-aminohippuric acid (PAH) is removed from the kidney.

Answer 197

Concentration x amount (how long we took the urine sample were direct words) ***review the book please

Answer 198

Excretion rate - filtered load

Answer 199

Filtered load - excretion rate

Answer 200

Rearrange them to solve for each part of the equation; keep your eyes on units

Answer 201

Glomerulus capillary blood pressure --> which will increase Net filtration pressure

Answer 202

It would be excreted as urine

Answer 203

Low renal arterial pressure would lead to a low GFR --> low GFR would lead to low filtration rate --> increased reabsorption --> low urine output

Answer 204

How well the afferent arterioles dilate

Answer 205

The afferent arteriole will get used to constricting & in the case of hypotension will have difficulty dilating

Answer 206

Podocytes can lose ability to reinforce capillary bed, fenestrations can widen & scarring can develop

Answer 207

Efferent arteriole is affected more than afferent

Answer 208

Afferent arteriole compared to efferent

Answer 209

Macula dense would sense extra fluid --> leading to reduction in angiotensin II --> which would dilate the efferent arteriole & reduce filtration rate

Answer 210

2/3rds (power points has 65% written)

Answer 211

A higher amount of Na reaching Macula densa --> kidney would interpret this as having a high GFR

Answer 212

A lower amount of Na reaching Macula Densa --> kidney would interpret this as having a low GFR

Answer 213

This would cause a deficit in the amount of Na that reaches the Macula Densa --> kidney would interpret this as having a low GFR & in response the kidney will increase the amount of Angiotensin II

Answer 214

Angiotensin II in normal glomerulus pressures will increase glomerulus pressures & long term this can increase the wear & tear tear of the capillary beds

Answer 215

ACE inhibitors, ARBs, & renin inhibitors - mostly ACE inhibitors

Answer 216

The proximal tubule

Answer 217

Proximal Tubule -- 142 Tubular cells -- 14 (10:1 gradient)

Answer 218

Na - 1:1 ratio

Answer 219

The more glucose that is reabsorbed the more Na is also reabsorbed --> this will reduce the amount of Na that reaches Macula Densa --> kidney will think GFR is low & try to increase GFR --> more Angiotensin II release

Answer 220

Hyperfiltration -- kidneys will always be trying to increase GFR --> which will increase the wear & tear of the nephrons - Sugar is also very sticky & will stick to things & elicit & immune response to destroy it - for every nephron that dies the remaining nephrons must increase their workload - increasing their wear & tear

Answer 221

1 Na (1:1 ratio)

Answer 222

(Same as high blood glucose) more amino acids --> more is filtered --> more is reabsorbed & along with Na --> less Na makes it to Macula densa --> kidney thinks GFR is low --> Angiotensin II is released

Answer 223

not normally

Answer 224

Reduced reabsorption of glucose --> downstream urine has higher glucose level --> urethra has high glucose --> increased UTI risk Glucose also makes the tubule sticky, leading to immune system response. The immune system can attack the tubule/urethra.

Answer 225

Can reduce glucagon - we need this. Most of the weight loss comes from muscle loss; not a great way to lose weight. Stop eating so much

Answer 226

Glucose is only reabsorbed in the PCT. If it makes it through the PCT, it will not be reabsorbed.

Answer 227

Apical side of the cell

Answer 228

Basolateral side

Answer 229

SGLT Dependent on the sodium electrochemical gradient to help pull glucose along with it into the cell.

Answer 230

Roughly the same; freely filtered, small, uncharged As we go further in the PCT, more and more is reabsorbed into the peritubular capillaries. This would mean we have a smaller amount of glucose in the distal areas of the PCT. Eventually, this number should be zero.

Answer 231

GLUT; No energy required. SGLT packs glucose into the cell, increasing glucose concentration in the tubular cell. If the concentration of glucose within the tubular cell is greater than the interstitial fluid, glucose flows through the basolateral side of the tubular cell passively.

Answer 232

S1 (early, S2/3 (late)

Answer 233

S1 (early part of the PCT). 90% of all glucose is absorbed here. The transporter is the SGLT2 transporter.

Answer 234

SGLT2 - works through concentration gradient of Na. It takes 1 Na and 1 glucose into the apical side of the tubular cells. -These are high through-put, or high efficiency transporters. However, they are low affinity compared to the later segments*** The basolateral side of the cell uses GLUT2 transporters to bring glucose into the interstitial fluid.

