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Renal Week 1 > Glomerular Hemodynamics > Flashcards

Glomerular Hemodynamics Flashcards

1
Q

what is male percentage of body weight that is water? Female?

A

60%

50%

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2
Q

what percent of water is in cells?

A

2/3

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3
Q

what fraction of water is extracellular fluid?

A

1/3

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4
Q

what percent of the ECF fluid is in plasma?

A

25%

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5
Q

what percent of the ECF fluid is in the interstitium?

A

75%

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6
Q

how is osmolality defined?

A

mOsm of a solute per kilogram of water

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7
Q

define tonicity

A

effective osmolality refers to the osmolality of solutes that do not freely cross the membrane

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8
Q

what is the normal osmolality of ICF and ECF?

A

275-295 mOsm/Kg

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9
Q

do salt and water intake directly affect the tonicity?

A

sure do

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10
Q

what four molecules contribute to the total osmolality?

A

Na, Glucose, BUN, and alcohol

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11
Q

what is the equation for total osmolality?

A

2xNa+glucose/18+BUN/2.8+EtOH/3.7

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12
Q

what is the equation for effective osmolality?

A

2xNa+glucose/18

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13
Q

why are BUN and EtOH not included in the effective osmolality equation?

A

because they do not cross the membrane

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14
Q

between ICF and ECF, what is exerting force for movement?

A

TONICITY

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15
Q

what is the net excretion equation?

A

filtration+secretion-reabsorption

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16
Q

what is the glomerular filtration rate?

A

rate of filtration at the glomerulus…main measure of kidney function

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17
Q

what is normal GFR for female and male?

A

Femal 95+-20

Male 120+-25

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18
Q

what is normal renal blood flow?

A

1000ml/min

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19
Q

equation for renal plasma flow?

A

renal blood flow X (1-hematocrit)

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20
Q

how to calculate the filtered load of a molecule?

A

GFR times the Plasma concentration of the solute

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21
Q

how to measure the excreted load?

A

Flow rate of urine times urine concentration of solute

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22
Q

how to measure reabsorption?

A

filtered load minus excreted load

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23
Q

how to measure secretion amount of solute?

A

excretion load minus filtered load

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24
Q

what is the unit of clearance?

A

ml/min

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25
Q

define clearance rate?

A

volume of plasma that is completely cleared of a substance per unit time

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26
Q

what is the clearance formula?

A

urine flow rate times urine concentration of solute divided by plasma concentration of solute

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27
Q

what is required to use a clearance formula?

A

plasma concentration must be in a steady state

28
Q

when is clearance 0?

A

when there is no filtration or secretion or solute totally reabsorbed

29
Q

in what scenario is GFR equal to excretion?

A

when solute is freely filtered, but not secreted or reabsorbed

30
Q

which two molecules almost meet requirements where GFR is equal to excreted load or clearance?

A

inulin and creatinine

31
Q

where do we get inulin?

A

from infusion…so to test GFR with this it takes a while

32
Q

since inulin is tough to use for GFR, what body molecule can we use? why?

A

creatinine…stable levels in plasma…only little bit is secreted and nothing is reabsorbed so pretty accurate of the GFR

33
Q

what two things are needed for a creatinine GFR test?

A

plasma sample and urine sample

34
Q

what three things can affect the levels of creatinine?

A

diet, changes in muscle mass and age

35
Q

how many milliliters are in a deciliter?

A

100 ml/dl

36
Q

how will creatinine levels be affected if GFR is low?

A

plasma creatinine increases in proportion to the decline in the GFR

37
Q

in acute changes of GFR, what happens to creatinine levels in the plasma?

A

they remain the same

38
Q

if creatinine levels in plasma remain the same and the GFR is cut in half, what happens to the filtered load and clearance volume?

A

it is halved as well

39
Q

after an acute change in GFR, how does the body respond to normalize the filtration load?

A

increases plasma creatinine concentration over time

40
Q

what molecule is used to measure renal plasma flow?

A

PAH para amino hippuric acid

41
Q

what percent of PAH is filtered and actively secreted in one pass?

A

90%

42
Q

since only 90% of PAH is cleared, how do we estimate the renal plasma flow with this number?

A

clearance is equal to 90% of renal plasma flow

43
Q

what is the equation for RPF?

A

RPF is equal to (UV/Ppah)/0.9 extraction ratio

44
Q

what is the filtration fraction?

A

fraction of plasma that is filtered

45
Q

what is the filtration fraction equation?

A

GFR/RPF

46
Q

what does the filtration fraction usually equal to?

A

20%

47
Q

the basement membrane in the glomerular filtration is negatively or positively charged?

A

negatively

48
Q

the negative charged basement membrane of the glomerulus makes it harder for which molecules to pass and easier for which molecules?

A

harder for negative charges

easier for positive charges

49
Q

what is the size cutoff for filtration through glomerulus?

A

40 angstroms

50
Q

why is albumin not filtered through glomerulus?

A

it is 36 angstroms but since it has a negative charge it cannot pass through the basement membrane

51
Q

compared to positive charged molecules, negatively charged molecule need to be bigger or smaller to pass through glomerulus filtration barrier?

A

Smaller

52
Q

give the starling force equation for GFR

A

Kf((PGC-PBS)-(oncoticGC-oncoticBS))

Kf is coefficient
PGC is hydrostatic pressure in caps
PBS is hydrostatic in space

53
Q

does plasma oncotic pressure increase or decrease along length of capillary?

A

increases because fluid going out and proteins staying in capillary

54
Q

does hydrostatic pressure increase or decrease along lenght of glomerular capillary?

A

pretty much stays the same

55
Q

hos is GFR maintained at variable MAPs?

A

RAAS autoregulation

56
Q

does urinary obstrcution lead to higher or lower GFR?

A

lower GFR because increased pressure in bowmans space

57
Q

does increased albumin lead to higher or lower GFR?

A

lower because of high levels of plasma oncotic pressure and water retention

58
Q

in hypovolemia, the RAAS system is activated and leads to an increase in what molecule?

A

angiotensin II

59
Q

in hypovolemia angiotensin II has what effect in glomerulus?

A

constricts the efferent arteriole…so increases the GFR

60
Q

in hypovolemia, the GFR increases and the efferent arteriole is constricted…so what happens to the RPF and the filtration rate?

A

RPF decreases and FF increases

61
Q

in hypovolemia, will the peritubular capllaries have increased or decreased plasma oncotic pressure? what effect will this have?

A

increased…leads to more reabsorption of filtrate and volume of blood increasing

62
Q

in hypervolemia, what is turned off?

A

RAAS system…so decrease angiotensin II

63
Q

in hypervolemia, what does the decreased angiotensin II do to the glomerulus?

A

dilates the efferent arteriole and therefore decreases the GFR

64
Q

in hypervolemia, the GFR is increased, but what about the RPF and the filtration rate?

A

RPF is increased and the FF is decreased

65
Q

in hypervolemia, with the low GFR, what happens to peritubular plasma oncotic pressure? what effect does this have on filtrate?

A

decreases the oncotic pressure and therefore less filtrate is reabsorbed and volume is lost

66
Q

diabetes insipidus is a disorder of what molecule? and leads to what?

A

ADH production is low or resistant…leads to loads of urine

Renal Week 1 (8 decks)

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