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Uro/Neph > Physiology > Flashcards

Physiology Flashcards

1
Q

Two types of nephrons and their functions

A
  1. Superficial (cortical) nephrons: Reabsorption and secretion
  2. Juxtamedullary nephrons: Concentration of urine
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2
Q

Bowman’s/Glomerular capsule general function

A

Site of filtration

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3
Q

Proximal convoluted tubule (PCT) general function

A

Reabsorption of water, electrolytes, glucose.

Secretion

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4
Q

Loop of Henle general function

A

Form osmotic gradient for water reabsorption

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5
Q

Distal convoluted tubules and collecting ducts general functions

A

Fine tuning of reabsorption of water, ions, urea

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6
Q

Basic process of urine formation (4 steps)

A
  1. Glomerular filtration
  2. Reabsorption
  3. Secretion
  4. Excretion
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7
Q

Describe reabsorption (general)

A

Fluid transported from tubular lumen into peritubular capillaries
99% of filtrate is reabsorbed to compensate for high glomerular filtration rate (GFR) of 180L/day

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8
Q

Describe the process of secretion (basic)

A

Transfer of metabolic anions and cations from peritubular capillaries into tubule

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9
Q

Describe the process of excretion (general)

A

Unwanted substances (urea, uric acid, drugs, chemicals) and excess electrolytes exit through collecting ducts and into ureteric/urethral passages

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10
Q

Glomerular filtration barrier filters on basis of both ____ and _____ of proteins

A

Size and negative charge

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11
Q

What are the functions of glomerular slit diaphragms

A

Nephrin proteins link neighboring podocyte feet. Pores permit passage of small molecules to medium sized proteins.

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12
Q

Describe nephrotic syndrome proteinuria (pathophysiology)

A

Low GFR and excess excretion of proteins

Proteinuria due to cell detachment or apoptosis of podocytes.
Fewer intracellular spaces decrease GFR. Large pores between hypertrophied podocytes generates significant loss of proteins.

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13
Q

Symptoms of nephrotic syndrome proteinuria

A

Frothy urine, edema, CNS problems, anorexia, malaise, abdominal pain

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14
Q

PCT reabsorbs ___ of the 180L/day filtered

A

2/3 or 60-80% (130 L/day)

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15
Q

All reabsorption depends on ____ pumps generating a ____ concentration gradient

A

Na/K pumps

Na concentration gradient

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16
Q

Glucose, galactose, fructose, amino acids, acetate, water soluble vitamins, etc. are all cotransported with _____ during reabsorption

A

Na+

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17
Q

With increases in filtered glucose, the capacity of tubule reabsorption reaches a plateau called _____ _____, where SGLTs are saturated, limiting further reabsorption. What pathology is this associated with?

A

Transport Maximum (Tmax)

Diabetes mellitus

18
Q

__-__% of protein is filtered, then reabsorbed into the ______

A

1-3%

PCT

19
Q

Most organic ions and drugs are ____ bound, not filtered, and secreted into the _____

A

Protein bound

PCT

20
Q

What pathology is inflammation of tubules and interstitium?

A 
Tubulointerstitial nephritis 
(E.g. UTI, pyelonephritis)
21
Q

What pathologies are associated with ischemic or toxic injury to the tubules

A

Acute tubular injury, acute kidney injury

22
Q

How much glucose is in the plasma clearance of a healthy individual?

A

0ml/min

23
Q

Blood osmolarity is ____ related to the urine concentration

A

Inversely

24
Q

Low levels of ADH causes (more/less) urine that is (pale/dark)

A

Low ADH = more urine, pale

25
Q

Nausea, nicotine, and morphine (stimulate/inhibit) ADH release

A

Stimulate

26
Q

Alcohol (stimulates/inhibits) ADH release

A

Inhibits

27
Q

Blood Volume: What condition is associated with dehydration, vomiting, hemorrhage, excessive perspiration, diuretics, or inadequate fluid intake

A

Hypovolemia

28
Q

Blood Volume: What condition is associated with excess salt intake

A

Hypervolemia

29
Q

5-10% blood volume changes are sensed by __________ in cardiac atria, right ventricle, large pulmonary vessels, aortic arch and carotid sinus.

These sensors generate responses mostly with ____ and sympathetic activity

A

5-10% blood volume changes are sensed by ( BARORECEPTORS ) in cardiac atria, right ventricle, large pulmonary vessels, aortic arch and carotid sinus.

These sensors generate responses mostly with ( ADH ) and sympathetic activity

30
Q

Na+ excretion is regulated by 2 primary mechanisms:

A

GFR and Reabsorption of Na+/water

31
Q

Hypovolemia: This condition is corrected by neuroendocrine factors that (increase/decrease) reabsorption and (increase/decrease) excretion in response to a drop in volume/pressure.

A

Hypovolemia: This condition is corrected by neuroendocrine factors that ( INCREASE ) reabsorption and ( DECREASE ) excretion in response to a drop in volume/pressure.

32
Q

Hypovolemia: Which (4) neuroendocrine factors increase reabsorption and decrease excretion in response to a drop in volume/pressure

A

Angiotensin II
Aldosterone
Sympathetic nervous system
ADH

33
Q

Thirst is induced by what peptide hormone?

A

Angiotensin II

34
Q

A drop in blood pressure in afferent arterioles triggers _____ release from JGA cells

A

Renin

35
Q

Renin converts angiotensinogen into _______

A

Renin converts angiotensinogen into ( Angiotensin I )

36
Q

Angiotensin converting enzyme (ACE) converts angiotensin I to angiotensin II. What are the functions of angiotensin II

A

Stimulate renal reabsorption (directly and indirectly via aldosterone and ADH)
General vasoconstriction
Increases sympathetic activity

37
Q

Explain how ACE inhibitors work

A

Inhibit conversion of Angiotensin I to Angiotensin II which causes a reduction in:

  • Na+ and water reabsorption from proximal/distal tubules
  • Aldosterone and ADH release

More excretion of salt and water = lower blood pressure

38
Q

Aldosterone actions

A

Regulates Na+ reabsorption in distal tubule and collecting ducts

Upregulates Na/K ATPases, Na+ channels (ENaC) and ATP levels in principal cells of distal tubule and collecting ducts

Increases reabsorption of Na+ (and water osmotically) to restore volume

Increases K+ secretion

39
Q

What is the RAAS System

A

Renin
Angiotensin II
Aldosterone
Sympathetic

40
Q

Congestive heart failure and renovascular hypertension (renal artery stenosis) inappropriately stimulate a correction for which condition

A

Hypovolemia

Uro/Neph (6 decks)

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