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Bloc D - Renal > Jan3 M1-GFR > Flashcards

Jan3 M1-GFR Flashcards

1
Q

cortex content

A

glomeruli, tubules

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2
Q

medulla content

A

collecting ducts, loop of Henle

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3
Q

embryo of nephron

A

two types of cells join in DCT

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4
Q

3 filtration layers at glomerulus from inside capillary to outside

A

endothelial layer, BM layer, foot processes of podocytes

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5
Q

podocytes are what

A

specialized epithelial cells

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6
Q

what filtrate does not contain

A

cells, proteins, fats*

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7
Q

max size of molecules going in filtrate

A

70 kDa (70 kg per mol)

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8
Q

albumin size + why not in filtrate

A

62 kDa. is negative. BM and podocytes are negative.

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9
Q

albumin of urine sign of what + 2 things that might have happened

A

glomerular disease.

damage to one of 3 layers OR loss of negative charge

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10
Q

how filterability of a substance varies with size and charge

A

less with bigger size.

positive > neutral > negative

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11
Q

clearance def

A

how much of a substance is removed from the circulation by the kidney and put into urine per unit time

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12
Q

GFR formula

A

K((Pgc - Pt) - (OPgc - OPt) = GFR

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13
Q

K in GFR formula

A

ultrafiltration coefficient (total capillary area available for filtration)

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14
Q

what can affect K

A

glomerular disease, immune complex deposition

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15
Q

what can affect Pgc

A

aff and eff R, diabetes, htn, CKD

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16
Q

what can affect Pt

A

tubular obstruction

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17
Q

what can affect OPgc

A

hypoalbuminemia, nephrotic syndrome

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18
Q

creatinine origin

A

creatine in muscle converted to Cr

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19
Q

Cr values needed to get GFR (or Crcl): what’s the formula

A

GFR x plasma conc Cr = urine conc Cr x urine volume

20
Q

what urine volume to use in crcl or GFR formula

A

24 hour urine collection

21
Q

how Cr varies with GFR

A

lower GFR = higher Cr (blood!!)

22
Q

stage 1 CKD def

A

kidney damage, normal GFR, above 90

23
Q

stage 2 CKD def

A

kidney damage, mild drop in GFR, 60-89

24
Q

stage 3 CKD def

A

moderate drop in GFR. 30-59

25
Q

stage 4 CKD def

A

severe drop in GFR. 15-29

26
Q

stage 5 CKD def

A

ESRD. less than 15.

27
Q

stage 5 CKD meaning

A

dialysis or need for dialysis or pre-dialysis

28
Q

urinary creatinine qt for males and females

A

males 0.2 mmol per kg daily

females 0.15 mmol per kg daily

29
Q

urinary creatinine used for what

A

check if complete 24 hr urine collection is done

30
Q

real way of determining GFR

A

Cockroft Gault formula: use serum Cr only

(140-age)xweightx(1.2 if male)div.serum Cr

31
Q

2 things to note about Cr and GFR

A
  1. have to be in steady state

2. CrCl overestimates GFR bc Cr secreted in PCT

32
Q

normal GFR

A

100 ml per min

33
Q

things that can affect Cr production (2)

A

meat intake and age (less muscle mass)

34
Q

urea origin and absorption in tubule

A

comes from a.a metab

PCT

35
Q

urea vs GFR

A

inversely proportional

36
Q

urea and Cr in hypovolemia

A

urea rises much more than Cr so can assess patients with acute renal failure

37
Q

range of renal autoregulation

A

BP 80 to 160

38
Q

renal autoregulation goal

A

maintain GFR

39
Q

renal autoregulation 5 components

A

myogenic, ATII (RAAS), SS, PGs, TG feedback

40
Q

myogenic reflex of autoregul

A

low BP: AA dilates and EE constricts

high BP: AA constricts and EE dilates

41
Q

components of juxtaglomerular apparatus

A
  1. macula densa cells of the DCT in contact with AA

2. juxtaglomerular cells (modified SM cells) in AA

42
Q

TG feedback (3 steps)

A
  1. macula densa cells sense NaCl in DCT
  2. if too low, produce NO to dilate AA
  3. juxtaglomerular cells release renin if BP is low (sense low volume)
43
Q

vasoconstriction in renal autoregul

A

SS reaction to drop in BP (SS: epinephrine causes vasoconstriction)

44
Q

ATII (RAAS) in renal autoregul

A

renin leads to ATII prod.

ATII constricts EA more than AA

45
Q

PGs in renal autoregul

A

PGs dilate the AA to preserve GFR

46
Q

NSAIDs and GFR

A

NSAIDs block PGs so drop GFR

Bloc D - Renal (32 decks)

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