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Phg 202 > Renal > Flashcards

Renal Flashcards

1
Q

Kidneys weigh ——-

  • % of the body weight
A

they weigh 300g (0.4% of body weight)

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2
Q

Kidney have a longitudinal slit called —- that leads to a shallow C shaped——

A

HILUS

renal sinus

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3
Q

outer —— —- zone is —-

inner——- zone ——

A

.outer granular reddish zone cortex

.an inner paler striated zone medulla

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4
Q

Junction between the 2 zones of the kidney is called the —-

A

Corticomedullary junction

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5
Q

medulla’s striated look is due to——

A

medullary pyramids (straight ducts and cribiform plates)

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6
Q

Cortex is made up of which parts of the nephron

A

Dct and pct

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7
Q

each base of renal pyramid originates from the —-to the——

A

Corticomedularry junction

papilla

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8
Q

Each kidney is made up of - nephrons

A

-1 to 1.4 million nephrons

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9
Q

What seperates 2 pyramids

A

columns of bertini

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10
Q

functional, structural unit of kidney is the ——

A

Nephron

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11
Q

Types of nephrons ,their percentage in the kidney, and their structure

A

cortical nephron: from 2/3 of outer cortex and ends in outer medullary; more numerous (85%); secretes EPO
-juxta medullary nephron: 1/3 of cortex and ends in inner medullary or even papilla; longer loop of henry; 15% of total nephron; secretes renin and prostaglandin

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12
Q

Which type of nephron has a longer loop of henle

A

-juxta medullary nephron

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13
Q

Which type of nephron is used to produce conc urine

A

-juxta medullary nephron

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14
Q

Number of nephrons started decreasing after what age

A

50

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15
Q

malpigian / renal corpuscles = - + -

A

glomerulus + bowman’s capsule

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16
Q

internally dilated part of a nephron is the -?

A

Bowman capsule

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17
Q

-bowman capsule has a diameter of approximately—?

A

200um

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18
Q

Which is bigger between the afferent and efferent arteriole

A

bigger afferent and smaller efferent arteriole

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19
Q

How many layers does the glomerulus have

List them

A

3

Capillary endothelium

basal membrane/lamina

epithelium/pondocytes

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20
Q

Function of the layers of the glomerulus

A

basal membrane/lamina to seperate the endothelium from epithelium

capillary endothelium with fenestra/holes for filtration

epithelium/pondocytes: numerous pedicles/pseudopodia that interdigitate to form slit pores

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21
Q

Size of :
The holes in the capillary endothelium
The slot pores formed by podocytes

A

70-90nm

25nm

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22
Q

in between the endothelium and basal laminar, are——- that aid in——

A

intraglomerular mesangial cells

contraction and regulate Glomerular filtration

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23
Q 
What type of cells make up the:
Bowman capsule 
Pct
Dct
Thick descending
Thin descending 
Thin ascending 
Thick ascending
Collecting ducts
A 
Flattened simple squamous 
Cuboidal cells with brush border
Cuboidal cells without brush border
cuboidal cells with brush border
flattened epithelium)
flattened epithelium)
Cuboidal cells without brush border
Cuboidal cells
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24
Q

Type of mitochondria in the
Pct
Loop of henle
Dct

A

high density mitochondria

Few scattered mitochondria

few but more dense mitochondria

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25
Q

Absence. Of lateral spaces between bases of the cells of PCT

T/F

A

F. bases of the cells have lateral spaces

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26
Q

What happens to the apical surface of the cells of the pct?

A

apical surface of cells bulge into tubular lumen;

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27
Q

Convoluted part of the the pct is called —-

A

pars convoluta

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28
Q

Straight part of the pct is called???

A

Pars recta/ thick descending limb

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29
Q

Length and diameter of pct

A

14mm length; 55um diameter

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30
Q

Who is longer

Pct or dct

A

Pct

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31
Q

Which part of the loop of henle has numerous mitochondria

A

Thick ascending limb

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32
Q

How is macula densa formed

A

when the thick ascending limb passes between the afferent and efferent arteriole(closer to the afferent), it gets modified into macula densa

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33
Q

Macula densa secretes what?

A

Thromboxane A2

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34
Q

Macula densa is majorly known as an

A

osmoregulator

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35
Q

Juxtaglomerula cells line the - arterioles up to - point

A

juxtaglumerulla granular cells line afferent arteriole densely before it enters the BC.