Answer 235

SGLT1 - "first isoform of the transporter" Located on the apical side of the tubular cell Requires 2 Na per each 1 glucose to reabsorb via concentration gradient of Na -High affinity, lower capacity than SGLT2** 10% of reabsorption of glucose is here GLUT-1 is on the basolateral side of the tubular cell There are very few SGLT1/GLUT1 transporters here

Answer 236

As fluid goes through the PCT, less and less glucose is present. This makes it more dilute. It is harder for glucose transporters to move glucose when it's dilute, so we use 2 Na to help move things along.

Answer 237

SGLT2 - only use 1 Na SGLT1 should be used to SCAVENGE**

Answer 238

Plasma concentration (assume normal GFR) Normal GFR + normal glucose = normal glucose filtered (filtered load)

Answer 239

Convert mL to dL 1.25dL/min GFR 100mg/dL Multiply those two dL cancels out - 125mg/min of normal glucose filtered load**

Answer 240

150mg/min Note: he gave us this number but did an example (last flash card) that gave us 125mg/dL. He just said "it's in the general ballpark."

Answer 241

100mg/dL Yes - healthy and fasting would be lower

Answer 242

How much stuff that is dissolved in plasma that is being filtered.

Answer 243

Stuff filtered x quantity filtered = filtered load

Answer 244

200mg/dL - know the term "threshold," he made a deal about it Note: He also said 200mg/dL might be a bit high, and typically between 100-200mg/dL you would see glucose in the urine.

Answer 245

Shortly after threshold, Excretion increases at a linear, 1:1 rate because our SGLT1-2 transporters cannot transport any faster (they are saturated). This is called "transport maximum."

Answer 246

No - it is shortly after threshold.

Answer 247

Glucose is making it past S1, S2, and S3. S2/3 transporters aren't necessarily maxed out, glucose is just starting to make it past the transporters. Transport maximum is when all SGLT transporters are saturated.

Answer 248

There is a set time for conformation/release/reset of SGLT transporters. When transporters reach saturation, they can't physically go any faster.

Answer 249

200mg/dL Threshold

Answer 250

Thick ascending limb of the loop of henle, ALMOST at the start of the DCT but not quite. Comes into contact with the efferent and afferent arterioles.

Answer 251

It counts the # of Na and Cl flowing past it to help manage GFR. It is more sensitive to Na.

Answer 252

Cells within the macula densa that come into contact the the efferent and afferent arterioles. They release renin when the macula densa thinks that GFR is too low.

Answer 253

Angiotensinogen is converted to Angiotensin I by Renin.

Answer 254

Angiotensin Converting Enzyme (ACE)

Answer 255

Angiotensin II

Answer 256

ACE found primarily in the lungs

Answer 257

Constricts the efferent arteriole --> Reduced renal blood flow, BUT increased glomerular pressure, which should increase GFR.

Answer 258

While research is currently unclear, it is thought that the afferent arteriole dilates in response to nitric oxide release from the macula densa. The efferent arterioles constricting decreases renal flow while increasing glomerular pressure and GFR. The afferent arteriole dilating makes up for the loss of renal blood flow from the efferent arteriole , and also raises glomerular pressures further, leading to even higher GFR. Clarification: afferent arteriole dilation causes INCREASE in renal blood flow.

Answer 259

Low BP --> Decrease in glomerular hydrostatic pressure --> Less NaCl flowing past the macula densa --> Juxtoglomerular cells release renin --> Renin converts angiotensinogen to AG I --> ACE converts AG I to AG II --> AG II constricts the efferent arteriole, while nitric oxide dilates the efferent arteriole --> Increase in glomerular hydrostatic pressure --> Increase in GFR

Answer 260

Efferent arteriole

Answer 261

Increase NaCl and H2O reabsorption. This helps conserve volume, hopefully increasing BP, which will directly result in increased renal blood flow. (Expands blood volume)

Answer 262

Angiotensin I receptors

Answer 263

Na/K pump is sped up -- this decreases the amount of intracellular Na & increases & increases secondary active transporter/exchangers that depend on Na/k pump

Answer 264

NHE -- Na/H exchanger is most heavily affected as the more Na is removed intracellularly, the more Na will move down its concentration gradient into the cell in exchange for a H The reabsorption of bicarb is also sped up -- this is secondary active transporter Na/HCO3 -- as bicarb is being reabsorbed into the renal interstitium it brings along a Na -- this is Bicarb driven & the Na/H exchanger also aids in this

Answer 265

Paracellular route -- in between cells (Cl is mostly reabsorbed through this route) Trans-cellular route -- through cells via channels or transporters

Answer 266

All the Na pumps that push Na into the renal interstitium makes the renal interstitium more positive given Cl motive to cross

Answer 267

NO, most water reabsorption is due to being pulled via osmosis

Answer 268

Urea - it is stored in the renal interstitium to help reabsorb water via osmosis

Answer 269

Brush border -- increases surface area & is prevalent in the proximal tubule -- this allows more room to place transporters by up to x20

Answer 270

-3 mV The charge is a product of the left over ions in the proximal tubule -- more so Cl

Answer 271

1.8 grams a day

Answer 272

1.7 grams a day are reabsorbed 100 mgs are not reabsorbed?

