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Renal > Quiz 1 > Flashcards

Quiz 1 Flashcards

0
Q

4 general renal functions

A

Excretion of endogenous and exogenous waste products
Regulation of water and electrolyte balance
Regulation of body fluid pH
Regulation of arterial blood pressure

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1
Q

2 examples of waste products excreted by kidneys

A

UREA (Blood Urea Nitrogen BUN)

Creatinine

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2
Q

what does angiotensin II do?

A

increase vasoconstriction

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3
Q

what does aldosterone do?

A

decrease urinary Na excretion

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4
Q

What does the renin-angiotensin-aldosterone system and Na+ balance regulate?

A

arterial blood pressure

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5
Q

If renal O2 delivery goes down, what occurs to regulate this?

A

renal erythropoietin synthesis increases to increase erythrocyte synthesis

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6
Q

What is the most important transcription factor for erythropoietin production?

A

Hypoxia-inducible factor-1 (HIF-1)

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7
Q

If there is normal O2 conc., what happens to HIF alpha?

A

degraded by prolyl hydroxylase

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8
Q

What occurs in erythrocyte production of O2 conc. is low?

A

HIF alpha and Beta dimerize–> increase EPO transcription/translation

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9
Q

What is HIF-1 dependent upon?

A

oxygen conc.

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10
Q

Where is the site of synthesis for EPO synthesis?

A

peritubular fibroblasts and endothelial cells

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11
Q

For the regulation of vitamin D activity, where is the site of activation?

A

Proximal tubule cells

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12
Q

Uremic toxicity:

Azotemia is specific for what occuring?

A

increase plasma creatinine and BUN

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13
Q

Plasma protein imbalance:

Edema

A

excess fluid deposition in the interstitial space

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14
Q

Metabolic acidosis has what type of pH

A

pH<7.4

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15
Q

Hyperkalemia has a plasma K+ at what level

A

plasma K+>4.0mEq/L

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16
Q

Body fluid homeostasis can be maintained until renal function decreases to what percent of normal?

A

20%

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17
Q

Is acute renal failure (ARF) reversible?

A

yes

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18
Q

Pre-renal ARF=

A

decrease renal blood flow–>decrease glomerular filtration rate

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19
Q

Intra-renal ARF=

A

acute tubular necrosis (ATN)-ischemia/toxin-induced

i.e structure is affected

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20
Q

Post-renal ARF=

A

urinary tract obstruction

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21
Q

Is chronic renal failure reversible?

A

no

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22
Q

Most common cause of chronic renal failure?

A

diabetes (34%)

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23
Q

What is an alternative to a kidney transplant?

A

dialysis

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24
Q

What is the dialysis principle?

A

Diffusion across artificial membrane (hemo-) or capillaries (peritoneal) dialysis

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25
Q

In the hemodializer model, what flows through the upper compartment and is RECIRCULATED?

A

blood

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26
Q

In the hemodializer model, what flows in the counter direction through the lower compartment and is frequently renewed (which means the old passes a couple times and then gets drained)

A

dialysis fluid

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27
Q

What happens with renal failure?

A

increase plasma cratinine (azotemia)
increase K+ concentration (hyperkalemia)
decrease plasma HCO3- conc. (metabolic acidosis)
fluid accumulation

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28
Q

Two primary forms of dialysis

A

hemodialysis

peritoneal dialysis

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29
Q

Fluid volume equation

A

amount of X added/conc. of X at equilibrium

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30
Q

What is the dilution principle?

A

1) Add known amount of a measurable substance X to unknown volume in the beaker
2) Mix until substance X distributes throughout the fluid
3) fluid volume=amount of X added/conc. of X at eq

31
Q

Osmosis

A

Movement of H2O across cell membranes

32
Q

Osmotic pressure

A

The driving force for movement of H20 across cell membranes

33
Q

Osmolarity=

A

conc. X number of dissociable partiles (mOsm/L)

= mmol/L X # particles/molecules

34
Q

OsmolaRity=

A

of solute particles per liter of solvent

35
Q

OsmolaLity=

A

of solute particles per kilogram of solvent (temp. independent)

36
Q

Tonicity of a solution is a term used when…

A

referring to membrane impermeability

37
Q

Isotonic

A

no change is cell volume

38
Q

hypotonic

A

cell swells

39
Q

hypertonic

A

cell shrinks

40
Q

Which kidney is a little higher than the other?

A

Left

41
Q

Is the human kidney multipapillate or unipapillate?

