Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Semester 4 (NME) > Kidneys 2 > Flashcards

Kidneys 2 Flashcards

1
Q

What are the functional units of the kidney and what do they consist of?

A

Nephrons (consisting of:)
1- Bowmans capsule (with glomerulus etc) +
2- Renal tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where does filtration take place in the kidney?

A

The renal corpuscle (bowmans capsule + glomerulus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What processes occur in the renal tubule?

A

Nutrient reabsorption
Water reabsorbtion (90% reabsorbed)
Secretion of waste products not already filtered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where does the ureter originate from and what course does it take?

A

From the pelvis of each kidney, descending over the top of psoas minor and in-front of the common iliac artery, into the R/L sides of the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where does the renal artery leave the abdominal aorta?

A

L2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 4 layers which surround each kidney?

A 
Pararenal fat (post/ posteriolat only)
Perirenal fat (around whole kidney)
Renal fascia 
Renal capsule (fibrous)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the renal sinus?

A

Cavity within the kidney which is occupied by the renal pelvis/ renal calyx BV’s/ nerves and fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the renal pelvis?

A

Dilation of ureter at kidney hilum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are renal calyces (single: calyx)? What are the two types?

A

Chambers through which urine passes
Minor: At the apex of each pyramid
Major: Lead to renal pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does the kidney endothelium repel proteins such as albumin? How is the affected in diabetes?

A

Has a negative charge so repels proteins

Charge lost in diabetes so = proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the main function of the PCT?

A

Reabsorb ions and organic nutrients

Reabsorbs water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the main function of the loop of henle (both limbs)?

A

Descending limb: Reabsorbs water

Ascending limb: Reabsorbes Na+/Cl-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the main function of the DCT?

A

Secretion of ions/acids/drugs/toxins

Variable water/ion re-absorption - this is fine tuned by hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where is urea re-absorbed from tubular fluid?

A

Collecting ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where does the tubular fluid go once it has left the DCT?

A

Many DCT’s feed into 1 collecting duct

Collecting duct feeds to minor calyx (now as urine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is counter-current multipilication?

A

Na+/Cl-/K+ re-absorption in the ascending loop of Henle by active transport creates an osmotic gradient with passively draws out water from the descending loop of Henle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What happens to substances reabsorbed in the nephron?

A

Go into peritubular capillaries

These all drain eventually to the efferent arteriole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What type of epithelium lines the PCT?

A

Cuboidal cells with microvilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What type of epithelium lines the Loop of Henle?

A

Squamous/ low cuboidal cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What type of epithelium lines the DCT?

A

Cuboidal cells w/o microvilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What type of epithelium lines the collecting ducts?

A

Cuboidal cells w/o microvilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What type of epithelium lines the papillary ducts?

A

Columnar cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the two types of nephrons?

A

Cortical (85%) - Stay in cortex- their peritubular capilaries drain to cortical radiate veins
Juxtamedullary (15%)- Peritubular capilaries drain to vasa recta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the two layers of epithelium in the renal corpuscle?

