Kidney and drug excretion Flashcards

1
Q

Kidneys receive 20% of cardiac output. True or false?

A

True

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2
Q

What is the role of the kidneys?

A

Elimination of nitrogen-containing waster e.g urea and uric acid
Maintain water, ionic and pH balance in body fluids
Central role in filtering blood and forming urine
Production of hormones
Elimination of drugs and metabolites

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3
Q

Which region of the kidney filters blood?

A

glomerular

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4
Q

Where is the renal pyramid found?

A

In the medulla

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5
Q

The nephron represents a functional unit of the kidney. True or false?

A

True

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6
Q

What does the renal corpuscle consist of?

A

Bowman’s capsule

Glomerulus

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7
Q

What are the functions of the renal corpuscle?

A

Filter the blood (glomerular filtration)

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8
Q

After blood has been filtered, the remaining blood leaves the glomerulus via ___________

A

efferent arterioles

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9
Q

The renal copuscle has two arteries - one going in and one going out. True or false?

A

True

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10
Q

What is the advantage of using inulin?

A

There isn’t any present in the body unless it is administered so it gives a good indication for GFR

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11
Q

What factors influence GFR?

A

Body size
Gender
Age

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12
Q

GFR in men is higher than women. True or false?

A

True

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13
Q

Where does glomerular filtration take place?

A

From the glomerular capillaries to the Bowman’s capsule

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14
Q

Glomerular filtration is an active process. True or false?

A

False - it is a passive, non-selective process

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15
Q

How does tubular secretion work?

A

Selective transport of molecules from the peritubular fluid to the lumen of renal tubules - facilitates excretion

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16
Q

Tubular excretion involves either transporters or passive diffusion. True or false?

A

True

17
Q

Tubular excretion takes place in proximal tubules only. True or false?

A

False - takes place in distal tubules too

18
Q

Which transporters are expressed in the basolateral membrane of the renal epithelia?

A

OAT1
OAT3
OCT2

19
Q

What does OAT1 transport?

A

Small organic anionic drugs

20
Q

What does OCT2 transport?

A

Small organic cationic drugs

21
Q

Transporters are present only on one side of the basolateral membrane of the renal epithelia. True or false?

A

False - present on both sides

22
Q

How does tubular reabsorption work?

A

Selective transport of molecules from the lumen of the renal tubules back to the plasma

23
Q

Is the descending loop of Henle permeable to Na+?

A

No

24
Q

Is the ascending loop of Henle permeable to Na+?

A

Yes

25
Q

Ascending loop of Henle passively absorbs Na+ and is not permeable to water. True or false?

A

False - actively reabsorbs

26
Q

What affects the rate and extent of reabsorption of drugs?

A

Lipophilicity

Degree of ionisation

27
Q

Unbound and unionised form of drug crosses the membrane. True or false?

A

True

28
Q

Renal drug excretion is a net effect of which 3 processes?

A

Glomerular filtration
Secretion
Reabsorption

29
Q

Nephron units are bad at removing nitrogenous wastes and conserving water and mineral ions. True of false?

A

False - very efficient at doing both

30
Q

Why do diabetics experience increased urination?

A

Because there is glucose in the urine so an increase in osmotic pressure in the renal tubule, leading to decrease in water reabsorption and an increase in urination

31
Q

For renal impairment, when is a dose adjustment needed?

A

If the fraction of drug excreted unchanged is more than 50%
Drugs with a narrow therapeutic window
Patient with impaired metabolism