module 2- renal review

Question 1

kidney function

Answer 1

filter toxins out of blood

Question 2

7 kidney functions

Answer 2

1) regulate electrolytes
2) regulate water balance
3) maintain pH
4) excrete metabolic wastes
5) excrete foreign compounds
6) secrete hormones
7) convert vitamin D to active form

Question 3

location of kidneys

Answer 3

retroperitoneal on back

Question 4

functional unit of a kidney

Answer 4

nephron

Question 5

2 parts of a nephron

Answer 5

vascular: blood containing
tubular: urine/filtrate containing

Question 6

path of blood to kidneys

Answer 6

renal artery -> smaller arteries -> afferent arteriole -> glomerulus

Question 7

path of filtrate to kidneys

Answer 7

efferent arteriole -> peritubular capillaries -> renal vein

Question 8

cortical vs juxtamedullary nephron

Answer 8

c-dips slightly into medulla, located in cortex of loop of henle
j: extends deeply into medullar, bowmans capulse is in cortex

Question 9

3 steps to urine formation

Answer 9

1) filtration
2) tubular reabsorption
3) tubular secretions

Question 10

what is filtered out vs not filtered

Answer 10

filtered: plasma, electrolytes, small peptides
not: plasma proteins, red/white blood cells, neg charged compounds

Question 11

3 forces that drive glomerular filtration

Answer 11

1) capillary blood pressure - pushes plasma into bowmans capsule
2) plasma- colloid osmotic pressure- higher concentration inside
3) bowmans capulse hydrostatic pressure - backflow that pushes plasma out

Question 12

what if GFR & how is it regulated

Answer 12

glomerular filtration rate
- autoregulation
- SNS control

Question 13

autoregulation of GFR

Answer 13

• myogenic stretch: too much pressure = decrease blood flow via constriction
• tubuloglomerular feedback: drop in BP = vasodilation
• granular cells send signals to mascula cells to dilate or constrict arteriole

Question 14

SNS control of regulation of GFR

Answer 14

decreases GFR & decreases BP

Question 15

rates of tubular reabsorption of water, sodium, glucose, urea & waste products

Answer 15

water: 99%
sodium: 99.5%
glucose: 100%
urea: 50%
waste: 0%

Question 16

3 elements secreted in tubular portion

Answer 16

sodium, glucose, AA & phosphate

Question 17

renal clearance definition

Answer 17

how much plasma volume is cleared out

Question 18

renal clearance equation

Answer 18

[solute in urine] x urine flow / [solute in plasma]

Question 19

where does urine concentration occur

Answer 19

renal medulla

Question 20

how does the kidney concentrate urine

Answer 20

ADH= allows concentrated urine, binds to V2 receptors & forms aquaporins for water to pass through

Question 21

how do diuretcs & caffeine work

Answer 21

dureitics: block V2 receptors = pee more = less volume in body = BP decreases
caffiene/alcohol: ADH drops b/c they inhibit ADH = urine cannot be concentrated = pee large volumes of dilute urine

Question 22

anatomical adaptations in aird vs wet environments for urine concentration

Answer 22

wet: low urine concentration
dry: high urine concentration

Question 23

2 factors that cause variation in urine

Answer 23

1) longer loops of henle = more concentrated urine
2) species

Question 24

4 physiological consequences of dysfunctional kidneys

Answer 24

1) decreased ability to concentrate urine
2) decreased waste removal
3) hyperkalemia
4) metabolic acidosis

Question 25

4 urinary conditions

Answer 25

1) UTI 2) blockage 3) autoimmune kidney disease 4) bladder rupture

Question 26

dialysis

Answer 26

blood from patient is pumped through system, dialysate fluid goes through gradient, is discarded, and clean blood is pumped back

Question 27

peritoneal dialysis

Answer 27

isotonic solution is pumped into abdomen

Question 28

descending vs ascending loop of henle

Answer 28

descending: filtering water into medulla ascending: filtering salt into medulla

Question 29

what do ace inhibitors do to BP

Answer 29

decrease

Question 30

metabolic acidosis

Answer 30

gain of acid, loss of bicarb

Question 31

metabolic alkalosis

Answer 31

loss of H or trap of H in GI tract, gain of bicarb

Question 32

respiratory acidosis

Answer 32

hypoventilation

Question 33

respiratory alkalosis

Answer 33

hyperventilation

Question 34

4 chemical buffer systems

Answer 34

1) carbonic acid / bicarb 2) protein- AA can accept or donate 3) hemoglobin- maintains & buffers pH 4) phosphate- can bind more H = allows more H to be pumped into urine

