others Flashcards by Anthos Christofides

causes of Fanconi syndrome

hereditary defects (Wilson disease, tyrosinemia, glycogen storage disease, cystinosis)
iscemia
multiple myeloma
nephrotoxins/drugs (ifosfamide, cisplatin, tenofovir, lead poisoning, expired tetracyclines)

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proportion of Na2+ reabsorption in proximal convoluted tubule, in thick ascending loop of Henle, in early distal convoluted tubule, collecting tubules

proximal convoluted tubule –> 65-80%
thick ascending loop of Henle –> 10-20%
early distal convoluted tubule –> 5-10%
collecting tubule –> 3-5%

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Total body water in higher than 60% of body weight in ….

and lower in…

higher –> newborns and adult males

lower –> adult females and adults with large amount of adipose tissue

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anions and cations of ICF

cations: K, Mg
anions: protein and Organin phosphates (ATP, AMP, ADP)

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anions and cations of ECF

cations: Na
anions: CL, HCO3, plasma proteins (in plasma)

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measure of ICF and interstitial fluid

ICF = TBW-ECF
INTERSTITIAL = ECF-PLASMA

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Isosmotic volume expansion - example, ECF volume, ICF volume, ECF osmolarity, HCT, (Na), BP

example: isotonic NaCL infusion
ECF volume: increased
ICF volume: - 
ECF osmolarity: - 
HCT: decreased (dilution, and no RBC shinkening)
(Na): - 
BP: increased

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isosmotic volume contraction - example, ECF volume, ICF volume, ECF osmolarity, HCT, (Na)

example: diarrhea 
ECF volume: decreased
ICF volume: -
ECF osmolarity: - 
HCT: increased 
(Na): -
BP: decreased

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Hyperosmotic volume expansion - example, ECF volume, ICF volume, ECF osmolarity, HCT, (Na), BP

example: High NaCl intake
ECF volume: increased
ICF volume: decreased 
ECF osmolarity: increased
HCT: decreased (dilution and shrinkage) 
(Na): increased
BP: increased

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Hyperosmotic volume contraction - example, ECF volume, ICF volume, ECF osmolarity, HCT, (Na), BP

example: sweating, Fever, Diabetes insipidus
ECF volume: decreased
ICF volume: decreased
ECF osmolarity: increased
HCT: - (because shrinkage) 
(Na): increased
BP: decreased

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hyposmotic volume expansion - example, ECF volume, ICF volume, ECF osmolarity, HCT, (Na), BP

example: SIADH
ECF volume: increased
ICF volume: increased
ECF osmolarity: decreased
HCT: - (because water into RBCs)
(Na): decreased
BP: increased

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Hypoosmotic volume contraction - example, ECF volume, ICF volume, ECF osmolarity, HCT, (Na), BP

example: Adrennal insuficiency (excrete more NaCL than water)
ECF volume: decreased 
ICF volume: increased
ECF osmolarity: decreased
HCT: increased
(Na): decreased
BP: decreased

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renal blood flow is …..% of the cardiac output

25%

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beside NO and PGEs, which else can cause vasodilation of renal arterioles

Bradykinin

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RBF autoregulation - range, mechanism

range 80-200 mm Hg

mechanis: a. Myogenic mechanism (afferent contract in response to stress
c. Tubuloglomerular feedback: increased glomerular pressure –> more fluid to macula densa –> afferent constriction

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GFR vs Creatinine according to age

GFR decreases with age, but serum Cr reamains constant because of decreased muscle mass

Increased or decreased filtration fraction - reabsorption vs secretion

increased –> increased (plasma protein) –> increased reabsorption in PCT
decreased –> decreased (plasma protein) –> decreased reabsorption in PCT

causes of increased glomerular P

dilation of afferent or constriction of efferent

causes of increased Bowman P

ureter constriction

symathetic effect on Renal arterioles

constricts afferent –> decreases GFR, RPF, but not the FF

PAH - rate of secretion

at low plasma concentrations, the secretion rate increases as the plasma concentration increases –> once the carriers are saturated, further increases in plasma concentration do not cause further increases in the secretion rate

equation for the fraction of the filtered water that has been reabsorbed
and example

fraction = 1 - (1/(inulin concentration in tubular/plasma))

if inulin concentration/plasma concentration = 2 –> 50% of the water has been reabsorbed

equation for the fraction of the filtered load (of a substance x) remaining at any point along the nephron

(TF/P)x/(TF/P)inulin

effects of ECF volume on proximal tubular reabsorption

ECF volume conraction –> increases peritubular capillary protein concentration and decreases P –> increased reabsroption
ECF volume expansion –> decreased peritubular capillary protein concentration and increased P –> decreased reabsorption

K+ balance is achieved when the

urinary excretion of K+ exactly euals intake K+ in the die

Proportion of K+ that is reabsorbed in PCT, thick ascending, and roloe of colecting duct

``` PCT: 67% (along with Na+ and H20 thick ascending: 20% collecting duct (H,K+ ATPase on a cells): occurs only on low k+ depletion ```

factors that increased/decreased distal K+ secretion

- -> electrochemical driving force for K+ accross the luminal membrane is increased or dicreased 1. K+ diet: if high --> secretion, if low --> not 2. aldosterin 3. ph, alkalosis --> secretion, acidosis, not (because K+/H+ exchanger) 4. diuretics: K sparing decrease secretion, thiazide and diuretics increase secretion 5. . Luminals anions --> excess anions (K+) increase K+ secretion

Urea reabsroprtion in nephron

50% from PCT ADH increased urea permeability in inner medullary collecting duct --> urea recycling in the inner medulla --> osmotic gradient urea excretion varies with urine flow rate --> at high levels of water reabsroption --> great urea reabsorption --> decreased urea excretion

Phosphorus and Mg2+ excretion in nephron

Pi: 85 % from PCT. PTH decreases this | Mg2+ reabsorbed in PCT, thick ascening DCT

Mg2+ vs Ca2+ in nephron

in thick ascending, Mg2+ and Ca2+ compete for reabsorption --> hypercalcemia causes Mg2+ excretion, hypermagnisemia causes Ca2+ excretion

Ca2+ reabsorption - percentages

PCT and ascending --> 90% | PTH on distal

regulation of urine in Water deprivation

increases plasma OSM --> anterior hypothalamus osmoreceptors --> ADH from posterior pituitary --> increases water reabsorption --> increases urine OSM and decrease urine volume --> decrease plasma OSM back to normal

regulation of plasma and urine osmolarity in Water intake

decreases plasma OSM --> decrease ADH from posterior pituitary --> decrease water reabsorption --> decreases urine OSM and increases urine volume --> increases plasma OSM back to normal

beside ADH permeability, ADH in nephrons also

increases corticopappilary osmotic gradient (stimulates NACL reabsroption in thick ascending, urea recycling)

Free water clearance - everything

is used to estimate the ability to concentrate or dilute the urine = urine flow rate - osmolar clearance (clearance of evertything) low ADH --> free H20 clearance in + (hyposomotic urine) high ADH --> free H20 clerance in - (hyperosmotic urine) isosmotic urine --+ free H2O is 0

causes of positive and negative free water clearance

positive --> primary polydipsia, CDI, nephrogenic DI | negative --> water deprivation, SIADH

ADH receptors

v1 - vessels | v2 - principal cells

thiazide vs loop diuretics according to urine dilution and concatenation

decreased dilution: both | decreased concentration: only loop (decreases corticopapillary gradient)

MCC of sturvite stone

Klebsiella + Proteus