Answer 273

They are excreted via urine Proteins are not absorbed anywhere else, only in proximal tubule

Answer 274

Proteins are reabsorbed via endocytosis or Pinocytosis - once the proteins are reabsorbed they are degraded into amino acids that can be absorbed

Answer 275

Carbonic Anhydrase

Answer 276

A compound is being actively pumped into the tubule

Answer 277

Once H binds to HCO3 to form H2CO3, Carbonic anhydrase speeds up the process of H2CO3 dissociating into CO2 & H2O which can easily diffuse across into tubular cells

Answer 278

Carbonic anhydrase speeds up the combining of CO2 & H2O to form carbonic acid (H2CO3) which then dissociates into HCO3 & H2O

Answer 279

H is paired with NH3 to form NH4

Answer 280

Bicarb would be absorbed & the NHE pump would slow down leading to acidosis - if the NHE pump is slowed Na reabsorption will be reduced, water will follow Na which would lead to less water reabsorption as well -- increased urine output

Answer 281

Proximal tubule

Answer 282

Glutamine will be used to produce 2 bicarbs (HCO3) & 2 ammoniums (NH4) - this occurs via stoichiometry by taking 1 glucose & converting it to produce 2 HCO3 & 2NH4

Answer 283

Liver - pts with liver failure have difficulty producing glutamine which then interferes with Acid/base balance

Answer 284

Greater inside the cell than outside the cell. Lots of cellular functions use phosphate.

Answer 285

No - a number of places

Answer 286

Paracellular (between cells) Transcellular (Through cells) A lot of Ca reabsorbed is dragged along with water and other stuff being reabsorbed

Answer 287

No: Just a channel selective for Ca

Answer 288

High outside the cell, inside the cell - calcium is motivated to come into the cell

Answer 289

Electro-gradient - the cell is negative, calcium is positive

Answer 290

Ca ATPase pump directly moves 1 Ca for 1 ATP. We also use the Na/Ca exchanger (3Na/1Ca), which is the same channel we have in the rest of the body

Answer 291

Variable: Depends on acid/base status

Answer 292

Harder to filter calcium if it is not free floating. i.e. calcium likes to hang around albumin (which is negatively charged, larger protein). Not all calcium in the plasma is filtered since it's following this larger negatively charged protein around

Answer 293

Parathyroid gland - monitors for levels of Ca in the ECF. This should mirror/relate to Ca levels in our blood

Answer 294

Little nodules on the SIDE (Para) of your thyroid

Answer 295

Parathyroid hormone (PTH) is released

Answer 296

- Encourages vitamin D3 activation - Increases the Ca reabsorption system in the kidney - Stimulates bone breakdown - Decreases activity of osteoblasts

Answer 297

- Increases amount of calcium we absorb from our diet

Answer 298

- If we take calcium supplements, we need to take it with activated vitamin D3 so it absorbs

Answer 299

-Increases numbers of calcium channels in the kidney. Not in Guyton, but daddy said so

Answer 300

-Increases osteoclast activity

Answer 301

Cells that break down bones - break bonds between calcium and phosphate which liberates them. Note: he said phosphate is broken by a different system, but that we shouldn't worry about that for now.. just know the above

Answer 302

Hardened calcium salt (Calcium and phosphate fused together)

Answer 303

Osteoblasts take calcium and phosphate, stick it together to form more bone Osteo = bone Blasts = build (if you see osteoB- just think B for build, makes it easy)

Answer 304

Osteoporosis High PTH -->increased osteoclast activity --> decreased bone mass --> used up stores of calcium --> Swiss cheese bones --> MORE LIKELY TO FRACTURE

Answer 305

Sarcoplasmic reticulum

Answer 306

Low Osteoclast - activity reduced Osteoblast - activity increased Emphasis from Schmidt - if we want to build bone, take calcium w/ activated vitamin D supplements. It reinforces bones and makes them stronger

Answer 307

- Acetylcholine - Creatine - Dopamine - Epinephrine - Choline - Histamine - Serotonin - Norepinephrine

Answer 308

- Atropine - Isoprel - Morphine - Procaine - Quinine - Tetraethylammonium

Answer 309

Two things headed the opposite direction (i.e. 1 of A comes into the cell, 1 of B leaves the cell etc.).