A

multi

42
Q

The apex of the renal pyramids terminates in a _____

A

papilla

43
Q

What part of the kidney produces urine?

A

nephrons

44
Q

what are nephrons located within?

A

corticomedullary tissue

45
Q

How thick is each nephron?

A

one epithelial cell thick

46
Q

Sub-segments pathway of the nephron

A

Proximal tubule–>loop henle–>distal tubule–>collecting tubule

47
Q

What type of nephron is the short-looped nephron?

A

cortical (superficial)

48
Q

Where does the cortical (short-looped) nephron make the u-turn?

A

b/w the outer and inner medulla. It never enters the inner medulla

49
Q

What is the long-looped nephron?

A

Juxtamedullary

50
Q

What is the juxtamedullary nephron important for?

A

urine concentration

51
Q

Three principle elements of renal function

A

1) Glomerular filtration
2) Tubular reabsorption
3) Tubular secretion

52
Q

Glomerular filtration

A

plasma filtered from glomerular capillaries into bowmans space

53
Q

Tubular reabsorption and its function

A

movement of substances from lumen into the peritubular capillary
principle mechanism for modifying the composition of the filtered fluid

54
Q

Tubular secretion

A

movement of substances from the peritubular capillary into the lumen

55
Q

What must be known to draw conclusions about excretory capacity?

A

urine flow rate

56
Q

Micturition reflex

A

As the bladder fills with urine: increase stretch–>increase parasympathetic activity–>increase detrusor muscle contraction

57
Q

Abnormalities of micturition?

A

Automatic bladder

Atonic bladder

58
Q

Automatic bladder

A

spinal cord damage above sacral region–>periodic unintended bladder emptying

59
Q

Atonic bladder

A

loss of sensory nerve fibers

No micturition reflex therefore bladder overflows a few drops at a time - overflow incontinence

60
Q

where is the site of ultrafiltration?

A

glomerulus

61
Q

Major components of the Filtration Slit (Diaphragm)

Mutation in these components are associated with what?

A

Connector proteins
Linker proteins
Actin-cytoskeleton complex

Glomerular dysfunction

62
Q

Mesangial cells functions

A 
Provide structural support
secrete ECM
phagocytic activity
secrete prostaglandins and cytokines
has contractile activity
63
Q

What gives the negative charge to the “filtration pathway”?

A

high glycoprotein content of the basement membrane

64
Q

Oncotic pressure is what?

A

osmotic pressure due to protein

65
Q

In contrast to systemic capillaries, hydrostatic pressure remains _____ along the glomerular capillary

What is this due to?

A

relatively constant

Presence of resistance points before and after the glomerular capillaries

66
Q

In contrast to systemic capillaries, glomerular oncotic pressure progressively _____ along the capillary

Why?

A

increases

b/c as fluid is filtered out the concentration of non-filterable proteins increases

67
Q

How is Glomerular Filtration Rate (GFR) primarily regulated?

A

By regulating glomerular capillary hydrostatic pressure (GC)

68
Q

If theres a decrease in resistance in the afferent arterioles, what happens to PGC, GFR, and RPF

A

PGC increase
GFR increase
RPF increase

69
Q

If theres an increase in resistance in the afferent arterioles, what happens to PGC, GFR, and RPF

A

all decrease

70
Q

If theres a decrease in resistance in the efferent arterioles, what happens to PGC, GFR, and RPF

A

PGC decrease
GFR decrease
RPF increase

71
Q

If theres an increase in resistance in the efferent arterioles, what happens to PGC, GFR, and RPF

A

PGC increase
GFR increase
RPF decrease

72
Q

GFR is primarily physiologically regulated by what?

A

changing resistance (diameter) of afferent arterioles via renal sympathetic nerves (vasoconstriction to decrease GFR) and angiotensin II (vasoconstrictor)

73
Q

Blood pressure has an inverse relationship with what?

A

sympathetic activity
angiotensin II

decrease in BP causes increase in symp. and angio to increase renal vasoconstriction = increases BP

74
Q

Major vasodilators?

A

prostaglandins

75
Q

What stimulates prostaglandin synthesis?

A

sympathetic activity

angiotensin II

76
Q

Changes in intratubular pressure due to a ureteral obstruction like a ureteral stone causes what reflex? what does it do?

A

Ureterorenal reflex
Obstruction causes ureteral stretch->sympathetic reflex->renal arteriole constriction->decrease GFR
(If there is an obstruction, the kidney slows down the hydrostatic pressure to reduce GFR and also prevent increases in pressure at the obstruction site risking severe damage)

Renal (3 decks)

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