McCarthy Renal

Question 1

the ____ arteriole is wider than the _____ arteriole

Answer 1

afferent wider than efferent

Question 2

the glomerular capillary has higher ______ and ______ than systemic capillaries

Answer 2

higher pressure and higher permeability

Question 3

there is a filtration of about ___ -___mL per min of plasma (free of cells and proteins) into bowman’s space

Answer 3

95-120

Question 4

urine production is about __mL/min. why is this significant?

Answer 4

1mL/min, majority of fluid is being absorbed by tubular cells and returned to system circulation

Question 5

what is Pgc, Pbs, and (pie)gc and which direction do they go?

Answer 5

Pgc: hydrostatic glomerular capillary pressure: favors filtration. force goes OUT of the capillary and INTO bowman’s space
Pbs: hydrostatic bowman’s space pressure: opposes filtration; force goes INTO capillary, OUT of bowmans space
(pie)gc: oncotic pressure of glomerular capillary; opposes filtration: force goes INTO capillary, OUT of bowman’s space

Question 6

what is the strongest of the forces? (Pgc, Pbs and (pie)gc)? which has the most influence on change of net filtration?

Answer 6

Pgc has the strongest pressure around +45 mmHg
(pie)gc has the most influence… increases towards the end of the glomerular capillary to about -35mmHg (when filtration equilibrium is reached)

Question 7

peritublar capillaries are …

Answer 7

low pressure with increased oncotic pressure

Question 8

juxtaglomerular cells of the afferent arteriole respond to _________ or ________ and release renin

Answer 8

decrease perfusion pressure or increased sympathetic stimulation

Question 9

what can cause decreased perfusion pressure of the kidney?

Answer 9

vole depletion or other diseases (like CHF)

Question 10

what are the 5 angiotensin II effects?

Answer 10

1. vasoconstriction
2. increased aldosterone secretion
3. increased proximal tubule Na+ reabs.
4. increased ADH secretion (made in hypothalamus, secreted by post. pituitary)
5. increased thirst

Question 11

vasoconstriction action of angiotensin II at low vs high levels?

Answer 11

low: efferent constriction - increased GFR
high: afferent and efferent constriction- decreased GFR

Question 12

aldosterone promotes reabsorption of what?

Answer 12

Na+ into the principal cells of the distal terminal tubule and collecting duct

Question 13

renin with the production of angiotensin II and aldosterone causes what?

Answer 13

Na+ reabs. in the proximal tubule AND distal tubules and collecting duct

Question 14

what do epinephrine and norepinephrine do?

Answer 14

increase renin secretion and increase prox tubule Na+ reabs.

Question 15

what does ADH do?

Answer 15

increase H2O reabs. in the aquaporin cells of late distal tubule and collecting ducts

Question 16

what is the best serum test for glomerular filtration rate? why?

Answer 16

creatinine: it is freely filtered, not reabsorbed.

Question 17

what does furosemide do?

Answer 17

blocks Na+, Cl- and K+ reabs in the thick ascending loop.

Question 18

how would you determine levels of ADH?

Answer 18

urine concentration: if its high then you have a high ADH. if urine is dilute then you have low ADH

Question 19

what does thiazide do?

Answer 19

blocks Na+ and Cl- reabs in the first part of the distal convoluted tubule

Question 20

what does spironolactone do?

Answer 20

blocks the Na+ reabs. and K+ excretion (b/c blocks the pump). It does so by blocking the effects of aldosterone

Question 21

hypernatremia means what?

Answer 21

high salt in the blood (Na+), so high Na+ in the ECF

Question 22

what would be the treatment for cerebral edema?

Answer 22

high Na+ conc. saline aka hyperosmotic (3%) to draw the water out of the brain

Question 23

what are normal creatinine and BUN levels?

Answer 23

creatinine: 0.6 - 1.2
BUN: 6-20

Question 24

ANP decreases what?

Answer 24

decreases sodium reabs in the DCT

Question 25

Angiotensin II and SNS both increase what?

Answer 25

increase Na+ reabs. in PCT