Answer 310

Look at the figures in the kidney book. He used them in class a lot

Answer 311

- Cation goes into PCT via secretion from renal interstitial space (got there by being leaked out of the peritubular capilaries. The peritubular capillaries reabsorb plenty of things, but they are porous*). [know this, pathway below) -Leaked from peritubular capillaries to the renal interstitial space - From renal interstitial space, transporters move the cation into the PCT cells - from PCT cells, removed from cell and placed into tubular lumen via proton cation antiporter (One proton comes into the cell, the organic cation leaves the cell and goes into the tubular lumen)

Answer 312

WWII, there was an interest in keeping injured military personnel alive. - was really the only antibiotic - Mold in petrie dish was making PCN producing mold/fungus - Used PCN in people (in 1942 for the first time), but did not stay in the blood for long - They found that synthetic hippurate made the PCN last a lot longer in the bloodstream, through competitive inhibition of antiporters (PCN and Hippurate use the same antiporter)

Answer 313

It can be used to secrete a little creatine. It's a larger compound that is also easily filtered/secreted Paraaminohippurate (sorry spelling)

Answer 314

- Bile salts - Hippurates - Prostaglandins - Urate/Uric acid - Oxalate acid

Answer 315

No. PAH is exogenous, however we do have other hippurates that ARE considered endogenous organic anions.

Answer 316

- Lots of drugs - Furosemide - Penicillin (super important; he stressed about kidney removing this easily without synthetic hippurate) - Salicylates - Sulfonamide - Acetazolamide - Chlorothiazide

Answer 317

Aspirin; Exogenous organic anion

Answer 318

aKG (Alpha Ketogluterate)

Answer 319

Freely floating around the cells normally in our body

Answer 320

- Within PCT, aKG (alpha-ketogluterate) is taken into the PCT cell alongside 3 Na. (from interstitial space; verify this) - Increased aKG (alpha-ketogluterate) concentration is tied to moving anion from renal interstitial space into the PCT in exchange for moving aKG back out to the interstitial space. - Facilitated transport allows anion to be moved into the proximal tubule for elimination

Answer 321

Not covered yet, but if you have extra time just look at it

Answer 322

2/3rds or 65%

Answer 323

2/3rds or 65%

Answer 324

The remaining percentage of solutes that were filtered is about 10% & the determination of whether or not these ions get reabsorbed is taken place in the later portions of the distal convoluted tubule & the collecting duct

Answer 325

Principle cells

Answer 326

Depends on how much ADH we have - ADH allows us to fine tune water reabsorption

Answer 327

Via the Na/Ca exchanger - Ca/ATPase pump also found here but majority of the work is done by Na/Ca exchanger

Answer 328

Na/K pump - it keeps the Na concentration intracellularly low by forcing Na into the renal interstitium -- this drives Na to want to come into the cell via Na/Ca exchanger

Answer 329

Thiazides - it inhibits the Na/Cl pump that allows entry of Na & Cl from the tubule into the Distal Tubular cells, this lowers the intracellular concentration of Na even more which in turn increases the motive of Na to want to come into the cell & place a Ca in the renal interstitium via Na/Ca exchanger

Answer 330

- Pts with osteoporosis as it increases calcium reabsorption - pts with history of kidney stones as it increases Ca reabsorption & kidney stones are crystalized calcium

Answer 331

Mineral Corticosteroid

Answer 332

it manages the amount of Na we hang on to

Answer 333

Principle cells

Answer 334

It binds to aldosterone receptors in the principle cells which increases the absorption of Na & H2O

Answer 335

Increases rate of secretion into lumen

Answer 336

K leaving via these K channels is driven by the Na/K pump therefore is still considered a secretory process

Answer 337

- speed of Na/K pump - the number Na channels on tubular lumen side - the number of open K channels on the tubular lumen side (Although daddy did say the details on the k channels are uncertain but he believes it is)

Answer 338

- ROMK -- these K channels are sequestered in the cell until K secretion is needed, then they will be placed on the cell wall (Aldo mediated) - BK channels (Big K) -- these are always found on the cell wall & do not move, these remain closed until ALOT of K secretion is needed (Aldo mediated - but details not certain)

