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PBL 2.2.5 > Phys 25-32: Kidney make pee > Flashcards

Phys 25-32: Kidney make pee Flashcards

1
Q

Evaporation loss of water from skin/respiratory tract per day

A

700ml

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2
Q

Intracellular fluid weight percent of body

Extracellular fluid weight percent of body

A

ICF 40%

ECF 20%

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3
Q

Lymphedema parasite

A

Wucheria Bancrofti

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4
Q

In advanced heart failure, increased secretion of _______ stimulates _______by the renal tubules, leading to _______

A

In advanced heart failure, increased secretion of ADH stimulates water reabsorption by the renal tubules, leading to hyponatremia and edema

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5
Q

What substance is used to create spacing between renal tubule cells

A

Proteoglycan filaments

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6
Q

Hypoxia stimulates kidney to secrete

A

Erythropoetin

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7
Q

Calcitriol aka

A

1,25-dihydroxyvitamin D3

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8
Q

Normal kidney blood flow per min

A

1100 ml

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9
Q

Smooth muscle of bladder aka

A

Detrusor

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10
Q

Max bladder pressure

A

40-60mmhg

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11
Q

Bladder sympathetics

A

L2 hypogastric nerves

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12
Q

Bladder parasympathetics

A

Sacral plexus S2/S3

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13
Q

Micturition facilitation and inhibition centers where

A

Brainstem, mostsly pons

Some in cerebral cortex

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14
Q

Cause of uninhibited neurogenic bladder

A

Damage to spinal cord means no brain inhibition of micturion reflex

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15
Q

Charge effect on filterability of substance in nephron

A

Postive charge filters more readily

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16
Q

Filtration coefficient equation

A

Kf = GFR/ filtration pressure

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17
Q

Increased bowmans hydrostatic pressure does ____ to GFR

A

Decreases

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18
Q

Increased glomerular colloid osmotic pressure does what to GFR

A

Decreases

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19
Q

Increased glomerular hydrostatic pressure does what to GFR

A

Increases

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20
Q

Renal blood flow equation

A

RBF = (Renal artery pressure - Renal vein pressure) / (renal vascular resistance)

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21
Q

Angiotensin and GFR

A

Prevents it from coming down, doesnt change it significantly

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22
Q

Sympathetic stim effect on GFR

A

Decreases

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23
Q

Endothelial-Derived nitric oxide ______ Renal Vascular Resistance and ______ Glomerular Filtration Rate

A

Increases

Decreases

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24
Q

NSAIDs and GFR

A

prostaglandins inhibitted, no efferent arteriole constriction

GFR down

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25
Q

Juxtaglomerular cells where

A

Walls of efferent/afferent arterioles

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26
Q

Macula densa response to sodium changes (2)

A

When sodium is decreased, macula densa decreases glomerular pressure, increasing GFR.

When sodium is decreased, macula densa signals juxtoglomerular cells to release renin

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27
Q

Protein ingestion and GFR

A

Increases GFR.

Increased protein reabsorption = increased sodium reabsorption. This causes macula densa to increase GFR

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28
Q

GFR and age

A

Low at birth, reaches adult levels at 2yo. At 40 begins decreasing 5-10% per decade

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29
Q

Glucose reabsorption location and transporter

A

Early proximal tubule

SGLT2

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30
Q

Protein reabsorption mechanism

A

Pinocytosis

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31
Q

% of sodium reabsorption in proximal tubule

A

65%

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32
Q

Site of secretion of organic acids and bases

A

Proximal tubule

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33
Q

Compound used to estimate renal plasma flow

A

PAH para-aminohippuric acid

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34
Q

thick ascending loop sodium transport by

A

NKCC2 co transporter.

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35
Q

Two types of cells in distal tubule

A

Principal cells

Intercalated cells

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36
Q

Principal cells reabsorb _______ and secrete _____

A

Reabsorb water and sodium

Secrete potassium

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37
Q

Intercalated cells reabsorb ___ and secrete _____

A

Potassium

Hydrogen ion

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38
Q

how does type A principal cell secrete potassium

A

Na+/K+ ATPase in basolateral membrane creates gradient.

K+ diffuses to lumen bc of gradient

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39
Q

Cell affected by potassium sparers

A

Principal cells (blocking sodium entry means no potassium efflux to lumen)

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40
Q

Type A vs B intercalated cells

A

Type A: Secretes hydrogen into lumen

Type B: Secretes bicarb into lumen

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41
Q

Type B cells main transporter into lumen

A

Pendrin Cl-/HCO3- counter transporter

42
Q

Urine is most dilute whre

A

Right at the end of the loop of henle

43
Q

Permeability of collecting duct to water is controlled by

A

ADH

44
Q

Substance used to calculate water reabsorption

A

Inulin (doesnt get reabsorbed)

45
Q

Aldosteron acts on _____ (kidney)

A

Principal cells in collecting tube

46
Q

aldosterone increases _____ reabsorption and ______ secretion is by stimulating _____ on the ______ side of the ______ membrane

A

aldosterone increases sodium reabsorption and potassium secretion is by stimulating the Na+-K+ ATPase pump on the basolateral side of the cortical collecting tubule membrane

47
Q

Aldosterone defficiency lab values (serum)

A

Sodium goes down (lost in urine)

Potassium goes up (can’t secrete)

