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HUBS192 2024 > Lecture 31: URINE COMPOSITION, FUNCTIONS OF KIDNEY, BASIC NEPHRON PROCESSES > Flashcards

Lecture 31: URINE COMPOSITION, FUNCTIONS OF KIDNEY, BASIC NEPHRON PROCESSES Flashcards

1
Q

What is found in normal urine?

A

Water, creatinine, urea, uric acid, H+, NH3, Na+, K+, drugs, toxins

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2
Q

How much water is in urine?

A

1.5L/day

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3
Q

What percentage of urine is water?

A

95-98%

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4
Q

How does normal urine look?

A

Clear, light or dark amber

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5
Q

what does normal urine taste like?

A

Acidic (pH 5-6), not sweet

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6
Q

What does the pH of urine depend on?

A

Diet

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7
Q

What is the pH of the urine of vegetarians?

A

Up to 7.2

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8
Q

What is the pH of the urine of meat eaters?

A

4.8

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9
Q

What is the smell of normal urine?

A

There is no smell

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10
Q

What may be found in pathological urine?

A

Glucose, protein, blood (erythrocytes), haemoglobin, leukocytes and bacteria

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11
Q

What is it called when there is haemoglobin in urine?

A

Haemoglobinuria

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12
Q

What is it a sign of when there is bacteria in urine?

A

Infection

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13
Q

What does pathological urine look like?

A

golden, red, brown, blue

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14
Q

What does pathological urine taste like?

A

Sweet = diabetes mellitus

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15
Q

What may pathological urine smell like?

A

Fruits or rotten

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16
Q

What may it mean when urine smells like fruit?

A

ketosis (fasting), diabetes, chronic alcohol abuse

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17
Q

What may it mean when urine smells rotten?

A

Infection (bacteria), tumor

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18
Q

What is measured in urinalysis?

A

Blood, specific gravity, glucose, pH and protein

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19
Q

Where is blood found?

A

Not urine or plasma

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20
Q

What may blood in the urine indicate?

A

Haematuria, urinary tract infection, damage to filtration barrier

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21
Q

What does specific gravity measure?

A

Osmolarity

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22
Q

What is the specific gravity of plasma?

A

285-300 mOsmol/L

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23
Q

What is the specific gravity of urine?

A

50-1335 mOsmol/L

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24
Q

What may it mean when specific gravity isn’t within the range?

A

Polyuria, diabetes mellitus, diabetes inspires (concussion)

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25
Q

Where is glucose found?

A

In plasma but not urine

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26
Q

What may it mean when there is glucose in the urine?

A

Glucosuria, diabetes mellitus

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27
Q

Where is protein found?

A

In plasma but not urine

28
Q

What may it mean when there is protein in the urine?

A

Proteinuria, glomerulonephritis, damage to filtration barrier

29
Q

What is the pH of plasma?

A

7.4

30
Q

What is the pH of urine?

A

4.5-8

31
Q

What may it mean when the pH of urine has changed?

A

Acidosis, alkalosis, asthma, anxiety disorder

32
Q

What are the functions of the kidney?

A
  • filters blood
  • hormone production (erythropoietin)
  • metabolism
  • gluconeogenesis (when fasting)
  • pH regulation
  • excretion of drugs, endogenous metabolites and toxins
  • reabsorption ofnutrients
  • salt/ion homeostasis
  • water homeostasis
33
Q

What does the kidney detect?

A

Low oxygen levels

34
Q

What does the kidney release?

A

Erythropoietin

35
Q

What does EPO do?

A

Stimulates the bone marrow to produce more red blood cells

36
Q

What may chronic renal failure lead to (EPO)?

A

Anaemia (low levels of red blood cells/haemoglobin > low oxygen levels)

37
Q

Why is potassium important in cells?

A

Resting membrane potential is based on potassium gradient (inside/outside) of cells

38
Q

Why is potassium important in neurons and cardiomyocytes?

A

Action potentials, rhythm generation in pace maker cells, contractility, signalling

39
Q

What does the kidneys do with potassium?

A

Secrete it as too much can kill

40
Q

What can kidney disease/failure lead to (potassium)?

A

Hyperkalemia (death)

41
Q

What is lidocaine?

A

A commonly used local anaesthetic in a practice or hospital

42
Q

What happens with lidocaine?

A

It is excreted by the kidneys after metabolisation in the liver due to its fat soluble (lipophilic) nature

43
Q

What happens with aspirin?

A

It is already highly water soluble (hydrophilic) and excreted directly by the kidneys

44
Q

What happens with lipophilic things?

A

Metabolised in liver (some excreted in bile) and excreted directly by the kidneys

45
Q

What happens with hydrophilic things?

A

Excreted by the kidneys

46
Q

What is the formula for pH?

A

-log[H+]

47
Q

What does it mean when blood pH is above 7.4?

A

Alkalosis

48
Q

What does it mean when blood pH is below 7.4?

A

Acidosis

49
Q

What can vomiting cause?

A

Loss of acid so blood is more basic (alkalosis)

50
Q

What can diarrhoea cause?

A

Loss of bicarbonate so blood is more acidic (acidosis)

51
Q

What is bicarbonate?

A

The main buffer of the blood neutralising non-volatile acids coming from metabolism, food and drinks, maintaining a blood pH of 7.4

52
Q

What is bicarbonate concentration in the blood controlled by?

A

The lungs (exhalation of carbon dioxide) and kidneys by reabsorption of bicarbonate or secretion of hydrogen ions

53
Q

What does filtration do?

A

Creates a plasma like filtrate of the blood

54
Q

What does reabsorption do?

A

Removes useful solutes from the filtrate and returns them to the blood

55
Q

What does secretion do?

A

Adds additional wastes from the blood to the filtrate

56
Q

What determines the way a substance is handled in the kidneys?

A

The balance between filtering, reabsorption and secretion

57
Q

How are many substances filtered?

A

With a constant rate at the renal corpuscle (glomerulus) with the exception of substances bound to protein

58
Q

What needs to happen to some substances?

A

They need to be partly reabsorbed (Na+/K+) or entirely reabsorbed(glucose) or entirely secreted (many drugs)

59
Q

what is the role of the glomerulus?

A

Filtration

60
Q

What is the role of the proximal tubule?

A

Bulk reabsorption of electrolytes (sodium, potassium), secretion of metabolites, drugs and toxins

61
Q

What is the role of the distal tubule?

A

Fine tuning electrolyte/water reabsorption

62
Q

What is the role of the collecting duct?

A

Fine tuning electrolyte/water reabsorption

63
Q

What happens with glucose?

A

It is reabsorbed only in the proximal tubule

64
Q

What happens with potassium?

A

It is reabsorbed (PCT) or secreted (DCT/ collecting duct) in different parts of the tubule (depends on diet)

65
Q

What happens with water?

A

It is reabsorbed in most parts of the tubule

66
Q

What happens with drugs and toxins such as penicillin?

A

Mostly excreted by active secretion, not filtration

67
Q

What happens with big molecules such as albumins?

A

They are not even filtered

HUBS192 2024 (38 decks)

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