Answer 339

Aldo & Potassium maintenance

Answer 340

ENaC - epithelial Na channels, these are Aldo mediated - tubule is made up of epithelial cells

Answer 341

Amiloride & Triamterene - useful if we want retain K

Answer 342

Spironolactone & Eplerenone

Answer 343

- ENaC Blockers --> prevent influx of Na from tubule --> this slows Na/K pump --> reduces the amount of K being secreted - Aldosterone antagonists --> prevent aldosterone from binding --> this slows Na/K pump & slows the amount of Na we reabsorb --> in turn reduces the amount of K we secrete

Answer 344

Directly increase the reabsorption of Na & indirectly increase the secretion of K

Answer 345

Zona glomerulosa -- outermost part of the adrenal gland

Answer 346

Zona fasciculata & Zona Reticularis - both are deeper in the adrenal cortex but Zona Reticularis is deeper than Zona fasciculata (so basically below it)

Answer 347

Zona fasciculata

Answer 348

Medulla -- the inner part of the adrenal gland

Answer 349

Epi is produced more by a 4:1 ratio

Answer 350

Sensitive to K levels - High levels of K --> more aldo released to reduce K - Low levels of K --> less aldo released to preserve K

Answer 351

Excess cortisol can bind to aldosterone receptors & release aldosterone which leads to increase reabsorption of Na & H2O & ultimately HTN & hypokalemia

Answer 352

Angiotensin II by binding to AT1 receptors found in the Zona Glomerulosa

Answer 353

11Beta-HSD Type 2

Answer 354

Intercalated cells - 2 types --> Type A & Type B

Answer 355

Secrete protons (H) - deals with acidosis

Answer 356

Reabsorb protons & secrete bicarb - deals with Alkalosis

Answer 357

- Hydrogen ATPase pump - takes 1 H & burns an ATP to dump it in the lumen -- this pumps givens type A cells the ability to pump ALOT of H if needed - H/K ATPase Pump - takes 1K in & pumps 1H out into lumen

Answer 358

Vasopressin (AVP) or ADH

Answer 359

V2 receptors

Answer 360

cAMP is increased which leads to activation of enzymes --> Protein Kinase A --> phosphorylates Aquaporin channels (AQP-2) which leads to more aquaporin channels being placed on the lumenar side of the principle cell --> leads to increased water reabsorption

Answer 361

AQP-3 & AQP-4

Answer 362

Nephrogenic Diabetes insipidus

Answer 363

Central Diabetes Insipidus

Answer 364

Diluting segment -- called this because we reabsorb electrolytes here & not water

Answer 365

Alcohol reduces the amount of ADH released from the brain & reduces kidneys response to ADH

Answer 366

300 mOsm - same as plasma as both water & Na were reabsorbed

Answer 367

1200 mOsm - renal interstitium is heavy concentrated leading to reabsorption of water

Answer 368

100 mOsm - solutes were reabsorbed but water was not diluting tubular fluid

Answer 369

300 mOsm - renal interstitium osmolarity begins to increase & water follows

Answer 370

1200 mOsm - this is in conservation mode where renal interstitium is heavy concentrated leading to a lot of water reabsorption

Answer 371

- the renal interstitium will be reduced 1200 leading to less water reabsorption in the loop & collecting duct - as the tubular fluid makes its way down the collecting duct Ions will still be absorbed however water will not as there is no ADH to activate aquaporin channels & urea transporters leading to an even lower urine osmolarity

Answer 372

ECF - 4/5ths Plasma - 1/5th

Answer 373

High Na intakes --> ANGII is reduced --> Aldo is reduced --> Reduced amount of salt that is reabsorbed as well as water

Answer 374

High salt intake will lead to an increase in BP as more Na is being reabsorbed d/t high ANGII levels and water follows Na leading to increased blood volume - Decrease Na intake

Answer 375

Less ANGII --> less Aldo --> less Na & water being reabsorbed --> low BP - increase Na intake

Answer 376

ACE inhibitors block ANGII & affects body's ability to deal with hypotension as ANGII plays a crucial role in dealing with low BP

Answer 377

High Na --> decreases ANGII to get rid of excess salt --> long term levels of low ANGII will lead to poor management of hypotensive states

Answer 378

The BP in the stenotic kidney will be low --> low BP leads to low pressures in the glomerulus capillaries & Low GFR --> less Na/Cl will reach the macula densa --> Kidney will think GFR is low & secrete renin which converts to ANGII --> ANGII will work on efferent arteriole to increase GFR & increase Na reabsorption --> this will lead to increased MAP

Answer 379

ANGII will increase pressure in the healthy kidney, the healthy kidney will try to compensate by reducing its amount of renin --> however this will only have slight effect on the overall pressure

Answer 380

ACE inhibitors, ARBS, & Renin inhibitors

Answer 381

Taste bud is an electronically excitable cell -- it has both Na & K channels (No Cl channels) -- the more Na we have around the cell the taste bud the more excitable/positive it becomes making our food easier to taste

Answer 382

2/3rds i.e, 2/3rds of calcium is reabsorbed at the PCT.