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36
Q

JG cells secrete—-

A

renin

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37
Q

extraglomerular messangial cells are found within the—— made by the —-

A

triangle

2 arterioles and macula densa

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38
Q

extraglomerular messangial cells are also called —-

A

Lacis cells or goomartogigh

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39
Q

Juxtaglomerula cells are granular or fine??

A

Granular cells

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40
Q

Lacis cells secretes ——?

A

prostaglandins and cytokinins

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41
Q

Abscence of microvilli on dct

t/F

A

F. Just very little

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42
Q

Pct and dct have basal infoldings and a striated look

T/F

A

T

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43
Q

Length and diameter of collecting duct

A

length of 20-22nm and diameter of 200um

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44
Q

Epithelium of collecting duct is made up of - and - cells

A

epithelium is made up of P cells and I cells

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45
Q

Function of :
I cells
P cells

And which one has fewer mitochondria

A

P cells: for osmoregulation; fewer mitochondria

-I cells: for acid base regulation ; fewer than p

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46
Q

in the interstitium of the medulla are secretory cells called —-

A

type 1 medullary interstitial cells

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47
Q

Which is more Numerous in the dct

I or P cells

A

P cells

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48
Q

RENAL ARTERY is from——

A

abdominal aorta around L2

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49
Q

The kidneys receive about —- % of the cardiac output

A

about 22-25% of cardiac output

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50
Q

Arrangement of structure in the hilus from front to back

A

Vein-artery-pelvis-artery

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51
Q

Renal artery to—- artery to—- to—- to—-, to—— to—- to——-

A

segmental

interlobar

arcuate

inter lobular

afferent arteriole

efferent arteriole

peritubular capillaries

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52
Q

URINE FORMATION involves how many steps

List them

A

-3 basic renal actions

GLOMERULAR FILTRATION

REABSORPTION
Secretion

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53
Q

Describe the steps of urine formation

A

GF: filter the blood to form primitive urine
TR:absorp stuff from urine to blood
TS: secrete from blood to urine

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54
Q

List the pressure that affect GFR and describe their effect on GFR and by how much

A

glomerulus hydrostatic pressure which is approximately 60mmHg in the afferent arteriole supports filtration

  • oncotic pressure: 25mmHg ; opposes filtration
  • tissue resistance : 10mmHg; opposes filtration
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55
Q

The net filtration pressure of GFR is ——?

A

net filtration pressure is 25mmHg

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56
Q

substances with molecular weight of less than ——- get filtered

A

68000

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57
Q

GFR is formed at the rate of -/day and -/min

A

180L/day

125ml/min

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58
Q

whole plasma volume gets filtered ——-/day

A

65 times

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59
Q

Which formulae relates the GFR and net filtration pressure

A

filtration coefficient = GFR
—————
Net filtration pressure

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60
Q

Effect of the following on GFR:
Increased blood flow
Decreased plasma protein
Hemorrhage

A 
Increase GFR
Increased gfr(causes edema)
Leads to decreased capillary bp=decreased GFR
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61
Q

List the Mechanisms of regulation of GFR

A

RENAL AUTOREGULATION

NEURAL REGULATION

HORMONAL REGULATION

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62
Q

Types of RENAL AUTOREGULATION and describe them

A

myogenic:
Blood flow: capillary pressure / flow resistance
-tubuloglomerular feedback : macula densa and renal tubule are used; macula sense the level of sodium chloride and adjusts the other guys accordingly

-AUTOREGULATION is possible within 80-180mmHg

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63
Q

Range at which AUTOREGULATION is possible

A

-AUTOREGULATION is possible within 80-180mmHg

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64
Q

Situations when neural regulation of GFR is major and important

A

hemorrhage or exercise

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65
Q

Compensatory mechanism of GFR during hemorrhage or exercise

A

vasoconstriction as a way to conserve blood volume during hemorrhage
-and greater blood flow during exercise

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66
Q

Effect of vasoconstrictors like angiotensin 2 on GFR

A

Reduces it

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67
Q

Effect of vasodilators on GFR

A

Increase it

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68
Q

Example of renal vasodilators

A

bradykinin, prostaglandins, and ANP

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69
Q

Renal blood flow is -L/min

A

1.25L/min

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70
Q

Luminal cell membranes face —-

Basolateral cell membranes face —-

A

face the tubular lumen

in contact with the lateral
intercellular spaces and peritubular
interstitium (“blood” side)

