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Nephrology > Overview of Renal Structure and Function - Wall > Flashcards

Overview of Renal Structure and Function - Wall Flashcards

1
Q

What is the major extracellular cation?

A

Sodium

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2
Q

What does total body Na determine?

A

Size of total body water

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3
Q

What is the major intracellular cation?

A

Potassium

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4
Q

What are the major extracellular anions?

A

Chloride

Bicarbonate

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5
Q

What is bicarbonate’s role in ECF?

A

Major ECFV buffer

Key factor in acid-base balance

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6
Q

What are the kidney’s endocrine functions?

A

Erythropoietin
1-alpha hydroxylase produce calcitriol
Renin

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7
Q

What are the kidney’s paracrine/autocrine functions?

A

Bradykinin (vasodilatory, natriuretic)
Prostaglandin (mostly vasodilatory)
Nitric oxide (vasodilatory)
Endothelin (potent vasoconstrictor)

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8
Q

What does angiotensin II do?

A

Vasoconstrict

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9
Q

What does aldosterone do?

A

Promote Na reabsorption

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10
Q

Name two accessory functions of the kidney.

A

Small peptide catabolism (ie insulin)

Gluconeogenesis during fasting (25-33%)

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11
Q

Define neutral, positive, and negative balance.

A

Neutral - Intake + Production = Excretion
Positive - Intake + Production > Excretion
Negative - Intake + Production < Excretion

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12
Q

What is the best index of kidney function?

A

GFR

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13
Q

What vertebral segments do the kidneys span?

A

T12 to L3

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14
Q

What percent of total blood flow to the kidney does the cortex receive?

A

90%

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15
Q

What does the hilum contain?

A

Renal artery, vein, nerves, pelvis, ureter, and lymphatics

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16
Q

What does the medulla contain?

A

Loops of Henle
Collecting ducts
Vasa recta

17
Q

What are sites of potential obstruction within the ureter?

A

Pelvic ureteral junction
Crossover of pelvic brim
Urinary trigone

18
Q

What is the most common spot for urethral obstruction in males?

A

Prostatic urethra

19
Q

Which type of nephrons have a higher pressure in the glomerular capillaries?

A

Juxtamedullary > Cortical

20
Q

Are nephrons working at full capacity under normal conditions?

A

Cortical - No (basis for reserve capacity)

Juxtamedullary - Yes

21
Q

What layers are between the mesangium and circulation?

A

Endothelial cells (with large fenestrations)

22
Q

Is urine volume a good index of kidney function?

A

No (urine flow rate / volume is not autoregulated)

23
Q

What does clearance represent?

A

Volume of plasma cleared of the substance

24
Q

What is the equation for clearance?

A

Cx = U * V / P

25
Q

What is the equation for clearance ratio?

A

Cx / GFR

26
Q

What does a clearance ratio 1 imply?

A

< 1 - filtered and reabsorbed
= 1 - filtered
> 1 - filtered and secreted

27
Q

What is the clearance of PAH equivalent to?

A

Renal Plasma Flow

28
Q

What is a normal filtration fraction?

A

~20% of RPF becomes glomerular filtrate

29
Q

What does decreased cardiac output or volume depletion result in?

A

RAS - increased FF

30
Q

What can the autoregulatory response in a hypovolemic state be disturbed by?

A

Decreased AT II production
ACE-inhibitors, AT receptor blockers, renin inhibitors
Prevent production of vasodilatory prostaglandins (NSAIDS)

31
Q

Describe the proximal and distal tubule in terms of resistance and capacity.

A

Proximal tubule - High capacity, Low resistance

Distal tubule - Low capacity, high resistance

32
Q

What is the major difference between carriers and channels?

A

Channels are not saturable

33
Q

What is the tonicity of the bulk reabsorption in the PCT?

A

Isotonically

34
Q

How much of the filtered load is reabsorbed by the PCT?

A

50-55%

35
Q

What is the tonicity of fluid that enters the LOH?

A

Isotonic

36
Q

What is reabsorbed in the thin descending limb?

A

Passive water and urea

37
Q

What is reabsorbed in the thin ascending limb?

A

Passive sodium / chloride

38
Q

What is reabsorbed in the thick ascending limb?

A

Active NaCl

Ca, Mg

39
Q

What is reabsorbed in the DCT?

A

NaCl

Calcium

Nephrology (18 decks)

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