Answer 383

Thin descending loop of henle As the tubule goes from the cortical area to medullary area of the kidney, the interstitial space is highly osmotic. This segment is permeable to water, so water reabsorption occurs. Not many ion transporters here - primary thing is water reabsorption.

Answer 384

2/3 PCT "A bunch more" in the descending loop of henle Fine tune adjustment in the later parts of the tubule

Answer 385

Coming from medullary to cortical area of the kidney - interstitial space is less osmotic. This area is relatively impermeable to water, so there is not much reabsorption here. NaCl transporter - Uses active transport via ATP/primary active transport to reabsorb relatively small amounts of NaCl from tubular fluid.

Answer 386

Important place for reabsorption of cation electrolytes of the tubular fluid. Driven by a system that allows K to leak back into the tubular fluid (or interstitial fluid if we need to not reabsorb as much mg/ca) via K leak channels on either end of the tubular cell. Mg, Ca - come though the paracellular route

Answer 387

+8mV (note, other areas of tubule were +3) Increased amount of K in the tubular fluid makes the charge this way. This charge helps push Mg/Ca (as they have a double positive charge) back into the tubular cells to be reabsorbed.

Answer 388

Na/K/ATPase pumps

Answer 389

Na/H (one H into the tubule, one Na in the tubular cell)

Answer 390

Thick ascending limb of henle is responsible for concentrating the renal interstitium. NKCC pump (Transports 1 Na, 1K, and 2 Cl into the tubular cell from the tubular lumen) is responsible for concentration of the renal interstitium. The concentration settles into the deeper areas (1200mOsm is the highest concentration) Note: K leaks back out of the cell to help Mg/Ca move via the paracellular route to be reabsorbed.

Answer 391

Diuretics shut down the NKCC (1 Na, 1Ka, 2Cl into the tubular cell) pump. This decreases concentration of the renal interstitium, which inhibits the ability to reabsorb water. We depend on the concentration of the renal interstitium to reabsorb water. Result: More water shows up in urine.

Answer 392

300mOsm 1200mOsm 100mOsm

Answer 393

1200 Note: He hinted that if there was higher flow, the osmolarity may not be the same.. Something to think about with high BP or poor autoregulation with hyperfiltration

Answer 394

Lizards live in arid environments and need to conserve water for extended time frames. Lizard osmolarity is significantly more concentrated, so they are able to reabsorb much more water.

Answer 395

Parathyroid hormone (PTH) Increases Ca reabsorption

Answer 396

Na/Ca exchanger Ca/ATPase pump ^These two are usually found together.

Answer 397

NaCl channel (1Na in, 1 Cl in as well)

Answer 398

Na/Cl channel in the DCT

Answer 399

A quarter Called the diluting segment sometimes; diluting electrolytes but no water from the tubule.

Answer 400

Vasopressin

Answer 401

Antidiuretic hormone (ADH)

Answer 402

Hang on to water - high vasopressin levels Get rid of water - low vasopressin levels

Answer 403

Central Diabetes Insipidus (dumping large amounts of urine) Brain stops producing ADH

Answer 404

Osmolarity of blood (i.e., salty blood from dehydration would cause high vasopressin levels so we can hang on to more water) BP - if the arterial BP is low (or blood volume), Vasopressin is released to hold onto volume to raise BP.

Answer 405

No pressure

Answer 406

Large veins, atria

Answer 407

Baroreceptors

Answer 408

Osmolarity of blood

Answer 409

Cells that specialize in sensing osmolarity. They send information to two nuclei in the brain (within hypothalamus/posterior pituitary)

Answer 410

Hypothalamus

Answer 411

Two production centers Supraoptic neuron - nuclei (collection of cell bodies) in front of the hypothalamus, but above the optic nerve Paraventricular nucleus - located on each side of the 3rd ventricle

Answer 412

5/6th of our ADH - major production area

Answer 413

Posterior pituitary From there, it is dumped into a rich network of blood vessels surrounding the posterior pituitary to be distributed around the body

Answer 414

Neurohypophysis

Answer 415

Adenohypophysis

Answer 416

Volume wouldn't change much - same osmolarity inside vs outside the cell

Answer 417

The cell would swell. The osmolarity in the cell is greater than the solution, so water would move from the solution into the cell to balance the osmolarity. Reduce the amount of vasopressin (ADH) production - if we get rid of water, we can get closer to a normal osmolarity.

