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Urology > Ren Reg > Flashcards

Ren Reg Flashcards

1
Q

Osmolarity equation

A

Concentration x no. of dissociated particles (Osm/L)

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2
Q

Body fluid distribution

A

2/3 intracellular fluid

1/3 extracellular fluid 
-1/4 intravascular (plasma)
-3/4 extra vascular 
—95% interstitial fluid
—5% transcellular fluid
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3
Q

Reabsorption thin descending limb

A

Water (passive) 15%

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4
Q

Reabsorption thick ascending limb

A

Sodium (active and passive)

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5
Q

Reabsorption of PCT

A

67% water

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6
Q

Reabsorption CD

A

Variable water

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7
Q

Urea recycling

A

Urea transported out of CD through UT-A1 (through apical cell membrane) and UT-A3 (through basolateral cell membrane) into medullary interstitium
Urea either goes to vasa recta (UT-B1) or loop of Henle (UT-A2)

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8
Q

Purpose of urea recycling

A

Increase osmolarity of interstitium

Urine concentration occurs
Urea excretion requires less water

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9
Q

Vasopressin production

A

Hypothalamus

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10
Q

Vasopressin storage

A

Posterior pituitary

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11
Q

Factors affecting ADH production

A 
Plasma osmolarity - positive 
Blood pressure -negative
Blood volume - negative 
Nausea - positive
Angiotensin II - positive 
Nicotine - positive 
Ethanol - negative 
Atrial natriuretic peptide - negative
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12
Q

Mechanism of action for ADH

A

Bind to V2 receptor
Activates G protein signalling cascade
Activates adenylate cyclase and then protein kinase A
Increases secretion of aquaporin 2 channels in recycled form
Transported to apical cell membrane
Water flows through AQP 2 (apical cell membrane) and then AQP 3 and 4 (basolateral cell membrane) to be reabsorbed in blood

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13
Q

ADH effect on aquaporin

A

AQP2 and 3 affected as required based on water intake

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14
Q

Diuresis thick ascending limb

A

Increased dilute urine excretion
Sodium reabsorption
(3)Sodium (2)potassium ATPase pump, potassium chlorine symporter and chlorine channel out to create low sodium concentration within
Sodium potassium (2)chlorine symporter pump in down gradient

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15
Q

Diuresis collecting duct

A

Sodium passive in

(3)Sodium (2)potassium ATPase out

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16
Q

Antidiuresis effect

A

Thick ascending limb: Sodium potassium chlorine (2) symporter increase
DCT: Sodium chlorine symporter increase
Collecting duct: Sodium channel increase

17
Q

Role of kidney in acid base balance

A

Secretion and excretion of H+
Reabsorption of HCO3-
Production of new HCO3-

18
Q

Reabsorption of bicarbonate ion percentage

A

PCT - 80%
Ascending limb - 10%
DCT - 6%
Collecting duct - 4%

19
Q

Fluid leaving PCT into thin descending limb

A

Isoosmotic

20
Q

Fluid leaving thick ascending limb into DCT

A

Hypoosmotic

21
Q

Fluid leaving DCT into CD

A

Hypoosmotic

22
Q

Diuresis DCT

A

Sodium potassium ATPase pump and potassium chlorine symporter out
Sodium chlorine symporter in

23
Q

Reabsorption of bicarbonate in PCT

A

CO2 enter cell by diffusion from tubular fluid
With water through carbonic anhydrase, produce H+ and bicarbonate
H+ leaves to tubular fluid through sodium hydrogen antiporter or hydrogen ATPase
Bicarbonate is reabsorbed into blood through sodium bicarbonate symporter

24
Q

Reabsorption of bicarbonate in DCT and CD

A

Alpha intercalated cell (normal)

  • proton ATPase pump or proton potassium ATPase pump H+ into tubular fluid
  • chlorine bicarbonate antiporter pump bicarbonate into blood

Beta intercalated cell (acidosis)

  • chlorine bicarbonate antiporter pump bicarbonate into tubular fluid
  • proton ATPase pump H+ into blood
25
Q

Production of new bicarbonate in PCT

A

Glutamine gives two molecules of ammonium and glutamate, which turns to 2 bicarbonates and reabsorbed
Ammonium exit through tubular fluid through sodium proton antiporter (substitute proton) or becomes ammonia and binds with proton in tubular fluid to become ammonium

26
Q

Production of new bicarbonate in DCT and CD

A

Alpha intercalated cell

  • hydrogen enters tubular fluid and neutralised by phosphate buffer system
  • gains one bicarbonate ion
27
Q

Metabolic acidosis characteristic

A

Decreased bicarbonate

Decreased pH

28
Q

Metabolic acidosis compensation

A

Increased ventilation

Increases bicarbonate reabsorption and production

29
Q

Metabolic alkalosis characteristic

A

Increased bicarbonate

Increased pH

30
Q

Metabolic alkalosis compensation

A

Decreased ventilation

Increased bicarbonate excretion

31
Q

Respiratory acidosis characteristic

A

Increased PCO2

Decreased pH

32
Q

Respiratory acidosis compensation

A

Acute - intracellular buffer

Chronic - increases bicarbonate reabsorption and production

33
Q

Respiratory characteristic

A

Decreased PCO2

Increased pH

34
Q

Respiratory alkalosis compensation

A

Acute - intracellular buffer

Chronic - decreased bicarbonate reabsorption and production

Urology (12 decks)

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