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Semester 2 > Patho Renal > Flashcards

Patho Renal Flashcards

1
Q

What mechanisms regulate renal blood flow?

A
  • Autoregulation
  • Neural Regulation
  • Hormones
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2
Q

If arterial pressure decreases or vascular resistance increases what happens to RPF?

A

It decreases

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3
Q

2 mechanisms of autoregulation?

A
  • Myogenic mechanism

- Tubuloglomerular feedback

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4
Q

A drop in systemic BP will cause the afferent arterioles to?

A

Dilate to increase renal perfusion

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5
Q

What is the regulator of myogenic autoregulation?

A

Baroreceptors in the afferent arteriole.

  • Increase pressure stimulates constriction
  • Decrease pressure causes dilation
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6
Q

What is the regulator of tubuloglomerular feedback?

A

Na concentration in the macula densa cells in the distal tubule

  • When Na increases they stimulate afferent arteriole constriction if decrease GFR
  • When Na decreases they dilate afferent arterioles to increase GFR
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7
Q

Primary innervation of the kidney comes from?

A
  • Celiac plexus

- Greater Splanchnic Nerve

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8
Q

Sympathetic stimulation of baroreceptors ha what effect on the afferent arterioles?

A

Vasoconstriction

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9
Q

Where are the baroreceptors which are responsible for the baroreceptor reflex acting on the kidneys?

A
  • Carotid Artery

- Aortic Arch

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10
Q

Renin is stored and released by which cells?

A

The granular cells of the afferent arterioles of the JGA

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11
Q

Primary Renin release is triggered by?

A

Decrease of BP in Afferent Arterioles decreases stretch of the JGA cells.

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12
Q

Secondary Renin release is triggered by?

A
  • Decreased Na in the DCT
  • Sympathetic B2 receptors on the JGA cells
  • Prostaglandin release
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13
Q

What vitamin is a potent negative regulator of renin gene expression?

A

Vitamin D

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14
Q

What is the renal effect of Vitamin D?

A

negative renin gene expression

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15
Q

Process of RAAS?

A
  1. Renin release
  2. Cleaves a-globulin (ANG 1 released to plasma by liver)
  3. ANG1 to ANG2 by ACE (lung and renal endothelium)
  4. ANG2 causes adrenal cortex to release ADH
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16
Q

Physiologic effects of RAAS to increase BP?

A
  • Na+ reabsorption
  • K+ excretion
  • Systemic vasoconstriction
  • Sympathetic stimulation
  • Thirst
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17
Q

Stimulation of stretch receptors in the renal AA causes which ion channels to open?

A

Ca++, which causes an increase in extra cellular Ca++

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18
Q

Local renal effects of decreases GFR?

A
  • Decreased Renal Perfusion Pressure

- Decreased urine output

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19
Q

Site of secretion

  • ANP
  • BNP
  • C type naturetic peptide
  • Urodilatin
A
  • Atrial myocardium
  • Ventricle myocardium
  • Vascular endothelium
  • DVT and Collecting Ducts
20
Q

Functions of ANG2

A
  • Aldosterone release (Na and H2O transient ion)
  • Vasoconstriction
  • ADH secretion (aka vasopressin)
  • Thirst
21
Q

Nephron functions?

A
  • Regulates ECF through UO
  • regulation of electrolytes (gluconeogenisis for active transport)
  • pH regulation (HCO3 reabsorption H+ secretion)
22
Q

Function of the glomerulus

A

Filtration

23
Q

Function of PCT

A 
Reabsorption of
Na (most of it)
Glucose
K
Amino Acids
HCO3
PO
Urea
H2O (ADH not required)

Secretion of
H
Foreign Substances

24
Q

Function of LOH

A
  • Concentration of urine (counter current mechanism)
  • Descending LOH H2O reabsorption exchange for Na
  • Ascending LOH Na reabsorption (active) H2O stays
  • Thin segment Urea secretion)
25
Function of DCT
Reabsorption - Na - H2O (ADH required) - HCO3 Secretion of - K - Urea - H - NH3 - Some drugs
26
Function of Collecting Ducts
Reabsorption - H2O (ADH required) - Urea in medulla Reabsorption or Secretion of - Na - K - H - NH3
27
Tonicity of the parts of the nephron
- PCT - Isotonic - Descending LOH - Iso - Tip LOH - Hypertonic - Ascending LOH - Hypotonic - DCT - Isotonic or Hypotonic - Collecting Duct - final concentration
28
Electrical charge of the glomerulus and which ions pass more easily?
Negative charge so positive ions pass more freely
29
What is the major force of filtration across the glomerular membrane?
Capillary Hydrostatic Pressure
30
Layers of the glomerular filtration membrane?
- Endothelial Capillary Pores - Basement Membrane - Podocytes
31
The glomerular basement membrane is permeable to which ions?
- Na+ - K+ - Cl-
32
Why is there always capillary hydrostatic pressure pushing into the bowman's capsule?
The afferent arteriole is larger than the efferent arteriole
33
Effect of NE on AA and EA?
Vasoconstriction
34
Effect of ANP of AA and EA?
AA - Dilation EA - Constriction Greater resistance --> Increase NFP --> Increase GFR --> Reduction in systemic BP
35
Effect of thromboxane on glomerulus
AA Constriction --> decreased GFR
36
What causes proteinurea in DM2?
Backpressure in AA
37
Definition of GFR?
Amount of plasma filtered by the kidneys/ unit of time. Average 120 ml/min
38
What substance is used to determine GFR?
Inulin - It is neither absorbed or secreted by renal tubules
39
% reabsorption in the PCT
60-70% Na, Cl and H2O 90% K 50% Urea 100% glucose
40
T/F PCT reabsorption is hormone regulated
False
41
% of fluid remaining in filtrate at the end of the PCT?
15%
42
H+ must combine with what?
HPO4-2 + H+ H2PO4- | NH3 + H+ NH4+
43
What site is the beginning of urine concentration?
Ascending Limb LOH
44
Site of action for ADH and Aldosterone
Collecting Duct | aldosterone on principle cells
45
Function of intercalated cells?
- Secrete H+ and HCO3- | - Reabsorption of K+
46
If glucose or amino acids get passed the PCT why are the excreted in the urine?
The remainder of the nephron is unable to reabsorb glucose or amino acids
47
Hormones secreted by the kidney
- Urodilatin - Vitamin D - Erythropoietin

Semester 2 (3 decks)

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