Renal

Question 1

Water distribution in body

Answer 1

Intracellular - 2/3

Extracellular - 1/3; 3/4 interstitial, 1/4 plasma

Question 2

Macula densa

Answer 2

Cells w/in juxtaglomerular apparatus that sample blood after it passes by the convoluted loop of Henle and adjust afferent and efferent arteriole diameter to maintain flow

Question 3

Podocytes

Answer 3

Cells that form the permeable membrane in the Bowman’s capsule

Question 4

Nephrotic syndrome

Answer 4

Large amounts of protein leak out of glomerulus;

Question 5

Nephron

Answer 5

Functional unit of the kidney

Question 6

Aldosterone

Answer 6

Increases Na+ and H+ reabsorption at distal and collecting tubules.
Released from adrenal cortex, stimulated by angiotensin II
Production controlled by ACTH from pituitary

Question 7

EPO (erythropoietin)

Answer 7

Released by kidneys, stimulates RBC production

Question 8

Creatinine Clearance

Answer 8

Creatinine can be used instead of Inulin to measure GFR.
Serum creatinine is inversely related to Ccr and GFR
High level of serum creatinine indicates low GFR/loss of nephrons. Serum levels don’t start increasing until ~70% of nephrons are lost.
Normal = .8-1.4; higher = increased GFR

Question 9

Angiostensin II

Answer 9

Stimulates aldosterone release
Systemic vasoconstriction
Preferential vasoconstriction of efferent renal arteriole
Increases Na+ reabsorption at proximal tubule

Question 10

ADH

Answer 10

Produced and stored in posterior pituitary
Released when hypothalamus senses increased serum osmolarity
Increases H2O permeability at distal tubule and collecting duct (V2 receptors)
Increase thirst via thalamus
Increase vasoconstriction of arterioles (V1 receptors)

Question 11

ANP/BNP

Answer 11

Released when atrium is stretched (BP is high)
Inhibits renin secretion
Inhibits Na+ reabsorption at tubules and collection ducts (opposes aldosterone)
Vasodilates afferent renal arterioles and constricts efferent (increase GFR)
High presence of ANP can indicate heart failure and differentiate b/w card. and pulm. issues

Question 12

Proteinuria

Answer 12

Protein in the urine

Causes immune response in the tubules and damages nephrons - chronic inflammation causes scarring

Question 13

Pre-renal kidney failure

Answer 13

Renal hypoperfusion - nephrons are functional but not getting enough blood/nutrients
Caused by low circulating volume - hemorrhage, dysentary, cholera, pancreatitis

Question 14

Intrinsic renal failure

Answer 14

Renaovascular obstruction (blockage in renal artery)
Glomerular disease/acute tubular necrosis - toxins in blood poison nephron cells
Interstitial nephritis - post-strep glomerulonephritis, lupus nephritis (immune cells develop antibody that attack kidneys)

Question 15

Casts in urine

Answer 15

Granular cast that resembles tubule - indicates tubule damage

Question 16

Functions of the kidney

Answer 16

Excretion of metabolic waste and toxins
Osmotic regulation
BP regulation
Acid/base regulation
RBC production regulation
Calcium, phosphorous and vitamin D regulation

Question 17

Juxtaglomerular cells

Answer 17

Found around afferent and efferent arterioles

Produce and release renin

Question 18

Macula Densa cells

Answer 18

Found in distal tubule
Monitors volume/flow in distal tubule through NaCl levels
At low NaCl, macula densa cells dilate afferent arteriole and increases renin relase

Question 19

Parathyroid hormone

Answer 19

Increases calcium reabsorption and phosphorous secretion

Question 20

Prostaglandin affect on GFR

Answer 20

Vasodilate afferent arterioles

Question 21

Sympathetic effect on GFR

Answer 21

Preferential vasoconstriction of afferent arterioles (decrease GFR)

Question 22

Aldosterone’s site of action

Answer 22

Distal tubule, collecting tubule, collecting duct

Question 23

Angiotensin’s site of action

Answer 23

Arterioles, proximal tubule

Question 24

ANP’s site of action

Answer 24

Tubules and collecting duct

Question 25

ADH’s site of action

Answer 25

Distal tubule, collecting tubule, collecting duct

Question 26

Parathyroid hormone’s site of action

Answer 26

Distal tubule

Question 27

Azotemia

Answer 27

Increased nitrogen in blood - indication of renal failure

Question 28

Oliguria

Answer 28

Low urine output (<40 ml/day)

Question 29

Uremia

Answer 29

Urea in blood

Question 30

Signs/symptoms of renal failure

Answer 30

Oliguria, azotemia, uremia, acidosis/alkalosis, electrolyte imbalance, calcium/phosphorous imblance