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RENAL SYSTEM > Physiology > Flashcards

Physiology Flashcards

1
Q

What is the 60-40-20 rule (% of body weight for average person)?

A

60% Total body water
40% ICF
20% ECF

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2
Q

What does ECF mainly composed of?

A

Na+
Cl-
HCO3-
Albumin

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3
Q

What does ICF mainly composed of?

A

K+
Mg+2
Organic phosphates (eg, ATP)

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4
Q

What is the range of serum osmolality?

A

285-295 mOsm/kg H2O

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5
Q

How to measure plasma volume?

A

Plasma volume can be measured by radiolabeling albumin.

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6
Q

How to measure extracelluler volume?

A

Extracelluler volume can be measured by inulin or mannitol.

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7
Q

What does ECF consist of?

A

75% ECF = Interstitial fluid
25% ECF = Plasma

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8
Q

What does glomerular filtration barrier composed of?

A

•Fenestrated capillary endothelium
•Basement membrane with type IV collagen chains and heparan sulfate
•Visceral epithelial layer consisting of podocyte foot processes (FPs)

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9
Q

How does the glomerular filtration charge barrier work?

A

All 3 layers contain - charged glycoproteins that prevent entry of - charged molecules (eg, albumin).

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10
Q

How does the glomerular filtration size barrier work?

A

Fenestrated capillary endothelium (prevents entry of >100 nm molecules/ blood cells); podocyte foot proccesses interpose with glomerular basement membrane (GBM); slit diaphragm (prevents entry of molecules >50-60 nm).

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11
Q

What is renal clearance and formula ?

A

Volume of plasma from which the substance is completely cleared in the urine per unit time.
Clearance= (Urine concentration*Urine flow rate)/Plasma concentration

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12
Q

How to measure GFR?

A

Inulin clearance can be used to calculate GFR. Because it is freely filtered and is neither reabsorbed nor secreted.

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13
Q

What is the normal GFR range?

A

100 mL/min

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14
Q

Why is creatinine clearance not used in the measurement of GFR?

A

Creatinin clearance is an approximate measure of GFR. Slightly overestimates GFR because creatinine is moderately secreted by renal tubules.

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15
Q

How to measure eRPF?

A

Effective renal plasma flow can be estimated using para-aminohipuric acid (PAH) clearance.
Between filtration and secretion, there is nearly 100% excretion of all PAH that enters the kidney.
eRPF underestimates true RPF slightly.

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16
Q

What is the renal blood flow formula?

A

RBF = RPF/(1-Hct)
Usually 20-25% of cardiac output.
(RPF:Renal plasma flow)

17
Q

What is filtration fraction (FF) formula?

A

GFR/RPF
Normal FF = 20%

18
Q

What is the filtered load formula?

A

Filtered load (mg/min) = GFR* plasma concentration (mg/mL)

19
Q

How does the prostaglandins work?

A

Prostoglandins Dilate Afferent arteriole (PDA)
Prostaglandins preferentially dilate afferent arteriole
↑RPF ↑GFR -FF

20
Q

How does the angiotensin II work?

A

Angiotensin II Constricts Efferent arteriole (ACE)
Angiotensin II preferentially constric efferent arteriole
↓RPF ↑GFR ↑FF

21
Q

What is a prostaglandin inhibitor?

A

NSAIDs

22
Q

What are the situations that increase GFR?

A

•Efferent arteriole constriction
•↓plasma protein concentration

23
Q

What are the situations that decrease GFR?

A

•Afferent arteriole constriction
•↑plasma protein concentration
•Constriction of ureter
•Dehydration

24
Q

What are the situations that decrease RPF?

A

•Afferent arteriole constriction
•Efferent arteriole constriction
•Dehydration (↓↓)

25
Q

What are the situations that do not affect RPF?

A

•↑plasma protein concentration
•↓plasma protein concentration
•Constriction of ureter

26
Q

What are the situations that increase FF?

A

•Efferent arteriole constriction
•↓plasma protein concentration
•Dehydration

27
Q

What are the situations that decrease FF?

A

•↑plasma protein concentration
•Constriction of ureter

28
Q

What are the situations that do not affect FF?

A

•Afferent arteriole Constriction

29
Q

What is the normal plasma level of glucose? Where is it reabsorbed?

A

Glucose at a normal plasma level range: 60-120 mg/dL
Completely reabsorbed in procimal convoluted tubule (PCT) by Na+/Glucose cotransport.

30
Q

When does glycosuria begin in adults?

A

In adults, at plasma glucose of 200 mg/dL glucosuria begins (threshold).

31
Q

What is the mechanism of formation of glycosuria in pregnancy?

A

Normal pregnancy is associated with↑GFR. With↑filtration of all substances, including glucose, the glucose threshold occurs at lower plasma glucose concentrations.
↓
Glucosuria at normal plasma glucose levels.

32
Q

What is the drug that causes glycosuria when the glucose plasma concentration is <200 mg/dL?

A

Sodium-glucose cotransporter 2 (SGLT2) inhibitors
(Flozin drugs)

33
Q

What is the splay phenomenon?

A

T for glucose is reached gradually rather than sharply due to the heterogeneity of nephrons.

34
Q

What is reabsorbed in the proximal convoluted tubule?

A

All glucose and amino acids
Most HCO3-, Na+, Cl-, PO4-3, K+, H20, uric acids.

RENAL SYSTEM (3 decks)

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