A

Outer: Simple squamous
Visceral: Has podocytes with filtration slits between them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are mesangial cells?
Support cells between capillaries, they can contract to dilate or constrict vessels
26
What substances act on mesangial cells?
Angiotensin II, ADH, histamine
27
What are the two main glucose transporters in the kidney?
GLUT 1 (2Na+ to 1 glucose) - High affinity/ low capacitity - Found in the late proximal tubule GLUT 2 (1Na+ to 1glucose) - Low affinity/ high capacity - Found in the early proximal tubule
28
What is the capacity of the glucose transporters in the kidney, what impact could this have clinically?
1.25mmol/min | So if plasma glucose is greater than 10mmol/L you will start to get glucosuria
29
Where do gluconeogenesis and glycolysis happen in the kidney?
Roughly 20% of bodies gluconeogenesis happens in the cortex of the kidney Glycolysis happens in the medulla
30
To increase filtration rate what must happen to the afferent and efferent arterioles?
Afferent must dilate | Efferent must constrict
31
What is GFR?
Rate of filtration per unit time
32
How do you calculate GFR?
Urine conc of substance (x) X urine vol (per unit time) ------------------------------------------------------------------------------ Plasma conc (x)
33
An increase in glomerular capillary hydostatic pressure will have what effect on GFR?
Increase it
34
An increase in bowmans capsule hydostatic pressure will have what effect on GFR?
Decrease it
35
An increase in glomerular capillary oncotic pressure will have what effect on GFR?
Decrease it
36
What three waste substances must be removed by the kidneys and why?
Need to be dissolved in water Urea (from AA breakdown) Creatinine (from creatinine phosphate in muscle) Uric acid (from recycling nitrogen bases in RNA)
37
What is the anatomy of the juxtaglomerular complex?
Juxtaglomerular complex = (Epithelium of DCT near renal corpuscle - ka macula densa) + (smooth muscle cells in afferent arteriole - ka juxtaglomerular cells)
38
What two things are secreted by the juxtaglomerular complex?
Renin and EPO
39
What stimuli cause the JG complex to release renin?
Decreased BP in glomerulus When stimulated by SNS Low osmotic conc of tubular fluid
40
What is ANP?
A powerful vasodilator molecule released by the atria | It causes dilation of afferent arterioles and constriction of efferent arterioles thus increasing GFR
41
What is BNP?
A powerful vasodilator molecule released by the ventricles | It causes dilation of afferent arterioles and constriction of efferent arterioles thus increasing GFR
42
What is the function of renin?
Converts angiotensinogen (from liver) to Angiotensin I
43
What converted Angiotensin I to Angiotensin II?
ACE in epithelial cells | Mainly in lungs
44
What are the effects of angiotensin II?
SM vasoconstriction / renal water retention (Increase BP) Pituitary releases ADH Zona glomerulosa releases aldosterone Increased thirst and cardiac output
45
How do changes in blood volume regulated GFR?
Increased blood volume = increased GFR | This promotes fluid loss
46
What does sympathetic stimulation do to GFR? How?
Powerfully decreases GFR | By constricting afferent arteriole
47
Raised urea indicates what? | Raised urea and raised creatinine indicates what?
Inc urea: Renal failure OR high protein load (starvation or exercise) Inc urea + creatinine: Renal failure only
48
What can chronic raised levels of cortisol do to glucose levels?
Caused chronic hyperglycemia | lead to diabetes
49
What is the key feature of cushings syndrome?
``` Chronically elevated cortisol Central obesity (face) with limb sparing ```
50
How does cortisol affect insulin levels?
Cortisol acts to INHIBIT insulin
51
What is the role of carbonic anhydrase?
Converts H2O + CO2 === H+ and HCO3-
52
Where are carbonic anhydrase enzymes commonly found and what are the two subtypes?
Found in lung and kidney CAII (type2)- Soluble in cytoplasm CAIV (type4)- Extra-cellular (linked to membrane by GP1)
53
What is the main area of acid secretion in the nephron?
PCT
54
Gluatamine metabolism produces what?
HCO3- and NH3 | NH3 joins H+ to make NH4+ and is secreted in PCT
55
What happens to the H+ and HCO3- produced by carbonic anhydrase?
H+ is secreted into tubular fluid (where it often combines to be buffered by phosphate H2PO4-) HCO3- is often re-absorbed into blood (although this costs ATP)
56
Foamy urine is a sign of what?
Proteinuria
57
What are microabuminuria and proteinuria signs off?
Kidney damage (leaking proteins)
58
Why do diabetic patients sometimes experience oedema?
Due to protein loss in kidney lowering blood oncotic pressure
59
What do patients with diabetic nephropathy experience hyperlipidemia?
Lowered triglyceride clearance in the kidney | Lowered lipoprotein lipase activity
60
Why do patients with diabetes experience raised BP?
Due to a decreased GFR (renal impairment)
61
Why are patients with diabetic nephropathy asked to keep to a low protein diet?
So less metabolites of protein are released into the blood (toxicity)
62
What is the clinical definition of CKD?
End stage, advanced kidney disease | eGFR less than 60ml/min for greater than 3months
63
Name 5 signs of CKD:
Anorexia / pruitus / peripheral oedema / weakness / fatigue / nocturia
64
Which AB's should be avoided in Px with CKD?
Penacillins/ cephalosporins
65
What does NICE recommend as treatment for CKD?
Start with ACEI > Diuretics > Dialysis
66
How is peritoneal dialysis conducted?
Incision made just below navel and permenant 'tenckhoff' catheter inserted Dialysate fluid is pumped in, catheter is sealed, fluid left for a while then removed again (with waste)
67
What are the two types of peritoneal dialysis?
CAPD (continous ambulatory)- Done at home with wheelchair stand to hang bags from, 4 times daily APD (automated PD)- Done by a machine overnight, fluid left in during day and removed next night
68
What is haemodialysis?
Arteriovenous fistula created in wrist/ upper arm Two needles inserted into fistula and connected to a machine Done 3x/week for ~4hrs at a time
69
What lifestyle changes must Px on haemodialysis undergo?
Limited to 1L of fluid per day (so to not overload kidney) | Px cuts down on high Na+/K+ foods
70
90% of pancreas transplants are of what type?
SPK (simultaneous pancreas-kidney)
71
What causes acidosis in CKD?
Not enough acid secretion HCO3- is lowered as it tries to mop up H+ Px hyperventilates and pCO2 is low (resp compensation)
72
Why is K+ raised during acidosis?
Because excess H+ in blood is pumped into cells and swapped for K+ (Also in CKD there is less K+ excretion)
73
Why do patients with CKD experience a swollen face and increased body weight?
Due to increased cortisol (as less is excreted)
74
What is an anion gap and what does a raised anion gap indicate?
Difference between Na+/K+ and HCO3-/ Cl- | Raised anion gap can indicate metabolic acidosis
75
What is the NET result of each H+ leaving a tubular cell in the kidney?
A HCO3- leaves on the basolateral side into serum
76
Where does 90% of the bicarbonate reabsorption (and H+ secretion occur)?
Proximal convoluted tubule
77
How does the body remove H+ in the late distal tubules and collecting ducts?
H+ secreted by primary active transport (usually with Cl-)
78
What is the pH of urine and which buffer system is this closest to?
6.8 | Closest to phosphate buffer system
79
Where does the ammonia buffer system originate from?
Glutamine is metabolised in liver to two NH4+ and two HCO3-
80
Why are nephrotic patients vulnerable to infection, which infections are they particually vulnerable to?
Staphylococcal and pneumococcal | Due to loss of immunoglobulins through the leaky renal filtration membranes

Semester 4 (NME) (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions