Nephro Uro Anderson Flashcards
the afferent arteriole is sensitive to
epinephrine
the efferent arteriole is sensitive to
angiotensin 2
interpretation of clearance > GFR
filtration + net secretion
interpretation of clearance = GFR
filtration only or secretion = resorption
interpretation of clearance
filtration + net resorption
contraction of afferent arteriole ___ GFR
decreases
contraction of efferent arteriole ___ GFR
increases
hyperosmolarity results in what response
thirst, ADH release
osmoregulation is through what part of the brain
hypothalamus
volume regulation is through what two things
baroreceptors and macula densa
volume blood loss results in what response
sympathetic activation, renin release from JGA
2/3rds of Na and H2O are reabsorbed in the
proximal tubule
all glucose, HCO3, and amino acids are reasorbed in the
proximal tubule
in the proximal tubule Na is resorbed using
Cotransport (glucose, AA, PO4) and countertransport (H+ exchange)
where is the site of Carbonic Anhydrase Inhibitor activity
proximal tubule…blocks HCO3 reabsorption
25% of Na is reabsorbed in the
thick ascending loop on henle
in the thick ascending loop of henle, Na is reabsorbed using
Na-K-Cl cotransporter
% of Na is reabsorbed in the
distal tubule/collecting duct
in the distal tubule/collection duct Na is reabsorbed via
Na-Cl cotransporter
67% of K is reabsorbed in the
proximal tubule
20% of K is reabsorbed in the
thick limb…Henle
in the tick limb…Henle the K is reabsorbed via
Na-K-2Cl cotransporter
if you have low Na/Cl at the macula densa, what happens
release of active renin from JGA = angiotenisin
what does angiotensin II do
constricts the efferent arteriole causes increased GFR
where does angiotensinogen come from
liver
enzyme that converts angiotensinogen to angiotensin I
renin
where is renin from
JGA
angiotensin I is converted to angiotensin II by
ACE
where is ACE from
lung
why is renin released from JGA
when GFR is low, low blood volume, increased blood osmolarity
in addition to constricting the efferent arteriole, angiotensin II does this to the adrenal cortex zona glomerulosa
causes release of aldosterone which tell distal tubule to reabsorb Na and excrete K…sodium reabsorption leads to increased water reabsorption, increased blood volume, and decreased blood osmolarity
where are osmoreceptors located
anterior hypothalamus
where does ADH come from
posterior pituitary
glutamic acid can undergo oxidative deamination to become
alpha ketoglutarate
what does ALT (alanine aminotransferase) do
takes alanine to pyruvate using vit B6
what does AST (aspartate aminotransferase) do
takes aspartate to oxaloacetate using vitamin B6
what are the two original substrates of the urea cycle
CO2 and NH4
where does the urea cycle happen
liver
what happens in the mitochondria portion of the urea cycle
CO2 and NH4 and put together using carbamoyl phosphate synthetase to create carbamoyl phosphate. Carbamoyl phosphate is them cobined with L-ornathine using ornithine transcarbamoylase and to create L-citruline which goes to the cytosol
what happens in the cytosol portion of the urea cycle
L-citruline undergoes several transaminations to become L-arginine. L-arginine has urea taken out of it by arginase. L-ornithine is the left over and that goes back into the mitochondria.
Acute Nephritis: acute post-strep Glomerulonephritis
Red cell casts, 1-2 weeks after recovery from sore throat; Children 6-10 yrs, moderate proteinuria.
IgA Nephropathy/Berger’s dz
Increased IgA in response to viruses, bacteria, food proteins…Antibodies injure glomerulus (precipitative nature of Ab’s)…Hematuria comes & goes; chronic GN
Henoch-Schonlein Purpura
Purpuric skin lesions on extensor surface of extremities & buttock…IgA precipitation after respiratory infection, kids 3-8 yrs…Hematuria recurrences for yrs.
Goodpasture’s Syndrome
Rapid GN with auto-antibodies to basement membrane…Young men who smoke…Death due to renal failure or lung hemorrhage
Nephrotic syndrome
Heavy proteinuria, hypoalbuminemia, severe edema, hyperlipidemia, lipiduria
…Kids > dt primary kidney dz
…Adults > SLE, DM, amyloidosis, membranous GN most common cause
…More in men. Immune complexes in basement membrane, food allergy
pyelonephritis
Affects tubules or interstitium
…Ascending fecal flora, females, pregnancy, BPH (secondary to stasis of urine). Pyelo- indicates renal Pelvis.
hydronephrosis
dilation of renal pelvis & calyces associated with progressive atrophy of kidney dt obstruction of urine outflow
Urolithiasis
75% Ca oxalate, radiopaque(show up on X-ray);
25% Radiolucent (no X-ray);
Proteus or Staph infection cause alkaline urine / increase crystal formation
Staghorn calculi = large obstructive stomes in pelvis;
6% uric acid calculi, secondary to gout, radiolucent
cystitis
Females > males,
E. coli, urethral trauma, bacterial contamination,
Can lead to PN, chronic cystitis,
Frequency, urgency, dysuria, suprapubic pain
interstitial cystitis
Usually women, chronic cystitis, inflammation of all layers of bladder, normal urinalysis.
Suprapubic pain when bladder is full which is relieved by voiding.
Adenocarcinoma/Hypernephroma
Cigarette, pipe, & cigar smokers; upper kidney pole, solitary, unilateral…
Metastasize to lung & bone before sx appear
Wilm’s Tumor
Common primary renal tumor in kids, genetic, age 2-5 yrs,
Large abd mass, painless hematuria, good prognosis with tx
Benign Ureteric Tumors
polyps. May be too small to cause obstruction
malignant ureteric tumors
primary rare, transitional cell CA, obstruction, painless hematuria
Tumors of the Bladder
Risk factors; Industrial solvents, > cigarette smoking.
Transitional cell tumors, benign papilloma; 90% transitional cell carcinoma, squamous cell carcinoma,
Painless hematuria, HCG in urine is marker of aggressive tumor, tends to recur after excision
