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Year 2 Renal > Physiological correlates of renal disease II > Flashcards

Physiological correlates of renal disease II Flashcards

1
Q

the PCT is permeable to:

A
  • water

- salt

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2
Q

what is the osmolarity in the PCT in comparison to plasma?

A

isoismotic

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3
Q

how is the permeability of the collecting duct described?

A

variable permeability according to hormonal control

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4
Q

what are the two requirements for forming a concentrated urine?

A
  • high osmolarity of renal medullary interstitial fluid

- high level of ADH

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5
Q

the ascending loop is permeable to:

A

salt

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6
Q

what structure serves as a counter current exchanger in order to minimize washout of solutes from the interstitium?

A

vasa recta

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7
Q

what is the role of the vasa recta?

A

serves as counter current exchanger to minimize washout of solutes from the interstitium

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8
Q

as you go deeper into the interstitium, how does osmolarity change?

A

higher osmolarity

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9
Q

why is the counter current exchange system necessary?

A

necessity to maintain osmolarity in the medulla

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10
Q

how does an increase in fluid osmolarity and plasma sodium concentration affect osmoreceptor cells?

A

osmoreceptor cells shrink

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11
Q

what causes osmreceptor cells to shrink?

A

increase in fluid osmolarity and plasma sodium concentration

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12
Q

after osmoreceptor cells shrink, what occurs in the hypothalamus? which nucleus?

A

release of ADH from supraoptic nucleus

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13
Q

the degree of dilution or concentration of the urine is controlled by what hormone?

A

ADH

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14
Q

an increase in plasma ADH has what effect on distal tubules and collecting ducts?

A

water permeability increases

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15
Q

fluctuation in NaCl delivery to the distal tubule is sensed by what structure?

A

juxtaglomerular apparatus

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16
Q

what controls the GFR by a feedback mechanism acting on the renal arteriolar resistance?

A

juxtaglomerular apparatus secondary to fluctuation in NaCl delivery to the distal tubule

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17
Q

what comprises the juxtaglomerular complex? where are these components located?

A
  • macula densa (initial distal tubule)

- juxtaglomerular cells (wall of arterioles)

18
Q

what are two functions of the macula densa?

A
  • sense the delivery of salt

- decide how much renin is released

19
Q

what type of adrenergic innervation stimulates renin release?

A

B1

20
Q

angiotensin II formation is regulated by changes in ________

A

BP

21
Q

how does angiotensin II affect sodium and water reabsorption? how does it do this?

A
  • increases sodium and water reabsorption
  • constricts efferent arterioles
  • directly stimulates sodium tubular reabsorption
  • stimulates aldosterone secretion
22
Q

where does aldosterone act? what is its role?

A
  • cells of cortical collecting tubule

- increases sodium reabsorption and potassium secretion

23
Q

levels of what compounds affect the level of aldosterone? what are these levels specifically?

A
  • high Na decreases plasma aldosterone

- high K increases plasma aldosterone

24
Q

an increase in activity of renal sympathetic nerves results in an increase of sodium and water reabsorption due to what three factors?

A
  • reduction in GFR by constriction of renal arterioles
  • increase in tubular sodium reabsorption
  • increase in renin release and angiotensin II formation, further stimulating tubular sodium reabsorption
25
Q

definition: renal clearance

A

volume of plasma that is completely cleared of the substance by the kidney per unit of time

26
Q

what are the uses of renal clearance?

A
  • quantify the rate at which blood flow through the kidneys

- basic kidney function

27
Q

what is the best overall index of kidney function?

A

GFR

28
Q

what is the renal clearance equation?

A

C = (V x U) / P

C = clearance 
V = urine flow rate 
U = urine concentration of x 
P = plasma concentration of x
29
Q

what is inulin? what is its clinical use?

A
  • polysaccharide molecule not produced by our body

- used to assess GFR

30
Q

what is the clniical significance of creatinine?

A

cleared from body entirely by glomerular filtration

31
Q

if a substance is completely cleared from the plasma, the clearance rate of that substance is equal to what measurement?

A

total renal plasma flow

32
Q

definition: filtration fraction

A

fraction of renal plasma flow (RPF) that is filtered into bowman’s capsule at the glomerulus

33
Q

what is the equation for GFR in terms of RPF and FF?

A

GFR = RPF x FF

34
Q

how does HTN exacerbate kidney injury?

A

alteration of renal hemodynamic and tubular reabsorption

35
Q

what type of kidney lesions promote HTN? what are 3 examples of these?

A
  • lesions that reduce the ability of the kidney to excrete sodium and water
  • increased renal vascular resistance
  • decreased glomerular capillary FF
  • excessive tubular sodium reabsorption
36
Q

what is acute kidney injury (acute renal failure) in the context of time frame, GFR, and sequelae?

A
  • syndrome that results in a sudden decrease in kidney function or damage from few hours to few days
  • rapid decline in GFR accompanied by accumulation of waste products in the blood and inability to maintain fluid and electrolyte balance
37
Q

what is the cause of pre-renal AKI?

A

kidney hypoperfusion

38
Q

what is the cause of renal AKI?

A
  • vessel and glomerular injury
  • tubular epithelial injury
  • renal interstitial injury
39
Q

what are the 4 sites of renal AKI?

A
  • vascular
  • glomerular
  • tubular
  • interstitial
40
Q

what is the cause of post-renal AKI?

A

urinary tract obstruction

41
Q

what are the physiological consequences of AKI?

A
  • water and sodium overload (edema, HTN)
  • hyperkalemia
  • metabolic acidosis
  • anuria (severe AKI)
42
Q

what is the cause of chronic kidney failure?

A

disorders of blood vessels, glomeruli, tubules, renal intersitium, and lower urinary tract

Year 2 Renal (38 decks)

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