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PHYSIO > Renal 2 > Flashcards

Renal 2 Flashcards

1
Q

How much fluid an hour does your kidneys produce?

A

7 L of fluid per hour

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2
Q

Endocrine function of the kidney:

A

production of EPO and activation of vitamin D: cofactor for intestinal calcium absorption

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3
Q

Nearly all the cells in the nephron have what?

A

A single cilium, which have mechanoreceptors and chemoreceptors, to sense flow rate and composition of filtrate

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4
Q

Smooth muscle cells in the glomerulus have two phenotypes?

A

contractile and secretory

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5
Q

3 types of cells in the glomerulus

A

endothelial cells, podocytes, mesengial cells

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6
Q

Name the order of layers from the glomerulus inside out

A

mesangial cells, mesangial matrix, endothelial cells, basement membrane, podocytes

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7
Q

What type of cells line the nephron/glomerulus?

A

columnar epithelial cells

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8
Q

What prevents the passing of cells and large proteins in the glomerulus?

A

basement membrane and proteins in the slit pores

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9
Q

What is normal GFR?

A

125 ml/min

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10
Q

What is the purpose of mesangial cells?

A

structural support of glomerular capillaries, secretion of matrix proteins, phagocytosis and regulating GFR; by contracting and relaxing mesangial cells can alter available surface area for filtration and affect GFR.

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11
Q

What is the most important factor for determining GFR?

A

blood volume, if blood volume increases GFR increases. auto regulation protects the glomerular cappilary

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12
Q

What is filtered load?

A

The amount of a particular solue filtered per time

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13
Q

What makes up the glomerular filtration barrier?

A

endothelial cells, basement membrane, podocytes. Macula densa cells are part of the juxtaglomerular apparatus and sense the chloride concentration in the distal tubule and adjust the diameters of arterioles accordingly.

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14
Q

Proximal convoluted tubule characteristics:

A

cuboidal epithelium and contains microvili

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15
Q

What transporters are on the proximal convoluted tubule?

A

Apical: Na/Glucose cotransporter, Na/H exchanger; NaCl go through the tight junctions;Na K atpase on the basolateral side

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16
Q

What does the PCT reabsorb?

A

2/3 of water, electrolytes, all of glucose, amino acids, proteins, vitamins

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17
Q

Loop of Henle thin descending loop is permeable to what?

A

water, and the thick ascending limb is IMPERMEABLE to water

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18
Q

What transporter is on the apical side of the thick ascending limb?

A

Na K 2CL (pumps ions into the interstitial) = this is where loop diuretics work!

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19
Q

Which nephrons are vital to make concentrated urine?

A

juxtamedullary nephrons

20
Q

Order of blood flow in capillaries

A

lobar, interlobular, afferent arteriole, glomerulus, efferent arteriole, peritubular capiliaries, interlobular vein

21
Q

Intercalated cells secrete what?

A

secrete H or HCO3 and reabsorb K

22
Q

Principal cells reabsorb and secrete what?

A

secrete K and reabsorb Na

23
Q

Where is the fluid hyposmotic?

A

In the distal convoluted tubule; further reabsorption is due to hormonal control

24
Q

Where does aldosterone and angiotensin II work?

A

In the principle cells: overall NA reabsorption and K excretion; angiotension II up regulates the amilaride transporter; aldosterone up regulates the NaK pump on the BL side.

25
Q

Where does ADH work?

A

Principal cells; makes aquaporins

26
Q

In the distal convoluted tubules what do ANP and urodilatin do?

A

urodilantin inhibits Na reabsorption at the amilaride pump on the apical side

27
Q

What pumps are in the intercalated cell on the apical side?

A

H/Na pump (uses ATP) and the H/K pump (uses ATP) on the BL side there is a CL/HCO3 counter transporter recycling bicarb (no ATP used)

28
Q

What forms the medullary pyramids?

A

the collecting duct which empty into the minor calicoes through the papilla to the renal pelvis

29
Q

Intercalated cells contain what pumps?

A

H ATPase, H/K pump; they reabsorb HCO3 via the Cl/HCO3 exchanger on the basolateral side

30
Q

Principle cells contain what pumps?

A

Na/K ATPase and reabsorb NA (aldoserone) on the BL side and H2O channles via aquaporins on the apical side

31
Q

What are the components of the juxtaglomerular apparatus?

A

glomerulus, macula densa, juxtaglomerular cells that produce and release renin

32
Q

3 ways to promote renin release

A

Macula densa senses NaCl, nerve, baroreceptor

33
Q

Macula densa senses concentrations of solutes in the distal tubule via what transporter?

A

Na 2Cl K, then it will affect renin release

34
Q

What are important chemical mediators of arteriolar resistance?

A

ANGIOTENSIN II, Adenosine,NO, prostaglandins

35
Q

Where does glucose get reabsorbed and how?

A

By the sodium dependent cotransporter: SGLT2

36
Q

True or false: bicarb is freely filtered by the glomerulus and must be reabsorbed to maintain acid base balance?

A

True; but bicarb is not directly reabsorbed across the renal epithelium it must do the carbonic acid equation. The H’s get across the apical/tubular membrane via a H/Na exchanger

37
Q

When regulating acid base balance, where is the Na/H exchanger located? apical or basolateral?

A

apical side, its pumping H out into the tubule to buffer, and pumping Na back into the interstitium.

38
Q

Secretion of potassium is promoted by what?

A

The Na-K pump on the basolateral side, this is regulated by ALDOSTERONE, potassium is also regulated by the K/H exchanger on the basolateral side!!

39
Q

Osmotic diuretics

A

Work at the PCT; increase osmolality of the filtrate causing more water to remain in the tubule

40
Q

ACE inhibitors

A

Work on the H/K pump in the DCT

41
Q

Loop diuretics work where?

A

the Na K 2Cl pump in the ascending loop of henle

42
Q

Thiazide like diuretics:

A

block Na reabsorption (DCT)

43
Q

Potassium wasting diuretics

A

osmotic, ACE inhibitors, loop and thiazide like diuretics

44
Q

Aldosterone blocking agents are:

A

POTASSIUM SPARING; still cause an increase in urine volume though

45
Q

The infant:

A

has low GFR in the post-natal period, has reduced ability to make concentrated urine due to immature kidneys, predisposed to fluid depletion.

46
Q

The adult/elderly

A

kidneys diminish at 40 and significantly by 60. loss of nephrons, diminished renal blood flow, decreased GFR, can’t conserve salt and water, most susceptible to electrolyte imbalances.

47
Q

order of the glomerular membrane

A

fenestrated epithelium, basement membrane, space between podocytes, filtration slit, bowman’s space

PHYSIO (7 decks)

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