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71
Q

Describe transcellular and paracellular movement

A

The term transcellular refers to movement
of solutes and water through cells
• The term paracellular refers to movement
of solutes and water between cells

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72
Q

For most substances which is more important:

ReAbsorption of secretion

A

ReAbsorption

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73
Q

For Which substances are secretion more important in:

A

K and H

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74
Q

How many percentage of the following are reabsorbed

Glucose 
Amino acids
Bicarbonate 
Calcium
Potassium
A

100
100
90

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75
Q
  • % of sodium reabsorption occurs in the ——
A

90%

In the pct

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76
Q

Permeability of water and salt through the following parts:
Descending thick limb
Ascending thin limb
Ascending thick limb

A

Impermeable to salt;permeable to water

Impermeable to water ; permeable to salt (passive reabsorption)

Impermeable to water ; permeable to salt (active reabsorptoin by Na-K-2Cl )

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77
Q

Glucose is reabsorbed in the —— portion of ——— from the lumen by ——— and then taken into the interstitium by ——-

A

Early portion of pct

SGLT2

GLUT2

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78
Q

Glucose reabsorption is by - type of transport

A

Secondary active co transport

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79
Q

when the Tm G is exceed, the amount of glucose in the urine ——

A

Rises

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80
Q

Transport maximum for glucose is —— in men and —— in women

A

375 mg/min in men and 300 mg/min in women.

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81
Q

Potassium level change from 4 to 5.5 mmoles/l =—-

A

hyperkalaemia

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82
Q

Potassium is not reabsorbed in the pct

T/F

A

F

83
Q

K + reabsorption along the proximal tubule is ——-and follows the ——- and fluid
But in collecting tubules, it may also rely on ——

A

largely passive
movement of Na +
active transport

84
Q

K + secretion is by ——transport of K across ——- membrane and ———- across —- membrane into ——

A

active

basolateral

passive exit

apical

tubular fluid.

85
Q

Mention the only 3 substances that are passively reabsorbed in the pct

A

Cl, H20, urea

86
Q

How many % of the following age reabsorbed at pct

Potassium 
Calcium 
Magnesium 
Sodium
Glucose
Amino acids
Bicarbonate
A 
90%
65%
25%
90%
100%
100%
100%
87
Q

Reabsorption of sodium at
First half of pct
Second half of pct
Is by which transporters and with who

A

SGLUT2: with glucose, amino acids etc

Na-H transporter: with chloride ions

88
Q

Places with a Na-k-2cl transporter

A

Macula densa and thick ascending limb

89
Q

Hydrogen secretion is through ———Transport.

A

Secondary active

90
Q

90% of Hco3 is reabsorbed passively at pct while H is actively secreted
T/F

A

T

91
Q

Ph of adult urine

A

Between ph 5-7

92
Q

Adult urine is acidic

T/F

A

F. It is slightly alkaline

93
Q

Define the counter current system

A

A counter current system is a system in which the inflow runs parallel to, opposite to and in close proximity to for some distance.

94
Q

counterthe outflow current mechanism is also called the———

A

Hair Pin countercurrent mechanism

95
Q

Function of counter current mechanism

A

To form concentrated urine

96
Q

The countercurrent mechanism depend on 3 things. List them

A

Loop of henle
Vasa recta
ADH

97
Q

The superficial layer has an osmotic pressure of —- while in the deeper layers at the renal papillae, the osmotic pressure is——

A

~300 mosm

~1200 mosm

98
Q

The counter current multiplier is the—-

The counter current exchanger is the ———

A

Loop of henle

Vasa recta

99
Q

What is the role of the vasa recta(counter current exchanger)

A

To take up the Na released from the nephron into the interstitium to make sure that the fluid reaching the dct is slightly hypotonic

100
Q

Who preserves the pre-established osmotic gradient of the counter-current system

A

Vasa recta

101
Q

Who prevent indefinite built up of salts inn the renal interstitial space?

A

Vasa recta

102
Q

Define renal clearance

A

It is the vol. of plasma that is completely cleared of a sub. (x) per unit time.

103
Q

Renal clearance is also called??

