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Fundies Second test > Renal 1 > Flashcards

Renal 1 Flashcards

1
Q

secretion vs. reabsorption

A

secretion: moving from system into glomiluar filtrate
reabsorption: from renal tubule into system

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2
Q

secretion vs. reabsorption

A

secretion: moving from system into glomiluar filtrate
reabsorption: from renal tubule into system

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3
Q

Renal activity major influencer of ____ and ____ fluid compartments

A

ECF and ICF

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4
Q

filtrate not urine until hits

A

ureter

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5
Q

Total boday water TBW broken into 2 categories

A

ECF 1/3

ICF 2/3

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6
Q

ECF broken into 3 categories

A
  1. interstitial fluid 3/4
  2. plasma 1/4
  3. transcellular fluid .5 liters
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7
Q

provides immediate environment around cell

A

ECF–responsible for health of individual cells

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8
Q

_____ plays major part in composition of ECF

A

kidneys

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9
Q

7 rolls of kidneys

A
  1. excretion of metabolic waste
  2. regulation of H2O/ electrolyte balance
  3. Regulate body fluid osmolarity
  4. Regulate arterial pressure
  5. Regulate acid/base balance–excretion of “fixed” acids
  6. Regulate erythrocyte production via erythropoietin- ^ HgB
  7. Influence Ca/ Phosphorus/ Vit D metabolic pathways
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10
Q

arterial pressure regulated by

A
  1. varying levels of Na+/H2O

2. direct and indirect effect of the Rennin-angiotensin-aldo system

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11
Q

Gen Kidney Functions 8

A
  1. osmotic press and volume
  2. ions
  3. Acid/Base
  4. BP
  5. waste removal
  6. Toxic compounds
  7. hormone production
  8. degrade hormones
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12
Q

Ca and Phosphorus move in ______ ________ in blood

A

opposite direction–seasaw

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13
Q

Functional unit of kidney

A

the nephron

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14
Q

____ kidney a little higher

A

left

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15
Q

outer layer of kidneys

A

cortex

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16
Q

______ and ______ calyx

A

major and minor

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17
Q

nephron composed of

A
  1. glomerulus–accompanying eff/aff arterial surrounded by Bowman’s capsule
  2. Renal tubules–
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18
Q

number of nephrons/ kidney

A

million

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19
Q

glomerulus produces

A

ultra filtrate of blood

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20
Q

renal tubules lined w/

A

epithelial cells function in reabsorption/ secration of:
water
electrolytes
and waste products

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21
Q

7 Areas of tubules

A
  1. proximal convoluted tubules
  2. proximal straight tubules
  3. thin descending limb of the loop of Henley
  4. thick ascending limp of LofH
  5. Early distal tubule and Macula densa
  6. distal convoluted tubule
  7. collection duct
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22
Q

second capillary network in the unusual arrangement of two capillary beds in series

A

peritubular capillary beds

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23
Q

kidneys engage in ________-allowing for consistant blood flow

A

autoregulation of blood flow–from roughly 60-180 torr–even for transplanted kidneys (not reliant on ANS)

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24
Q

**_______ ________ allows for autoregulation–watch video

A

jutaglomerular apparatus–macula densa cells at glomerular capillaries

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25
Q

_____% of blood presented to glomerulus is filtered

A

20%

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26
Q

filtrate is identical to serum plasma except missing

A

protein and other larger substances in serum plasma

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27
Q

GFR

A

glomerular filtration rate

ml/minute

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28
Q

renal pathophys

A
  1. DIABETES (main cause)
  2. HTN hypertension (^ African Americans–> kidney failure)
  3. glomerulunephritis
  4. UTI
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29
Q

if protein in urine

A

problem with glomerulus likely–podocytes damaged–> proteinuria

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30
Q

leakage of very large amounts of protein (albumin) from glomerulus resulting in massive proteinuria

A

nephrotic syndrome –> edema (lower oncotic pressure)

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31
Q

fenestrated filtering cells of glomerulus

A

podocytes

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32
Q

molecule used to test GFR

A

Inulin–Fick principle

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33
Q

small rises in serum creatinine may indicate

A

impairment or loss of function of majority of nephrons

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34
Q

constrict afferent blood flow

A

lower RBF
lower GFR
& visa versa for dilation

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35
Q

constrict efferent blood flow to glom

A

lower RBF
raise GFR
and visa versa for dilation

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36
Q

Renal activity major influencer of ____ and ____ fluid compartments

A

ECF and ICF

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37
Q

filtrate not urine until hits

A

ureter

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38
Q

Total boday water TBW broken into 2 categories

A

ECF 1/3

ICF 2/3

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39
Q

ECF broken into 3 categories

A
  1. interstitial fluid 3/4
  2. plasma 1/4
  3. transcellular fluid .5 liters
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40
Q

provides immediate environment around cell

A

ECF–responsible for health of individual cells

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41
Q

_____ plays major part in composition of ECF

A

kidneys

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42
Q

7 rolls of kidneys

A
  1. excretion of metabolic waste
  2. regulation of H2O/ electrolyte balance
  3. Regulate body fluid osmolarity
  4. Regulate arterial pressure
  5. Regulate acid/base balance–excretion of “fixed” acids
  6. Regulate erythrocyte production via erythropoietin- ^ HgB
  7. Influence Ca/ Phosphorus/ Vit D metabolic pathways
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43
Q

arterial pressure regulated by

A
  1. varying levels of Na+/H2O

2. direct and indirect effect of the Rennin-angiotensin-aldo system

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44
Q

Gen Kidney Functions 8

A
  1. osmotic press and volume
  2. ions
  3. Acid/Base
  4. BP
  5. waste removal
  6. Toxic compounds
  7. hormone production
  8. degrade hormones
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45
Q

Ca and Phosphorus move in ______ ________ in blood

A

opposite direction–seasaw

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46
Q

Functional unit of kidney

A

the nephron

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47
Q

____ kidney a little higher

A

left

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48
Q

outer layer of kidneys

A

cortex

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49
Q

______ and ______ calyx

A

major and minor

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50
Q

nephron composed of

A
  1. glomerulus–accompanying eff/aff arterial surrounded by Bowman’s capsule
  2. Renal tubules–
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51
Q

number of nephrons/ kidney

A

million

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52
Q

glomerulus produces

A

ultra filtrate of blood

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53
Q

renal tubules lined w/

A

epithelial cells function in reabsorption/ secration of:
water
electrolytes
and waste products

54
Q

7 Areas of tubules

A
  1. proximal convoluted tubules
  2. proximal straight tubules
  3. thin descending limb of the loop of Henley
  4. thick ascending limp of LofH
  5. Early distal tubule and Macula densa
  6. distal convoluted tubule
  7. collection duct
55
Q

second capillary network in the unusual arrangement of two capillary beds in series

A

peritubular capillary beds

56
Q

kidneys engage in ________-allowing for consistant blood flow

A

autoregulation of blood flow–from roughly 60-180 torr–even for transplanted kidneys (not reliant on ANS)

57
Q

**_______ ________ allows for autoregulation–watch video

A

jutaglomerular apparatus–macula densa cells at glomerular capillaries

58
Q

_____% of blood presented to glomerulus is filtered

A

20%

59
Q

filtrate is identical to serum plasma except missing

A

protein and other larger substances in serum plasma

60
Q

GFR

A

glomerular filtration rate

ml/minute

61
Q

renal pathophys

A
  1. DIABETES (main cause)
  2. HTN hypertension (^ African Americans–> kidney failure)
  3. glomerulunephritis
  4. UTI
62
Q

if protein in urine

A

problem with glomerulus likely–podocytes damaged–> proteinuria

63
Q

leakage of very large amounts of protein (albumin) from glomerulus resulting in massive proteinuria

A

nephrotic syndrome –> edema (lower oncotic pressure)

64
Q

fenestrated filtering cells of glomerulus

A

podocytes

65
Q

molecule used to test GFR

A

Inulin–Fick principle

66
Q

small rises in serum creatinine may indicate

A

impairment or loss of function of majority of nephrons

67
Q

constrict afferent blood flow

A

lower RBF
lower GFR
& visa versa for dilation

68
Q

constrict efferent blood flow to glom

A

lower RBF
raise GFR
and visa versa for dilation

69
Q

loop of Hennley dips into

A

medulla

70
Q

inflammation of nephron

A

leads to scarring –> nonfunctioning

71
Q

Highest portion of renal tubules for reabsorption of nutrients from glomerular filtrate

A

proximal convoluted tubules (90 L/day)

72
Q

saturation kinetics

A

in relation to glucose reabsorption in proximal convoluted tubules–glucosuria when glucose transporters saturated

73
Q

descending loop of Henley main function

A

highly permeable to water–>concentrates filtrate as is descends through pyramids–pumps –

74
Q

proximal tubules less permeable to

A

waste products such as urea

75
Q

inner renal medulla is very ________

A

hyperosmolar–sucks water from the tubules of osmosis –> ^ solute concentration in filtrate

76
Q

THIN ascending loop of Henle ______ to H20

A

impermeable–permeable to NaCl–>medulla pulls salt out–CYCLE to keep gradiant high in medulla

77
Q

THICK ascending loop of Henle _____ to H2O. Actively transports large amounts of ___ ___ and ____, making urine _____

A

impermeable-
Na, Cl, K-
HYPOtonic

78
Q

test of GFR–minimally altered by glomerulus

A

creatinine clearance test– freely filtered–tests sum-total of creatine cleared–TESTS GFR

79
Q

site of action of Loop Diuretics

A

Thick ascending loop of Henle–impair Na, Cl, K pumps

80
Q

osmolarity

A

concentration of solutes in solution

81
Q

juxtaglomerular complex located in

A

early portion of distal renal tubule–part of feedback control for GFR

82
Q

Ascending loop of henle is the ________ portion

A

filtrate diluting

83
Q

descending loop of henle is the _______ portion

A

filtrate concentrating

84
Q

distal renal tubules are ______ to H2O. Avidly ____ ions

A

impermeable –

reabsorb

85
Q

ADH (vasopresin) ______ pores

A

opens—in area btwn cortex and medulla

86
Q

areas of final precessing of glomerular filtrate

A

late distal renal tubule and cortical collecting tubules

87
Q

compound released by JG changes angiotensin I –> angiotensin II (jobs: vasoconstriction arterial, releases aldo from adrenal cortex, and ^ proximal renal tubule reabsorbtion of Na)

A

renin

88
Q

permeability of late distal renal tubules and cortical collecting ducts controlled by

A

ADH–

89
Q

hyperkalemia

A

^ potassium

90
Q

in distal renal tubule and cortical collecting tubules, which cells absorb Na and H2O and secrete K

A

“Principle Cells”

Also increases Na absorption here–trades for K

91
Q

area of final urine processing

A

medullary collecting ducts

92
Q

Medullary collecting duct’s permeability to H2O controlled by? Secretes ___ against ______ gradient.

A

ADH-

H+, gradient (IMP for acid/base regulation)

93
Q

fixed acid

A

anything but CO2 for our purposes

94
Q

system that controlles release of aldo

A

renin-angiotensin-aldosterone system

95
Q

bicarbonate is ______ –generated by kidneys

A

basic

96
Q

If osmolarity of body fluids is increased, the hypothalamus will stimulate pituitary to release ____.

A

ADH-increases reabsorption of H2O

97
Q

hormone that inhibits reabsorption of Na+, H2O. (opposite of aldo)

A

atrial natriuretic peptide-

distention of atria (too much preload) ANP is released

98
Q

hormone released by ____ ____ in response to low serum Ca?

A

parathyroid gland-

parathyroid hormone

99
Q

parathyroid hormone increases _____ ___ _______, and decreases _____ _____ _______

A

renal Ca reabsorption-

renal phosphate reabsorption

100
Q

kidney sends message with ______. Receives messages by way of _______, _____, _____,

A

Renin-

ADH, aldo, atrial natriuretic peptide

101
Q

Kidney role in acid/base dynamic

A
  1. synth and reabsorb HCO3

2. excrete fixed acids i.e. NH4+

102
Q

2 terms for buildup of nitrogen based waste products in body from inadequate renal function (renal failure)

A
  1. uremia

2. azotemia

103
Q

RAPID decline in renal function

A

Acute renal failure–primarily result of decline in GFR

104
Q

renal failure from lack of blood flow to kidneys

A

pre-renal failure

105
Q

(acute) problem with kidney its self

A

intrinsic acute renal failure–i.e. toxin

106
Q

(acute) obstruction in kidney output (bladder obsturction, prostatic hypertrophy, tumor, etc.)

A

post renal failure–backs urine up–no filtration

107
Q

3 ACUTE liver failures–often reversible

A

pre-renal
intrinsic
and post-renal failure

108
Q

non-reversible, decline in GFR over months-years–loss of nephron mass

A

chronic renal failure CRF

109
Q

causes of chronic renal failure

A

HTN, Diabetes melitus, obstruction, infection

110
Q

end stage chronic renal failure

A

anuria

111
Q

Signs/ symptoms of chronic renal failure

A
  • uremia
  • hyperkalemia
  • metabolic acidosis
  • anemia
  • osteoporosis
  • volume overload-CHF
  • pheripheral neuropathy
  • anorexia
  • endocrine disturbances
112
Q

abnormal constituents of urine on urinalysis

A
  1. glucose
  2. proteinuria
  3. hematuria (RBCs or HgB)
  4. presence of WBCs
  5. ^ # of crystals (microscopically)
  6. Casts (“cast” of renal tubule–should never see i.e. blood)
  7. Bilirubin
113
Q

measure of urine concentration by urinalysis

A

specific gravity–roughly 1035 (concentrated) - 1001 (dilute)

114
Q

pH of urine

A

5-9, depending on diet

115
Q

Renal function serum (blood) test (3)

A
  1. creatinine
  2. Blood urea nitrogen BUN
  3. creatinine clearance
116
Q

prevent ARF and CRF

A

adequate treatment of streptococcal infections

117
Q

specific gravity of ____ is apx isotonic with normal serum osmolarity

A

1010

118
Q

afferent:
efferent:

A

in–larger

out–smaller

119
Q

BUN vs. creatinine clearance

A

BUN not as useful–too much mod/reuptake of blood uria nitrate

120
Q

one “unit” of blood

A

one pint = 450 mL

121
Q

diarhea as from dissentery or cholera–water comes from

A

circulating blood volume–>no cardiac preload (pre-renal failure)–>heart collapse–>death

122
Q

pancreas makes

A
  • bicarb to neutralize stomach acid

- enzymes to break down foodstuffs

123
Q

As it pertains to ADH action on:
V1 receptors:
V2 receptors:

A

V1 = vasoconstriction (hence the name “vasopressin”)

V2 receptors mediate water reabsorption

124
Q

Angiotensin II ______ efferent vessels to greater degree than _______ vessels

A

constricts,

afferent

125
Q

Prostaglandins cause __________ of afferent arterioles

A

vasodilation

126
Q

SNS ______ afferent arterioles to greater degree than efferent

A

constricts

127
Q

_______ and _____ ____ are completely reabsorbed

A

glucose and aa’s

128
Q

loope of Henle responsible for _____ ______, hyperosmolar gradiant set by ascending pulls water from descending

A

countercurrent multiplication

129
Q

________ ______ _______ secrete H+ against _____ _____

A

medullary collecting ducts,

large gradient

130
Q

Aldosterone production directed by _____ ______, secretion directed by ____________________

A

pituitary gland,

renin-angiotensin-aldosterone system

131
Q

renal hypoperfusion as from hypovolemia example of:

A

PRERENAL azotemia

Fundies Second test (8 decks)

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