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Quiz 1 Flashcards

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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
What is the dialysis principle?
Diffusion across artificial membrane (hemo-) or capillaries (peritoneal) dialysis
25
In the hemodializer model, what flows through the upper compartment and is RECIRCULATED?
blood
26
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)
dialysis fluid
27
What happens with renal failure?
increase plasma cratinine (azotemia) increase K+ concentration (hyperkalemia) decrease plasma HCO3- conc. (metabolic acidosis) fluid accumulation
28
Two primary forms of dialysis
hemodialysis | peritoneal dialysis
29
Fluid volume equation
amount of X added/conc. of X at equilibrium
30
What is the dilution principle?
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
Osmosis
Movement of H2O across cell membranes
32
Osmotic pressure
The driving force for movement of H20 across cell membranes
33
Osmolarity=
conc. X number of dissociable partiles (mOsm/L) | = mmol/L X # particles/molecules
34
OsmolaRity=
of solute particles per liter of solvent
35
OsmolaLity=
of solute particles per kilogram of solvent (temp. independent)
36
Tonicity of a solution is a term used when...
referring to membrane impermeability
37
Isotonic
no change is cell volume
38
hypotonic
cell swells
39
hypertonic
cell shrinks
40
Which kidney is a little higher than the other?
Left
41
Is the human kidney multipapillate or unipapillate?
multi
42
The apex of the renal pyramids terminates in a _____
papilla
43
What part of the kidney produces urine?
nephrons
44
what are nephrons located within?
corticomedullary tissue
45
How thick is each nephron?
one epithelial cell thick
46
Sub-segments pathway of the nephron
Proximal tubule-->loop henle-->distal tubule-->collecting tubule
47
What type of nephron is the short-looped nephron?
cortical (superficial)
48
Where does the cortical (short-looped) nephron make the u-turn?
b/w the outer and inner medulla. It never enters the inner medulla
49
What is the long-looped nephron?
Juxtamedullary
50
What is the juxtamedullary nephron important for?
urine concentration
51
Three principle elements of renal function
1) Glomerular filtration 2) Tubular reabsorption 3) Tubular secretion
52
Glomerular filtration
plasma filtered from glomerular capillaries into bowmans space
53
Tubular reabsorption and its function
movement of substances from lumen into the peritubular capillary principle mechanism for modifying the composition of the filtered fluid
54
Tubular secretion
movement of substances from the peritubular capillary into the lumen
55
What must be known to draw conclusions about excretory capacity?
urine flow rate
56
Micturition reflex
As the bladder fills with urine: increase stretch-->increase parasympathetic activity-->increase detrusor muscle contraction
57
Abnormalities of micturition?
Automatic bladder | Atonic bladder
58
Automatic bladder
spinal cord damage above sacral region-->periodic unintended bladder emptying
59
Atonic bladder
loss of sensory nerve fibers | No micturition reflex therefore bladder overflows a few drops at a time - overflow incontinence
60
where is the site of ultrafiltration?
glomerulus
61
Major components of the Filtration Slit (Diaphragm) Mutation in these components are associated with what?
Connector proteins Linker proteins Actin-cytoskeleton complex Glomerular dysfunction
62
Mesangial cells functions
``` Provide structural support secrete ECM phagocytic activity secrete prostaglandins and cytokines has contractile activity ```
63
What gives the negative charge to the "filtration pathway"?
high glycoprotein content of the basement membrane
64
Oncotic pressure is what?
osmotic pressure due to protein
65
In contrast to systemic capillaries, hydrostatic pressure remains _____ along the glomerular capillary What is this due to?
relatively constant Presence of resistance points before and after the glomerular capillaries
66
In contrast to systemic capillaries, glomerular oncotic pressure progressively _____ along the capillary Why?
increases | b/c as fluid is filtered out the concentration of non-filterable proteins increases
67
How is Glomerular Filtration Rate (GFR) primarily regulated?
By regulating glomerular capillary hydrostatic pressure (GC)
68
If theres a decrease in resistance in the afferent arterioles, what happens to PGC, GFR, and RPF
PGC increase GFR increase RPF increase
69
If theres an increase in resistance in the afferent arterioles, what happens to PGC, GFR, and RPF
all decrease
70
If theres a decrease in resistance in the efferent arterioles, what happens to PGC, GFR, and RPF
PGC decrease GFR decrease RPF increase
71
If theres an increase in resistance in the efferent arterioles, what happens to PGC, GFR, and RPF
PGC increase GFR increase RPF decrease
72
GFR is primarily physiologically regulated by what?
changing resistance (diameter) of afferent arterioles via renal sympathetic nerves (vasoconstriction to decrease GFR) and angiotensin II (vasoconstrictor)
73
Blood pressure has an inverse relationship with what?
sympathetic activity angiotensin II decrease in BP causes increase in symp. and angio to increase renal vasoconstriction = increases BP
74
Major vasodilators?
prostaglandins
75
What stimulates prostaglandin synthesis?
sympathetic activity | angiotensin II
76
Changes in intratubular pressure due to a ureteral obstruction like a ureteral stone causes what reflex? what does it do?
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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