A

plasma clearance

104
Q

Renal clearance is used for???

A

Measure GFR
Measure RPF
Measure RBF

105
Q

Formula for renal clearance?

A

Cx= Ux Vx

Px

106
Q

Meaning of the parameters for renal clearance formula

A

Cx=clearance of substance x Ux= conc. of x/ml of urine. V= vol. Of urine produced /min. Px = plasma conc. of subs .X/ml of plasma.

107
Q

Preferred substance used for renal clearance
For research
For clinical use

A

Inulin

Creatinine

108
Q

Inulin clearance = GFR

T/F

A

T. It’s 125ml/min

109
Q

Inulin is gotten from —-

A

Plants…

110
Q

If C < 125 ml/min, substance—-
If C = 0, substance ——
If C = 125 ml/min, ——-
If C > 125 ml/min, ——-

A

reabsorbed

completely reabsorbed, or not filtered

no net reabsorption or secretion

substance secreted (most drug metabolites)

111
Q

What substance is used to measure renal blood flow

A

PAH ( Paraminohippurate ) is used.

112
Q

Formulae for renal plasma flow

A

C C PAH PAH P = U PAH x V ml/mol PAH = RPF

113
Q

What other substance can be used to measure RPF besides PAH

A

diodrast

114
Q

Formula for ERBF

A

RPF x 100
——————-
100-HCT

115
Q

Formula for TRBF

A

TRBF:RPF x 1
——
1-Hct

116
Q

Values for
Urea clearance
PAH clearance
Inulin clearance

A

UREA CLEARANCE = 70ml/min

  • PAH clearance = 660ml/min
  • inulin clearance = 125ml/min
117
Q

Ph range of arterial and venous blood

A

Arterial: 7.4 (+- 0.02)
Venous: 7.35(+-0.02)

118
Q

Acids are proton —-

Bases are proton ___

A

Donors

Acceptors

119
Q

Sources of hydrogen ion in the body

A

Phosphorus containing protein releases phosphoric acid

Anaerobic respiration of glucose produces lactic acid

Fat metabolism yields organic acids and ketone bodies

Transporting carbon dioxide as bicarbonate releases hydrogen ions

120
Q

Vegetarian diet has an acidic effect

T/F

A

F. They have alkalizing effect

121
Q

What is a buffer

A

A buffer is a solution that accept little or no change in pH.

122
Q

H+ is removed from the body by which mechanisms

A

Lungs and kidney

123
Q

Examples of buffers

A

Bicarbonate buffer
Acetate buffer
Phosphorous buffer

124
Q

First line of defense in case of H+ imbalance is —-
Second line—-
Third line is ——-

A

Chemical buffer systems-occurs in seconds
Lungs: works in minutes
Kidneys: takes hours

125
Q

Blood buffers can remove H+ from the body

T/F

A

F. They can only mop it up

126
Q

Is the brain sensitive gon mood co2 and ph levels

A

Yes it is

127
Q

Respiratory regulation of ph is by controlling ——

A

Co2 and H20

128
Q

Which mechanism brings a permanent solution to the acid base imbalance

A

Renal mechanism

129
Q

Hydrogen secretion occurs in type - cells and type - cells

A

I and A

130
Q

principal function of Anti-Diuretic Hormone is —-

A

to cause

retention of water by the kidney.

131
Q

ADH regulates the body fluids by ——

A

increases the permeability to water of the distal tubules and the collecting ducts.

132
Q

Deficiency of ADH leads to —-

A

diabetes insipidus

133
Q

Describe diabetes insipidus

A

formation of hypotonic large volume of urine with net water loss from the bod

134
Q

Renin- angiotensin system

  • releases angiotensinogen
  • converts angiotensinogen into x
  • released by - converts x into y
A

Liver
Renin; angiotensin 1
ACE;lungs;angiotensin 2

135
Q

Function of natriuretic hormone(ANP)

A

Its main function is to lower blood pressure and to control electrolyte homeostasis.

136
Q

ANP causes an increase or decrease in GFR

A

Increase in GFR

137
Q

ANP and aldosterone have the same or opposite effect

A

Opposite. ANP aids salt secretion

138
Q

Function of erythropoietin

A

adjustment in erythropoiesis

139
Q

What percentage of ERYTHROPOIETIN is produced in the liver and what percentage is produced in the kidney

A

●85% produced in the kidney and 15% in liver

140
Q

Half life of EPO in circulation

A

5hrs

141
Q

Major stimulus of EPO is—-

Minor stimulus of EPO is —-

A

Hypoxia

Alkalosis at high altitude and hemorrhage

142
Q

EPO is aided by which NTs and inhibited by what

A

Catecholamines, adenosine

Adenosine antagonists

143
Q

Example of adenosine antagonists

A

Theophylline

144
Q

Vitamin D3 is first converted to —- in the ——-

Then it is finally converted to ——- in the ——- of the kidney by —- enzyme

A

25,hydroxycholecalciferol;liver

1,25 dihydroycholecalciferol in the pct of the kidney by 1 α-hydroylase.

145
Q

Active vitamin D is stimulated by

A

Low. Ca level

146
Q

Define micturition

A

It is the process by which the urinary bladder is emptied i.e. urination.

147
Q

The 2 processes involved in micturition are???

A

the progressive filing of the bladder until the tension rises above the threshold level.
2.nervous reflex called micturition reflex.

148
Q

The main bladder muscle is called

A

Detrusor muscle

149
Q

What innervates the bladder

A

Sympa and parasympa nerves

150
Q

Effect of sympathetic nerves and parasympathetic nerves on the bladder and the internal urethral sphincter

A

Sympathetic nerve inhibits the bladder and stimulate the internal sphincter.

• Parasympathetic nerve stimulate the bladder and inhibits the internal sphincter.

151
Q

What innervates the external sphincter

A

Pudendal nerve

152
Q

The parasympathetic nerves involved are—-?

The sympathetic nerves involved are—-?

A

S2,3,4

L1,2

153
Q

First sensation of bladder filling is experienced at a volume of——

Then the 1st desire to void/urinate is when the bladder contains about———

A person becomes uncomfortably aware of a full bladder when the volume is——

The volume of urine that normally initiates a reflex contraction is about——-

An increase in volume to ——creates pain and loss of control!

A

100 – 150 ml in an adult.

150-250 ml of urine.

350-400 ml.

300-400 ml.

700ml

154
Q

Cystometrogram is a plot of —-

A

intravesical pressure vs volume of fluid in the bladder

155
Q

Cystometrogram has 3 segments. Describe them

A

Initial rise in pressure

Nearly flat segment

Sudden sharp rise in pressure

156
Q

Define the law of Laplace

And state the formulae

A

Pressure in a spherical viscus is equal to twice the wall tension divided by the radius

P=2T/r

157
Q

In which segment of the Cystometrogram does the law of Laplace apply

A

Segment 2

158
Q

In which segment of the Cystometrogram is the micturition reflex triggered

A

Third segment

159
Q

Micturition reflex is self regenerative

T/F

A

T

160
Q

Micturition inhibitory areas of the brain and facilitatory areas are??

A

Pons and posterior hypothalamus

Cortex and midbrain

161
Q

Micturition is purely —- in young kids and begins to come under —— control around 2-3 yes old

A

Reflex due to incomplete myelination of the nerve fibers

Cortical control

162
Q 
Causes of:
Atonic bladder
Automatic bladder
Uninhibited neurogenic bladder
Denervated/hyperactive bladder
A

Bbvc

163
Q

Causes of atonic bladder

A

sensory nerve fibers (afferent) from bladder to spinal cord are damaged

Damage to the sacral region of the spinal cord

Tumors, tabes dorsalis

164
Q

In atonic bladder, the efferent fiber are damaged

T/F

A

F. They are intact

165
Q

In atonic bladder, all reflex contraction is lost

T/F

A

T

166
Q

Atonic bladder leads to ——

A

Overflow incontinence

167
Q

Cause of automatic bladder

A

spinal cord damage above sacral region

168
Q

In which bladder issue is higher center voluntary control lost

A

Automatic bladder

169
Q

Cause of Uninhibited Neurogenic Bladder

A

damage to brain/spinal cord that control inhibitory signals for micturition

170
Q

Cause of Denervation/Hyperactive bladder

A

tumors of cauda equina / filum terminale

171
Q

Effect of age on:

Frequency of involuntary bladder contraction

Total bladder capacity

incidence of nocturia

Bladder contractility

A

Increased
Reduced
Increased
Decreased

172
Q

If the underlying problem is metabolic, - mechanism would help

A

Respiratory mechanism

173
Q

Epithelial cells in the dct are - cells

A

I cells

174
Q

Jg cells are most common in which tunicas

A

Tunica media and tunica adventitia

175
Q

Ag1 is a —peptide
Ag2 is a —— peptide
Ag3 is a —peptide
Ag4 is a —-peptide

A

Deca
Octa
Hepta
Hexa

176
Q

Angiotensin 2 has a short or long life span??

