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PJ1311 Semester 2 > Kidneys > Flashcards

Kidneys Flashcards

1
Q

List the key functions of the kidney

A

Regulate fluid osmolality/volume
Regulate electrolyte balance
Acid/base balance
Excrete metabolic product and foreign substances
Produce/excrete hormones
Gluconeogenic

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2
Q

Where does filtration start

A

Glomerulus

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3
Q

Functioning unit of kidney

A

Nephron

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4
Q

Forces influencing filtration in kidney

A

Hydrostatic pressure/blood pressure
Colloid osmotic pressure
Fluid pressure in bowman’s capsule

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5
Q

Briefly explain what generates colloid osmotic pressure

A

Protein in plasma but not in bowmans capsule

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6
Q

When is autoregulation of GFR constant

A

Arterial BP between 80-180

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7
Q

What will be filtered in blood

A

Up to 70 kd
H29
Na/k/ck
Mg/glucose/ urea/ creatinine / insulin

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8
Q

What is not filtered in kidney

A

Over 70 kd
Proteins
Immunoglobulins
Ferritin
Cells

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9
Q

Where does reabsorption occur

A

In proximal tubule

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10
Q

How is surface area increased in proximal tubule

A

Brush border

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11
Q

What is meant by isoosmotic in proximal tubule

A

Solute and water reabsorbed are coupled

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12
Q

In proximal tubule explain the effect of tight junction

A

Increase permeability for paracellular transport

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13
Q

What is reabsorbed and what is secreted in reabsorption

A

Glucose/aa /organic absorbed completely
Some phosphate
Ca and water in para to sodium
Secretion of h+\ uric acid and drugs

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14
Q

In proximal convoluted tubule, how are glucose aa/ water reabsorbed

A

Active transport

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15
Q

What can excess saturation in urine indicate

A

Kidney disease

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16
Q

Components of loop of henle

A

Ascending
Descending
Macula densa

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17
Q

Effect of different absorption on urine

A

Water reabsorbed = concentrated
Water secreted = dilute

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18
Q

Where is calcium absorbed

A

In descending limb

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19
Q

Difference between medulla and cortical of loop of henle

A

Medulla no pth
Cortical pth

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20
Q

How is water absorbed in descending limb

A

Passively

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21
Q

How is interstitial hypertonicity maintained

A

Active absorption of sodium from THIck ascending limb

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22
Q

Describe how differenr areas of loop of henle have different permeability

A

Descendinf permeable to water
Ascending permeable to nacl

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23
Q

Role of the thick ascending limb

A

Pump for nacl

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24
Q

Describe the Distal nephron

A

Compromises distal convoluted tubule & collecting duct allowing regulation of reabsorption and secretion

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25
Q

In the distal nephron, what receptors does it have

A

Receptors hormone for regulation of water /solute

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26
Q

In distal convoluted tubiuke, how is calcium absorbed

A

Under pth

27
Q

Site of action for adh

A

Collecting duct

28
Q

Water absorption influenced by

A

Adh
Medullary hypertonicity

29
Q

what do distal nephrons reabsorb

A

Sodium
Secrete h ions
Secrete k ions under influence of aldosterone
Generate new bicarbonate

30
Q

Importance of urea

A

From protein breakdown
Amino groups removed
Ammonia converted to urea

31
Q

In kidneys describe importance of urea

A

Helps maintain high osmolarity gradient in medulla region= drive water reabsorption

32
Q

Process of urea recycling

A

Adh increases reabsorption of h20 in vasa recta + urea
Urea recycled

33
Q

Why is it important to keep concentration of urea hugh in interstitial fluid

A

Maintain high concentration gradient in medulla

34
Q

Importance if na reabsorption

A

Account for over 90% of ECF osmotic activity
When na above load = ECF osmotic activity increased

35
Q

What can a change in ECF lead to

A

Matching expansion/reduction of plasma volume leading to increase or decrease of BP

36
Q

Extracellular volume afffects ….

A

Blood pressure

37
Q

Types of control in distal nephron

A

Allows for production of conc/dilute urine
= influence ECF volume

38
Q

What happens when blood volume is low in regards to secretion and absorption

A

Decrease water secretion
Increase nacl absorption

39
Q

How do you increase nacl absorption

A

Detection
Areas in nephron to alter absorption
Signal response
Response

40
Q

The process ofnincreasing/ decreased nacl absorption

A

Fine tuning

41
Q

What does aldosterone act on

A

Distal nephron
Increasing nacl absorption
And signalling to brain to keep water there

42
Q

In distal nephron what must be present for nephron to be permeable

A

Vasopressin

43
Q

What can changes in medulla lead to

A

+Hypertonic medulla=
More aquaporins in collecting duct= concentrated urine produced
-Hypotonic = doesnt allow concentrated urine to be produced

44
Q

Maximum vasopressin at collecting duct

A

Collecting duct freely permeable to water

45
Q

Absence of vasopressin at collecting duct

A

Collecting dict impermable to h20

46
Q

Factors affecting release of vasopressin

A

Osmolarity greater than 280
Descrrased atrial stretch due to low BV
Low BP

47
Q

Relationship between plasma osmolarity and vasopressin

A

Directly proportional

48
Q

What happens if blood pressure is too high

A

As a result of increased BP=
Increased stretch detected
ANP released
Vasopressin inhibitted
Increase GFR
-Renin
No aldosterone = low BP

49
Q

Effect of decreased circulating volume

A

Increased renin via juxtglomerular cells

50
Q

Juxtaglomerular cells release renin in response to

A

Sympathetic nervous system stimulation
Decrease filtrat osmo
Low sodium levels in macula densa
Decreased stretch due to decreased blood flow

51
Q

Role of sympathetic nervous system in urination

A

Contract internal sphincter & relax detrusor muscle

52
Q

Role of para system in urination

A

Relax internal urethral
Contract detrusor muscle

53
Q

Role of somatic control in urination

A

Vountary control of both internal and external muscles

54
Q

When do kidneys secrete erythropoietin

A

Hypoxia due to decreased rbc
Reduced oxygen availability
Increased tissue demand for oxygen

55
Q

Enhanceed erthropoeitin increases

A

Rbc in circulating blood
Xoygen carrying ability of blood

56
Q

Recall the erythropoietin mechanism

A

Hypoxia/- rbc
Kidney and liver release erythropoietin
Ery stimulate rbc in bone marrow
Enhand eryth= increased rbc
Increased 02 carrying ability of blood

57
Q

Where are epo cells found

A

Interstitium of renal parenchyma

58
Q

Process of synthesis of epo cells

A

De novo in response to hypoxia so no detectable storage of hormone

59
Q

Mechanism by which hypoxia leads to EPO synthesis
-Activation

A

Epo bind to specific molecules on cell surface aka epo receptors
Activation of epo = intracellular signal in immature erythroid cells promote survival

60
Q

What do EPOs promote

A

Proliferation
Erythroid differentiation

61
Q

Epo cells lead to

A

Increased rate of eryth differentiation
Increased red cell mass

62
Q

Dietart requirment

A

Proteins/lipid /irons
Iron in liver spleen and bone marrow

63
Q

Where is IC iron stored

A

Protein iron complexes eg ferritin/ hemosiderin

64
Q

When might epo levels be low

A

Humans with end stage renal failure , low epo serum conc
Restored once renal transplant successfull

PJ1311 Semester 2 (6 decks)

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