Question 35

acid-base equation

Answer 35

H2O + CO2 <-> H+ + HCO3-

Question 36

vasa recta

Answer 36

supply medulla with O2

Question 37

ADH released vs not released

Answer 37

released=permeable tubules = concentrated not release= impermeable tubules = dilute

Question 38

renal clearance = GFR

Answer 38

no reabsorption or secretion

Question 39

renal clearance < GFR

Answer 39

absorption, no secretion urea

Question 40

renal clearance > GFR

Answer 40

no absorption, only secretion

Question 41

macula densea cells

Answer 41

monitor fluid - if too little = signal arteries to increase fluid

Question 42

podocytes

Answer 42

contractile cells, flatten

Question 43

basement membrane

Answer 43

neg charged, small positively charged proteins can enter

Question 44

kidney stone

Answer 44

pressure in capsule increases =decrease in filtration rate

Question 45

how much filtrate is produced by kidneys each day

Answer 45

180L, urine =1.5-2L

Question 46

dilation = ( ) in GFR

Answer 46

decrease

Question 47

extrinsic neural control of GFR when BP is decreased

Answer 47

increase SNS activity = vasoconstrict

Question 48

how many layers does a molecule need to go through to reach the blood?

Answer 48

5

Question 49

what is the engine for reabsorption

Answer 49

sodium

Question 50

Na cotransporter

Answer 50

moves NA from lumen to cell and transports glucose to be reabsorbed

Question 51

antiporter

Answer 51

proton is transferred from cells to lumen

Question 52

when 1 Na enters, how many H leave

Answer 52

1

Question 53

secondary active transport relies on what gradient for energy

Answer 53

sodium

Question 54

what % of Na is reabsorbed in proximal tubule

Answer 54

65%

Question 55

what 2 hormones effect distal tubule / collecting duct

Answer 55

aldosterone & ANP

Question 56

what is released when BP is too low vs too high?

Answer 56

low=renin high=ANP

Question 57

what does renin do for angiotension

Answer 57

angiontension -> angiotension I

Question 58

what does ACE do for angiotension

Answer 58

angiotension I -> angiotension II

Question 59

what 2 things occurs when angiotension II is detected

Answer 59

vasoconstriction & sodium reabsorption

Question 60

SNS effects on angiotension II

Answer 60

noradrenaline release

Question 61

by reabsorbing more Na, we excrete more

Answer 61

K

Question 62

what do principle cells reabsorb & when

Answer 62

Na when cells detect aldosterone

Question 63

what does aldosterone act on

Answer 63

distal tubule

Question 64

ANP net effect

Answer 64

decrease blood pressure

Question 65

renal threshold

Answer 65

max concentration of solute in plasma that can be completely reabsorbed

Question 66

what is secreted during acidosis

Answer 66

when Na is brought in, H is taken out instead of K = hyperkalemia

Question 67

baroreceptors release ( ) when there is a drop in BP

Answer 67

ADH

Question 68

how to fix drop in BP

Answer 68

put more fluid in circulatory system

Question 69

T or F: marine animals metabolize blubber to obtain water

Answer 69

T

Question 70

T or F: urea uses aquaporins

Answer 70

T

Question 71

urobilin

Answer 71

bilirubin metabolite

Question 72

RBCs in urine would come from before or after kidneys?

Answer 72

after

Question 73

uric acid stone

Answer 73

lots of meat/protein

Question 74

struivite crystals

Answer 74

magnesium amnion phosphate

Question 75

gout

Answer 75

uric acid crystals formed in gout

Question 76

arterial vs venous side of blood pH levels

Answer 76

arterial-7.45 venous-7.35

Question 77

3 places H can be secreted from

Answer 77

proximal tubule, distal tubule & collecting duct

Question 78

human panic attack

Answer 78

hyperventilation-respiratory alkalosis- drop in CO2, increase in pH, no change in bicarb

Question 79

dairy cow has low pH & decrease in bicarb

Answer 79

metabolic acidosis

Question 80

high pH

Answer 80

metabolic alkalosis

Question 81

myogenic stretch

Answer 81

too much pressure = decrease blood flow via constriction

Question 82

tubuloglomerular feedback

Answer 82

vasodilation

Question 83

granular cells function

Answer 83

send signals to mascula cells to dilate or constrict arterioles

Question 84

noradrenaline effect

Answer 84

increase CO & BP