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Cardiovascular, renal and PNS > Kidney > Flashcards

Kidney Flashcards

1
Q

functions

A

regulation of extracellular fluid volume

maintenance of ion balance + pH in plasma

excretion of foreign substances

renin secretion + activation of RAAS

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2
Q

nephron

A

basic functional unit of the kidney

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3
Q

glomerulus

A

site of ultrafiltration of blood

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4
Q

loop of Henle

A

countercurrent multiplier

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5
Q

Net pressure in ultrafiltration

A

(glomerular capillary hydrostatic pressure - oncotic pressure in Bowman’s space) - (oncotic pressure of blood plasma - pressure in Bowman’s space)

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6
Q

what does the glomerular filtrate has similar contents to in a normal kidney?

A

blood plasma (except for plasma proteins and blood cells)

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7
Q

reabsorption/absorption

A

movement of solutes and water from tubular filtrate into interstitial fluid and plasma

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8
Q

secretion

A

movement of solutes and water from plasma and interstitial fluid into tubular filtrate

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9
Q

transcellular

A

through epithelial and across luminal/basolateral membrane

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10
Q

excretion

A

extrusion of solutes and water in tubular filtrate by kidneys

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11
Q

major sites Na+ reabsorption

A

PCT - 60-70%

thick ascending loop - 20-30%

DCT - 5-10%

collecting duct - 1-3%

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12
Q

diuresis

A

increased excretion of urine

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13
Q

what are the different types of group diuresis?

A

loop diuretics -> act on thick ascending loop of Henle

thiazides/thiazide-like -> act on distal tube

potassium-sparing diuretics -> act on collecting duct

osmotic diuretics -> act on PCT and thin descending limb of loop of Henle

carbonic anhydrase inhibitors -> act on PCT

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14
Q

luminal membrane of collecting duct

A

passive Na+ / K+ exchange

Na+ co-coupled transporters

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15
Q

basolateral membrane of collecting duct

A

active transport of Na+ / K+ via pump

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16
Q

tight junctions

A

leaky and freely permeable to water and some ions

17
Q

what is the driving force of sodium reabsorption in PCT?

A

activity of basolateral Na+ - K+ ATPase

creates Na+ concentration gradient between tubular lumen and interstitial space

18
Q

role carbonic anhydrase

A

H2CO3 -> H2O + CO2 in lumen

CO2 + H20 -> HCO3- + H+ inside epithelial cell

H+ excreted via luminal Na+ / H+ exchanger

19
Q

why is urine alkalisation beneficial?

A

increases excretion of weak acids

decreases crystallisation of weak acids in urine

prevents formation of uric acid + stones

20
Q

agents that are used therapeutically to increase pH of urine

A

sodium bicarbonate -> treat aspirin overdose

citrate -> metabolised to bicarbonate (increases base secretion in urine)

21
Q

mechanism of action for loop diuretics

A

inhibition of luminal Na+ / K+ / 2Cl- co-transporter

22
Q

renal effects of loop diuretics

A

reduces Na+ / Cl- reabsorption

increases K+ / Ca2+ / Mg2+ excretion

23
Q

therapeutic uses of loop diuretics

A

acute pulmonary oedema

chronic heart failure

oedema due to nephritic syndrome (loss of plasma proteins through glomerulus)

liver cirrhosis

resistant hypertension

24
Q

mechanism of action for thiazides/thiazide-like diuretics

A

inhibition of luminal Na+ / Cl- co-transporter

25
Q

renal effects of thiazides

A

reduces Na+ / Cl- reabsorption

increases K+ / Ca2+ reabsorption

26
Q

thiazide vs loop diuretics

A

[thiazide]

= less powerful

= moderate diuretics

= more prolonged actions

= have vasodilation properties after prolonged used

27
Q

potassium-sparing diuretics

A

Prevent Na+ reabsorption in collecting tubule

28
Q

potassium-sparing diuretics - therapeutic effects

A

treat hypokalaemia

heart failure

aldosteronisms

29
Q

aldosterone

A

made in adrenal cortex

released when drop in blood pressure

-> increases activation of luminal Na+ channels
-> increases synthesis of basolateral Na+ / K+ ATPase

30
Q

ADH - MoA

A

increases expression of aquaporin-2 on luminal membrane

31
Q

ADH - renal effects

A

increases water reabsorption = increased BP

32
Q

effect of caffeine/alcohol on ADH

A

inhibits secretion of ADH from pituitary gland

increases urine production

33
Q

effect of nicotine on ADH

A

stimulates ADH secretion

decreases urine production

34
Q

diabetes insipidus (DI)

A

production of large amounts of diluted liquids

35
Q

Neurohypophysis (central) DI

A

reduced ADH secretion but normal kidney response

causes = brain trauma, surgery, genetics

treatment = desmopressin (synthetic ADH)

36
Q

nephrogenic DI

A

normal ADH levels but impaired kidney response

causes = lithium poisoning, kidney diseases, genetics

therapy = thiazides

Cardiovascular, renal and PNS (16 decks)

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