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sf3renal > Questions derived From bRS Phys > Flashcards

Questions derived From bRS Phys Flashcards

1
Q

At steady state, ECF and ICF osmolarity are?

A

The same

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2
Q

What happens in the infusion of Isotonic NaCl?

A

ECF volume increases (no change occurs in osmolarity and therefor no shift of water to ICF)

Plasma [protein and hematocrit] decreases

Arterial blood pressure increases

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3
Q

What changes occurs in diarrhea (loss of isotonic fluid)

A

ECF volume decreases (but no change occurs in the osmolarity, so water does not shift from ICF)

Plasma [protein and. Hematocrit] increase

Arterial blood pressure decreases

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4
Q

What occurs in excessive NaCl intake?

A

Osmolarity of ECF increases

Water shifts from ICF to ECF (causing ICF osmolarity to increase)

ECF volume increases and ICF volume decreases

Plasma [protein and hematocrit] decrease bc of the increase in ECF volume

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5
Q

What happens in sweating in a desert? (Hyperosmotic volume contraction)

A

ECF osmolarity increases (more water than salt lost in sweat)

ECF Volume decreases -> water shifts from ICF to ECF -> ICF osmolarity increases to equal ECF

ICF volume decreases

Plasma [protein] decreases (hematocrit concentration stays the same due to the loss of fluid from RBC’s)

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6
Q

What happens in Syndrome of inappropriate antidiuretic hormone? (Gain of water)

A

Osmolarity of ECF decreases

ECF volume increases, water shifts to cells, ICF osmolarity decreases, ICF volume increases

Plasma protein concentration decreases

(Hematocrit remains same bc water shifts into RBC’s)

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7
Q

What happens in adrenocortical insufficiency (loss of NaCL)

Aka hyposomotic volume contraction

A

Osmolarity of ECF decreases
Water shifts into cells, ecf volume dcreases, ICF osmolarity decreases, ICF volume increases

Plasma [protein] increaases

Hematocrit concentration increases

Arterial blood pressure decreases

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8
Q

Vasoconstriction of renal arterioles occurs due to ?

A

Activation of sympathetic nervous system

Angiotensin II

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9
Q

What causes vasodilation of renal arteries ?

A

Prostaglandins E2 and I2, bradykinin
Nitric Oxide
Dopamine

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10
Q

Autoregulation of renal blood flow is accomplished by ?

A

Changing renal vascular resistance

(Myogenic mechanism - stretch reflex)

(Tubuloglomerular feedback - macula densa senses increased load and causes constriction in nearby afferent arteriole)

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11
Q

RBF is constant over a blood pressure range of ?

A

80-200mmHg

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12
Q

What happens to BUN and creatinine when GFR decreases?

A

They both increases

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13
Q

In prerenal azotemia (hypovolemia) BUN increases ____ than serum creatinine and there is a _______ BUN/creatinine ratio

A

More

Increased

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14
Q

Normal filtration fraction ?

A

0.20

FF = GFR/RPF

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15
Q

Increases in filtration fraction leads to ?

A

Increased protein concentration of peritubular capillaries and increased reabsorption in the proximal tubule

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16
Q

Decrease in filtration fraction leads to ?

A

Decreases in concentration of protein in the peritubluar capillaries and a decrease in reabsorption in the proximal tubule

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17
Q

The glomerular barrier consists of ?

A

The cappillary endothelium

Basement membrane

Filtration slits of the podocytes

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18
Q

What causes increases in Bowmans space hydrostatic pressure?

A

Constriction of the ureters

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19
Q

Increases in glomerular capillary protein concentration cause ______ in net ultrafiltration pressure and GFR

A

Decreases

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20
Q

______ in the proximal tubule reabsorbs glucose from tubular fluid into the blood

A

Na-Glucose cotransport

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21
Q

RPF is measured by the clearance of PAAH at plasma concentrations of PAH that are ______ than at Tm

A

Lower

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22
Q

Parathyroid hormone causes ______ and increased urinary ______

A

Phosphaturia

.cAMP

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23
Q

The ______ and _____ reabsorb more than 90% of the filtered calcium by passive processes that are coupled to Na reabsorption

A

Proximal tubule and thick ascending limb

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24
Q

_____ % of plasma calcium is filtered

A

60

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25
Q

Loop diuretics (Furosemide) cause ____ urinary calcium excretion

A

Increased

[urinary calcium is linked to Na reabsorption in the loop of henle. Inhibiting Na reabsorption therefore also inhibits Ca reabsorption]

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26
Q

The _________ and _________ reabsorb 8% of the filtered calcium by an active process

A

Distal tubule and collecting duct

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27
Q

How does PTH increase calcium reabsorption in the kidney?

A

By activating adenylate cyclase in the distal tubule.

28
Q

Thiazide diuretics _____ calcium reabsorption in the early distal tubule

A

Increase

29
Q

In the thick ascending limb, Mg and Ca ______ for reabsorption, therefore, hypercalcemia causes an increase in Mg Excretion and vice versa

A

Compete

30
Q

Hyperosmotic urine is produced when circulating _____ levels are high

A

ADH

31
Q

Gradient of osmolarity from the cortex to the papilla. Composed primarily of NaCl and urea. Established by countercurrent multiplication and urea recycling. Maintained by countercurrent exchange in the vasa recta

A

Corticopapillary osmotic gradient

32
Q

Gradient of osmolarity from the cortex to the papilla. Composed primarily of NaCl and urea. Established by countercurrent multiplication and urea recycling. Maintained by countercurrent exchange in the vasa recta

A

Corticopapillary osmotic gradient

33
Q

Countercurrent multiplication in the loop of henle is dependent on?