Answer 418

Cellular dehydration - water would leave the cell to attempt to balance the osmolarity between the cell and solution. Vasopressin (ADH) production would increase - we want to conserve free water to dilute the osmolarity, thus bringing it closer to normal.

Answer 419

Think of the cell as an osmoreceptor. With swelling osmoreceptors (cell), the rate of production of action potentials to the vasopressin production are is decreased. With shrinkage of osmoreceptors (cell), the rate of action potentials sent to the vasopressin production area is increased. Vasopressin production is increased. Note: He compared this to the neuro stretch receptors; these work opposite to those.

Answer 420

Low: 50mOsm High: 1200mOsm

Answer 421

Vasopressin (ADH)

Answer 422

Urea reabsorption from tubular fluid

Answer 423

Waste product of metabolism Useful for water reabsorption (raises osmolarity of interstitium)*** major component of the concentrated renal interstitium**** Filtered freely due to being small. No specific channel, just dragged along with everything else. Reabsorbed in the late PCT and loop of henle.

Answer 424

Aquaporin channels

Answer 425

Cell wall of the collecting duct (prevents some urea from being removed from the body)

Answer 426

UT-a1 UT-a3

Answer 427

Vasopressin (ADH); the only thing in our body that influences water reabsorption WITHOUT affecting salt reabsorption. Aldosterone/AGII both influence water reabsorption, but also affect salt reabsorption.

Answer 428

not really - kidney does a good job managing osmolarity (But NOT perfect, slight slant on autoregulation graph)

Answer 429

The vasopressin system is knocked out, which then knocks out control of osmolarity. This would result in significant swings in plasma osmolarity.

Answer 430

Probably have too much fluid - decrease in vasopressin to fix it

Answer 431

Gastric distention decreases thirst

Answer 432

Keep lips moist. Dry lips lead to increased signaling to drink water/thirst.

Answer 433

Alcohol Clonidine Haloperidol

Answer 434

Body anticipates vomiting. When we vomit, we lose fluids. When we lose fluids, the brain produces more vasopressin to conserve/replace lost fluid.

Answer 435

Morphine Nicotine

Answer 436

Not much - it is controlled (but slanted graph) as long as we have a functional aldosterone system.

Answer 437

Renal failure High dose of spironolactone or triamterene If we take the control system offline, we have to be careful about K intake, as levels could change dramatically.

Answer 438

Blood osmolarity is reduced slightly. Vasopressin levels are reduced. Urinary flow rate goes up within around half a hour. Urinary flow rate goes up until blood osmolarity is balanced once again, taking just a few hours. Urinary osmolarity will have massive decrease during time that water reabsorption decreases. (more water, no extra electrolytes).

Answer 439

Doesn't affect electrolytes - only water.

Answer 440

600mOsm We see wide ranges between person to person, as we all consume vastly different diets (often times too much salty pizza)

Answer 441

Might have a small increase in BP, but the kidney is able to take care of most of it with no long term BP effects.

Answer 442

They have a higher baseline BP than a normotensive person. The kidneys are capable of maintaining BP/fluid status without long term BP effects even with HTN. Note: The kidneys are slightly less capable of managing fluid/salt status in patients with essential HTN than someone who is normotensive.

Answer 443

Renalvascular HTN - Usually because of a stenotic renal artery, which creates salt sensitivity. The kidneys have a lard time getting rid of extra electrolytes and fluid because of this. The higher our salt intake, the higher our BP in this case. Note: Anything that over expresses the RASS system will create some salt sensitivity.

Answer 444

African American people tend to have salt sensitive HTN, as well as some parts of Asia. African Africans don't have salt sensitive HTN. African Americans who have recent ties to African Africans usually do not have salt sensitive HTN.

Answer 445

We expect to see over expression of RASS, but instead we see LOW RASS activity. Despite this, ACE inhibitors are still useful even through there's not much to inhibit.

Answer 446

Diet can play a role in HTN, but HTN is usually genetic.