48
Q

Parathyroid hormone tubular absorption effect

A

Decreases PO4- reabsorption

Increases Ca2+ reabsorption

49
Q

ADH binds to ____, stimulating _______ movement to lumen

A

V2

AQP-2

50
Q

Angiotensin II stimulates reabsorption of

A

Sodium, H20, H+

51
Q

Atrial Natriuretic Peptide reabsorption effects

A

Decreases sodium and water

52
Q

Sympathetic nervous system _____ sodium reabsorption

A

Increases

Also renin release

53
Q

ADH released by ____ in response to _____

A

Posterior pituitary

increased osmolarity

54
Q

Max daily urine excretion of water

A

20 liters

55
Q

Tubular fluid in proximal tubules is ____osmotic

A

Isosmotic

56
Q

Part of nephron where fluid is most concentrated

A

Bottom of loop of henle

57
Q

Fluid leaving distal tubular segment is ___osmotic

A

Hyposmotic

58
Q

Max urine concentration

A

1200-1400 mOsm/L

59
Q

Maximum urine NaCl excretion

A

600 mOsm/L

60
Q

Two requirements to make concentrated urine

A

1) High ADH level
2) High osmolarity renal medullary fluid

61
Q

Osmolarity of medullary fluid

A

Increases progressively up to 1400 mOsm/L

62
Q

Urea contributes to % of urine osmolarity

A

40-50%

63
Q

Passice secretion of urea into thin loops off henle is facilitated by

A

Urea transporter UT-A2

64
Q

Concentration of urea in tubular fluid in inner medullary collecting duct facilitated by

A

UT-A1 and UT-A3

65
Q

What prevents medullary hypersmolarity from being disapated

A

The Vasa recta

66
Q

Increased medullary blood flow ____ urine concentration abilty

A

Decreases

67
Q

Water diffusion across tubular epithelium is aidead by

A

Aquaporin 1

68
Q

How to calculate osmolar clearance

A

(Urine Osmolarity x Volume) / (Plasma osmolarity)

69
Q

How to calculate free water osmolarity

A

= (Urine volume) - (Urine volume)

70
Q

Central diabetes insipiduse caused by

A

Failure to secrete ADH

71
Q

Nephrogenic diabetes insipidus caused by

A

Kidneys fail to respond to ADH

72
Q

Estimation of plasma osmolariy from plasma sodium formula

A

Plasma Osmolarity = 2.1 x Plasma sodium

73
Q

ADH release steps

A

1) Increased plasma OSM causes osmoreceptor cells in anterior hypothalmus to shrink
2) Shrinkage of osmoreceptor cells causes them to fire
3) Action potentials are conducted to posterior pituitatry, which stimulates ADH release

74
Q

Lesions in ___ brain region cause defecits of ADH secretion

A

AV3V region

75
Q

Drugs that increase ADH release

A

Morphine
Nicotine
Cyclosphimide

76
Q

Drugs that inhibit ADH release

A

Alcohol
Clonidine
Haldol

77
Q

Nausea and ADH secretion

A

Nausea is a potent ADH release stimulus

78
Q

Thirst mechanism activated at ___ (threshold)

A

Sodiun concentration 2mEq/l above normal

79
Q

Angiotensin II and aldosterone effect on sodium concentration

A

Minimal

80
Q

Cell potassium uptake after a meal is mediated by

A

Insulin

81
Q

Alkalosis/Acidosis and potassium shift

A

Alkalosis pushes K+ into cells

Acidosis pulls out K+ from cells

82
Q

Potassium secretion occurs in _____ cells of _____

A

Principal cells of late distal and cortical collecting tubules

83
Q

Secretion of potassium in principal cell steps

A

1) K+ passively diffuses from blood to renal interstitium
2) K+ actively transported into principal cells by Na/K ATPase
3) K+ passively diffuses into urine

84
Q

Type A intercalated cell vs Type B intercalated cells (potassium)

A

Type A: Reabsorb potassium
Type B: Secrete potassium

85
Q

How does acidosis increase K+ extracellularly

A

Inhibits Na/K ATPase

86
Q

PTH 3 main effects

A

1) Stimulates bone resoprtion
2) Stimulates Vitamin D activation
3)increases renal tubular calcium reabsorption

87
Q

PTH acts at ______ to _____ calcium

A

Ascending loop of henle

Reabsorb

88
Q

Calcium reabsorption and acid/base

A

Acidosis: reabsorption increased
Alkalosis: Reabsorption inhibited

89
Q

Acidosis ______ potassium secretion by kidney

A

Decreases

90
Q

Most important acid/base buffer in body (intracellular and extracellular

A

Intracelullar: Cell proteins
Extra cellular: bicarb

91
Q

Bicarb equation

A
92
Q

Increased hydrogen Ion concentration in blood stimulates _____ (breathing)

A

Pulmonary ventilation

93
Q

In late distal and collecting tubules, H+ is secreted via

A

Primary active tranport

94
Q

Urinary ____ carries excessive H+ into urine and generates new _____

A

Phosphate

Bicarb

95
Q

Most important urinary buffer in chronic acidosis

A

Ammonia

96
Q

Renal glutamine metabolism is stimulated by ____

A

Acidosis

97
Q

How does glutamine metabolism help with acidosis

A

It is metabolized to NH4+ and HCO3-. NH4 is secreted, HCO3- is reabsorbed into blood

98
Q

Net acid excretion rate calculation

A
99
Q

Hydrogen secretion calculation

A
100
Q

Renal tubular H+ secretion is stumulated by increases in:

A

Extracellular H+
Increased PCO2

PBL 2.2.5 (11 decks)

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