A

NaCl reabsorption in the thick ascending limb and countercurrent flow in the descending and ascending limbs of the loop of Henle

(It is augmented by ADH which stimulates NaCl reabsorption in the thick ascending limb)

34
Q

The presence of ADH ______ the size of the corticopapillary osmotic gradient

A

Increases

35
Q

The capillaries that supply the loop of henle

A

Vasa recta

36
Q

Maintain corticopapillary gradient by serving as osmotic exchangers.

Blood from this equilibriates osmotically w/ the interstitial fluid of the medulla and papilla

A

Vasa recta

37
Q

When producing concentrated urine, _____ of the filtered H2O is reabsorbed isosmotically (with Na, Cl, Bicarb, gluc) in the proximal tubule

A

2/3

38
Q

The thick ascending limb of the loop of henle, with high ADH (making hyperosmotic urine) is called the ______

A

Diluting segment

39
Q

In High ADH (hyperosmotic urine) the thick ascending limb of the loop of henle reabsorbs ______ by _______, and is impermeable to _______

A

NaCl

Na-K-2Cl cotransporter

H2O

40
Q

The TF/Posm after the thick ascending limb in high ADH (hyperconcentration of urine) has a TF/Posm that is ___ 1.0

A

TF/Posm < 1.O

41
Q

The early distal tubule in situations of high ADH is ______ to water

A

Impermeable

42
Q

ADH ______ the H2O permeability of the principal cells in the late distal tublule

A

Increases

43
Q

ADH ______ the H2O permeability of the principal cells of the collecting ducts in high ADH scenarios

A

Increases

44
Q

Hyposmotic urine is produced when ?

A

Circulating ADH levels are low or ADH is ineffective

45
Q

______ stimulates both countercurrent multiplication and urea recycling

A

ADH

46
Q

In the absence of ADH what happens to water in the proximal tubule /?

A

The same as in situations of high ADH

About 2/3 of the filtered water is absorbed isosmotically in the proximal tubule

47
Q

In no ADH, what happens in the thick ascending limb of the loop of henle ?

A

Same as w/ in Presence of ADH (but not as much as in it )

NaCl reabsorbed w/o water and the tubular fluid becomes dilute

48
Q

What happens in the early distal tubule in no ADH

A

Same as w/ presence of ADH

NaCl is reabsorbed w/o H2O and tubular fluid is further diluted

49
Q

What happens in the late distal tubule and collecting ducts in the absence of ADH ?

A

The cells here are impermeable to water in the absence of ADH

Even though fluid flows thru the corticopapillary osmotic gradient, the osmotic equilibration does not occur

Osmolarity of final urine dilut

50
Q

What part of the nephron is free water produced in ?

A

The diluting segments

The thick ascending limb and the early distal tubule

51
Q

In the absence of ADH, Ch2o is _____-

A

Positive

52
Q

In the presence of ADH, Ch2o is

A

Negative

53
Q

Ch2o =

A

V - Cosm

54
Q

Urine that is isosmotic to plasma (Ch2o = 0) is produced when treatment with ?

A

Loop diuretics

Because these will inhibit NaCl reabsorption in the thick ascending limb. Inhibiting both dilution in the thick ascending limb and production of the corticopapillary osmotic gradient, therefore, the urine cannot be diluted during high water intake or concentrated during water deprivation

55
Q

What can lead to the production of urine that is hyposmotic to plasma ?

A

High water intake

Central diabetes insipidus

Nephrogenic diabetes insipidus

(These all lead to low or innefective ADH )

56
Q

What can cause urine that is hyperosmotic to plasma ?

A

(High ADH)

Water deprivation

SIADH

57
Q

An acid produced from carbon dioxide

Can be excreted by the body by ventilation

A

Volatile acid

58
Q

An acid such as lactic acid or sulfuric acid that accumulates in the body as a result of digestion, dz, or metabolism. Must be excreted from the body by organs other than the lungs (urine)

A

Nonvolatile acids

59
Q

Reabsorption of filtered HCO3- occurs primarily in the _____-__

A

Proximal tubule

60
Q

Increases in Pco2 result in ______ rates of HCO3- reabsorption

A

Increased

61
Q

ECF volume expansion results in________ HCO3- reabsorption

A

Decreased

62
Q

ECF volume contraction results in _______ HCO3- absorption

A

Increased

63
Q

Angiotensin II ______ Na-H exchange and thus _______ HCO3- reabsorption

A

Stimulates

Increases

64
Q

Fixed H produced from the catabolism of protein and phospholipid is excreted by which two mechanism?

A

Titratable acid and NH4

65
Q

H-ATPase is _____ by aldosterone

A

Increased

66
Q

NH3 is produced in renal cells from ______

A

Glutamine

67
Q

Hyperkalemia ______ NH3 synthesis

A

Inhibitis

sf3renal (13 decks)

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