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1
Q

causes of Fanconi syndrome

A
  1. hereditary defects (Wilson disease, tyrosinemia, glycogen storage disease, cystinosis)
  2. iscemia
  3. multiple myeloma
  4. nephrotoxins/drugs (ifosfamide, cisplatin, tenofovir, lead poisoning, expired tetracyclines)
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2
Q

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

A
  • 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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3
Q

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

and lower in…

A

higher –> newborns and adult males

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

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4
Q

anions and cations of ICF

A

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

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5
Q

anions and cations of ECF

A

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

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6
Q

measure of ICF and interstitial fluid

A 
ICF = TBW-ECF
INTERSTITIAL = ECF-PLASMA
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7
Q

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

A 
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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8
Q

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

A 
example: diarrhea 
ECF volume: decreased
ICF volume: -
ECF osmolarity: - 
HCT: increased 
(Na): -
BP: decreased
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9
Q

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

A 
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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10
Q

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

A 
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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11
Q

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

A 
example: SIADH
ECF volume: increased
ICF volume: increased
ECF osmolarity: decreased
HCT: - (because water into RBCs)
(Na): decreased
BP: increased
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12
Q

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

A 
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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13
Q

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

A

25%

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14
Q

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

A

Bradykinin

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15
Q

RBF autoregulation - range, mechanism

A

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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16
Q

GFR vs Creatinine according to age

A

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

17
Q

Increased or decreased filtration fraction - reabsorption vs secretion

A

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

18
Q

causes of increased glomerular P

A

dilation of afferent or constriction of efferent

19
Q

causes of increased Bowman P

A

ureter constriction

20
Q

symathetic effect on Renal arterioles

A

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

21
Q

PAH - rate of secretion

A

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

22
Q

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

A

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

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

23
Q

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

A

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

24
Q

effects of ECF volume on proximal tubular reabsorption

A
  • 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
25
Q

K+ balance is achieved when the

A

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

26
Q

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

A 
PCT: 67% (along with Na+ and H20
thick ascending: 20%
collecting duct (H,K+ ATPase on a cells): occurs only on low k+ depletion
27
Q

factors that increased/decreased distal K+ secretion

A
  • -> 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
28
Q

Urea reabsroprtion in nephron

A

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

29
Q

Phosphorus and Mg2+ excretion in nephron

A

Pi: 85 % from PCT. PTH decreases this

Mg2+ reabsorbed in PCT, thick ascening DCT

30
Q

Mg2+ vs Ca2+ in nephron

A

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

31
Q

Ca2+ reabsorption - percentages

A

PCT and ascending –> 90%

PTH on distal

32
Q

regulation of urine in Water deprivation

A

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

33
Q

regulation of plasma and urine osmolarity in Water intake

A

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

34
Q

beside ADH permeability, ADH in nephrons also

A

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

35
Q

Free water clearance - everything

A

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

36
Q

causes of positive and negative free water clearance

A

positive –> primary polydipsia, CDI, nephrogenic DI

negative –> water deprivation, SIADH

37
Q

ADH receptors

A

v1 - vessels

v2 - principal cells

38
Q

thiazide vs loop diuretics according to urine dilution and concatenation

A

decreased dilution: both

decreased concentration: only loop (decreases corticopapillary gradient)

39
Q

MCC of sturvite stone

A

Klebsiella + Proteus

Renal (15 decks)

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