Answer 447

Every molecule of an osmotic diuretic = one less water molecule reabsorbed. An osmotic diuretic is filtered, but not reabsorbed. Manitol is an osmotic diuretic. Glucose can be an osmotic diuretic if it stays in the tubule. 5000iU of vitamin C is filtered but not reabsorbed well - can be an osmotic diuretic.

Answer 448

Angiotensin I

Answer 449

Na/electrolyte reabsorption is dependent on ATI receptors. If we block AGII, AGI receptors are not activated. Less AGI activity = less Na reabsorption in the tubule.

Answer 450

AGII - will talk about this more next semester; can constrict blood vessels

Answer 451

K sparing diuretics

Answer 452

K wasting diuretics

Answer 453

There is a taste receptor. This receptor is activated when the cell fires an action potential. Action potentials are driven by Na/K channels. Salt increases excitability of the cell, leading to increased action potentials, and more tasty food.

Answer 454

Potassium - a little goes a long way, and it tastes bad.

Answer 455

Less thirst; won't drink as much, fluid volume will decrease

Answer 456

Add more salt

Answer 457

To save the other kidney from damage. If a kidney is stenotic, there is less flow --> less NaCl past the macula densa --> more renin --> more AGII --> elevated BP --> raises glomerular pressures of healthy kidney an can cause harm

Answer 458

Broke - creatinine Rich - Inulin

Answer 459

1.25mg/min (125mL/min) 1mg/dL x 1.25dL/min = 1.25mg/min

Answer 460

0.15mg/min; small amount compared to what is filtered (1.25mg/min) He said don't worry about this.. but just in case

Answer 461

1.40mg/min creatinine excreted. Excretion = production normally, so 1.40mg/min creatinine is produced. Excretion = production Will not build up in our blood under normal circumstances

Answer 462

Filtration Small amount is secreted into the tubule from peritubular capillaries

Answer 463

Filtered load + secretion into tubule - absorption = excretion

Answer 464

Byproduct of skeletal muscle metabolism

Answer 465

No: split between 2,000,000 nephrons if we're under 40, healthy, with both kidneys.

Answer 466

Filtration will now be 0.625dL/min (62.5mL/min). This is half as much as before. We are filtering less fluid, so we will also excrete less. We still produce the same amount (1.40mg/min). If we lose half of our nephrons, we must find a new normal balance of production/excretion. Creatinine levels double if half of the nephrons are lost. Each halving of nephrons doubles creatinine level again and again, as we need more and more creatinine to filter the same amount as before (increases workload of remaining nephrons). Sorry wordy

Answer 467

When we lose a kidney, we double the workload of the remaining nephrons. We also double concentration of creatinine. When we have COPD, the body has trouble getting rid of extra CO2, so over time the blood CO2 levels rise till it finds a new equilibrium. (breathe off as much as we are producing). More concentration of CO2 = easier it will be to get rid of CO2

Answer 468

Sicker, worse blood sugar, higher BP (Nephrons take a harder beating over time) As we lose nephrons, filtration is reduced, workload is increased, and creatinine is increased.

Answer 469

There is physiologic hypertrophy. The GFR is able to increase by as much as 50%, so looking at these patients a year later would not have the GFR we expect - they would have higher. The kidney would not have much overwork injury. This is similar to the heart with exercise.

Answer 470

Diabetes induced hypertrophy of the kidney - likely will get worse, not better.

Answer 471

No - somehow the kidney can filter 50% more than usual while keeping the glomerular pressure at 60mmHg

Answer 472

No - the remaining adrenal gland can pickup the workload similar to the kidney.

Answer 473

62.5nl/min (nanoliter)

Answer 474

0.75nl/min

Answer 475

Yes Decreased ability to do work. Can't eat as much salt, K, proteins (break into amino acids) Takes a lot of work to filter/excrete/secrete this stuff - takes a toll on the nephrons

Answer 476

Acid-base balance is toast Can't get rid of protons as well - results in metabolic acidosis.

Answer 477

2/3rds ICF 1/3rd ECF

Answer 478

Same osmolarity roughly. Not much water movement - no need for osmolarity to change. Fluid stays in ECF

Answer 479

Fluid has more water than salt than we do in our bodies. Lowers osmolarity in all compartments. Water stays in ECF, but some moves over to the ICF to help balance osmolarity.

Answer 480

Fluid has a larger portion of salt than water than our bodies. Osmolarity of body will be elevated. Extra salts from ECF will pull water from ICF into the ECF to balance osmolarity. This can cause cellular dehydration.

Answer 481

It is! You've made it to the end!