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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
Q

Function of DCT

A

Reabsorption

  • Na
  • H2O (ADH required)
  • HCO3

Secretion of

  • K
  • Urea
  • H
  • NH3
  • Some drugs
26
Q

Function of Collecting Ducts

A

Reabsorption

  • H2O (ADH required)
  • Urea in medulla

Reabsorption or Secretion of

  • Na
  • K
  • H
  • NH3
27
Q

Tonicity of the parts of the nephron

A
  • PCT - Isotonic
  • Descending LOH - Iso
  • Tip LOH - Hypertonic
  • Ascending LOH - Hypotonic
  • DCT - Isotonic or Hypotonic
  • Collecting Duct - final concentration
28
Q

Electrical charge of the glomerulus and which ions pass more easily?

A

Negative charge so positive ions pass more freely

29
Q

What is the major force of filtration across the glomerular membrane?

A

Capillary Hydrostatic Pressure

30
Q

Layers of the glomerular filtration membrane?

A
  • Endothelial Capillary Pores
  • Basement Membrane
  • Podocytes
31
Q

The glomerular basement membrane is permeable to which ions?

A
  • Na+
  • K+
  • Cl-
32
Q

Why is there always capillary hydrostatic pressure pushing into the bowman’s capsule?

A

The afferent arteriole is larger than the efferent arteriole

33
Q

Effect of NE on AA and EA?

A

Vasoconstriction

34
Q

Effect of ANP of AA and EA?

A

AA - Dilation
EA - Constriction

Greater resistance –> Increase NFP –> Increase GFR –> Reduction in systemic BP

35
Q

Effect of thromboxane on glomerulus

A

AA Constriction –> decreased GFR

36
Q

What causes proteinurea in DM2?

A

Backpressure in AA

37
Q

Definition of GFR?

A

Amount of plasma filtered by the kidneys/ unit of time.

Average 120 ml/min

38
Q

What substance is used to determine GFR?

A

Inulin - It is neither absorbed or secreted by renal tubules

39
Q

% reabsorption in the PCT

A

60-70% Na, Cl and H2O
90% K
50% Urea
100% glucose

40
Q

T/F PCT reabsorption is hormone regulated

A

False

41
Q

% of fluid remaining in filtrate at the end of the PCT?

A

15%

42
Q

H+ must combine with what?

A

HPO4-2 + H+ H2PO4-

NH3 + H+ NH4+

43
Q

What site is the beginning of urine concentration?

A

Ascending Limb LOH

44
Q

Site of action for ADH and Aldosterone

A

Collecting Duct

aldosterone on principle cells

45
Q

Function of intercalated cells?

A
  • Secrete H+ and HCO3-

- Reabsorption of K+

46
Q

If glucose or amino acids get passed the PCT why are the excreted in the urine?

A

The remainder of the nephron is unable to reabsorb glucose or amino acids

47
Q

Hormones secreted by the kidney

A
  • Urodilatin
  • Vitamin D
  • Erythropoietin

Semester 2 (3 decks)

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