A

Short

177
Q

ADH is secreted from ___

A

Hypothalamus

178
Q

Kidneys have a portal circulation. List the 2 beds and state which is of higher pressure

A

Glomerulus -high (60)

Peritubular-low (10)

179
Q

What is filtration fraction

A

fraction (portion) of the renal plasma, which becomes the filtrate.
FF= GFR/RPF x100

180
Q

Define
High threshold substances
Low threshold substances
Non threshold substances

And give examples

A

Do not appear in urine under normal conditions. Glucose, amino acids,vitamins, etc

Appear in urine even under normal circumstances

Must appear in urine no matter the circumstances. Creatinine

181
Q

Tubular epithelial cells are connected with their neighboring cells by——. And space between 2 cells are called—-?

A

tight junctions

Lateral intercellular space

182
Q

ADH binds with —- receptors that are —-tropic

A

Vasopressin

Metabotropic

183
Q

Which aquaporin does the kidney use

A

Aquaporin 2

184
Q

Renal threshold for glucose is ?

A

180mg/dl

185
Q

Location of specialization of the following H secreting mechanisms

Na-H pump
ATP pump
Bicarbonate 
Phosphate 
Ammonia
A

Dct

Dct;CD

Pct;loop;dct

Dct;CD

Pct

186
Q

Which is easier to use, creatinine or inulin

A

Creatinine

187
Q

Origin of pudendal nerve

A

S2,S3,S4

188
Q

UNINHIBITED NEUROGENIC BLADDER is also called —-???

A

spastic neurogenic bladder or hyperactive neurogenic bladder.

189
Q

ADH is produced by —- but secreted by —-

A

Hypothalamus

Pituitary gland

190
Q 
In relation to plasma, what’s the osmolarity of the fluids in these regions.
Bowman’s capsule 
Pct
Thick descending 
Thin descending 
Thin ascending 
Thick ascending 
Dct and CD
A 
Isotonic
Isotonic
Slightly hypertonic
Very hypertonic 
Slightly hypertonic 
Hypotonic
Hypertonic
191
Q

Which cells are responsible for the ADH induced water reabsorbtion

A

P cells

192
Q

Pcells stands for —

I cells stands for —-

A

Principal cells

Intercalated cells

193
Q

Define Osmotic diuresis

A

Diuresis is the excretion of large quantity of water through urine. Osmotic diuresis is the diuresis induced by the osmotic effects of solutes like glucose

194
Q

Osmotic diuresis is common in what sickness

A

Diabetes mellitus

195
Q

Define polyuria

A

Polyuria is the increased urinary output with frequent voiding.

196
Q

Deficiency of ADH leads to—-

Excess of ADH leads to —?

A

Diabetes insipidus

Syndrome of inappropriate hyper secretion of ADH

197
Q

Define Nephrogenic Diabetes Insipidus

A

ADH secretion is normal but the renal tubules just fail to respond to the ADH leading to polyuria

198
Q

Define Barter Syndrome

A

Genetic defect in the thick ascending limb making the person not able to reabsorb enough NaCl and water leading to excretion of sodium and water in urine

199
Q

Respiratory alkalosis can be fixed by ???

A

Metabolic mechanism

200
Q

What is my name😤

A

thee stallion

201
Q

Effect of spironolactone on potassium levels

A

Prefer hypokalemia

202
Q

Beta blockers in hypertension treatment will contribute to hyperkalemia
T or F

A

T. Beta Adrenergic stimulation usually causes potassium to move into the cell

203
Q

The most numerous intracrllular buffer is—-

A

Protein buffer

204
Q

Normal bicarbonate levels :

Normal co2 levels

A

Normal bicarbonate levels are: 23 to 30 mEq/L in adults.

the value of PCO2 ranges between 35 to 45 mmHg or 23 to 29 milliequivalents per liter (mEq/L)

Phg 202 (4 decks)

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