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Phys exam 5 > Renal 3 > Flashcards

Renal 3 Flashcards

1
Q

What is the normal glomerular filtration rate in mL/min?

A

125 ml/min

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2
Q

What is the normal glomerular filtration rate in L/day?

A

180 L/day

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3
Q

Rate of production of Glomerular Filtrate
Plasma volume filtered into nephrons/unit time
-Occurs via bulk flow
-Unselective

A

Glomerular filtration rate

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4
Q

____ % of plasma flowing through the glomerular capillaries gets filtered into nephron (filtration fraction)

A

20%

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5
Q

What is the only factor prevening filtration?

A

Size

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6
Q

____ is GFR/RBF

-can be altered

A

Filtration Blood flow

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7
Q

Glomerular filtration is a function of the renal _____

A

corpuscle

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8
Q

______ fluid filtered out of glomerulus into Bowman’s Space

A

Protein Free

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9
Q

Protein Free fluid filtered out of glomerulus into ______

A

Bowman’s Space

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10
Q

If proteins don’t filter, they get ______

A

Excreted

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11
Q

If proteins don’t filter and then get excreted, how does this effect the colloid osmotic pressure in the capillaries?

A

Decreases colloid osmotic pressure in capillaries

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12
Q

If proteins don’t filter and then get excreted, what does the decrease in colloid osmotic pressure in the capillaries cause?

A

Edema

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13
Q

Blood in Glomerular Capillaries separated from Bowman’s Space by a _______

A

Filtration Barrier

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14
Q

______: (Visceral Layer of Bowman’s Capsule)

  • Foot processes that cover outside of basal lamina
  • Creates Filtration Slits
A

Podocytes

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15
Q

What are the 3 layers of the filtration barrier?

A 
Capillary endothelium (fenestrated)
Basal Lamina
Podocytes
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16
Q

What charge is carried by the filtration barrier?

A

Negative charge

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17
Q
  • Modified smooth muscle cells
  • Surround Glomerular Capillary loops
  • Not part of filtration barrier
  • Modify size of filtration slits and alter rate of filtrate production
A

Mesangial cells

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18
Q

T/F: All substances small enough to fit through filtration pores and slits will be filtered i.e. everything but plasma proteins and RBCs

A

True

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19
Q

Do smaller or larger molecule filter better?

A

Smaller

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20
Q

Do cations (+) or anions (-) filter better?

A

Cations (+)

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21
Q

Does a more positive charge produce a higher or lower filterability?

A

Higher

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22
Q

In minimal change nephropathy – loss of _____ charge on GBM

A

negative

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23
Q

In minimal change nephropathy – loss of negative charge on GBM which leads to _____ filtered through GBM

A

proteins

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24
Q

In minimal change nephropathy – loss of negative charge on GBM which leads to proteins filtered through GBM leading to _____

A

Proteinuria

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25
Q

If a substance has a molecular weight less than or equal to 20 angstroms it is _____

A

Freely filtered

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26
Q

If a substance has a molecular weight greater than or equal to 50 angstroms it is _____

A

completely blocked

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27
Q

If a substance has a filterability of 1, it is _____

A

Freely filtered

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28
Q

If a substance has a filterability of 0, it is _____

A

Not filtered

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29
Q

______: product of the permeability and surface area of the capillaries; usually high

A

Capillary filtration coefficient (Kf):

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30
Q

_____: Balance of hydrostatic and colloid osmotic forces acting across the capillary membrane.

A

NFP:

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31
Q

GFR is ____ because of high hydrostatic pressure and high Kf .

A

high

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32
Q

GFR is high because of ____ hydrostatic pressure and ____ Kf .

A

high; high

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33
Q

What is NFP under normal conditions?

A

10 mmHg

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34
Q

What pressure is missing in the Starling’s forces in the kidney?

A

Colloid osmotic pressure in the interstitial fluid

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35
Q

Why is there no Colloid osmotic pressure in the interstitial fluid?

A

No proteins in Bowman’s capsule

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36
Q

What is the hydraulic conductivity multiplied by surface area?

A

Kf

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37
Q

____ = hydraulic conductivity x surface area
–400x higher than any other capillary bed
–Normally not highly variable.
–Alterations not used to regulate GFR

A

Kf

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38
Q

Diseases can ____ Kf
–Thickened basement membrane: hypertension, diabetes mellitus
–Decreased capillary surface area: glomerulonephritis.

A

lower

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39
Q

Decreased capillary surface area is called _______

A

glomerulonephritis

40
Q

Does Kf regulate or impact GFR?

A

Impact

41
Q

Primary control point for GFR.

Determinant of GFR most subject to physiological control.

A

Hydrostatic pressure of glomerulus (Pg)

42
Q

What are the 3 factors that influence Pg?

A

Arterial pressure (buffered by autoregulation)
Afferent arteriolar resistance
Efferent arteriolar resistance

43
Q

____ is a hydrostatic pressure:

Not a physiological regulator of GFR (normally changes as a function of GFR).

A

Hydrostatic pressure of Bowman’s capsule (Pb)

44
Q

What 2 diseases affect GFR via Pb?

A
  • Tubular obstruction (kidney stones and tubular necrosis)

- Urinary tract obstruction (prostate hypertrophy/ cancer)

45
Q

Increases along length of glomerular capillary:–Affected by filtration fraction.Opposes hydrostatic pressure.GFR decreases along length of capillary.

A

Glomerular Capillary Colloid Osmotic Pressure (πG)

46
Q

How is πG affected by more fluid entering into the nephron?

A

Increased πG

47
Q

πG is proportional to _____ multiplied by _____

A

πG α ([protein]plasma)(FF)

48
Q

Hydrostatic Pressure in Glomerular capillaries can be altered by altering the resistance of the ____ and _____; Leads to changes in GFR

A

afferent and efferent arterioles

49
Q

Constriction of the afferent arteriole or dilation of the efferent arteriole has what effect of GFR?

A

Decreases GFR

50
Q

Dilation of the afferent arteriole or constriction of the efferent arteriole has what effect of GFR?

A

Increase GFR

51
Q

Would an increase or decrease in Kf decrease GFR?

A

Decrease

52
Q

Would an increase or decrease in Pb decrease GFR?

A

Increase

53
Q

Would an increase or decrease in πG decrease GFR?

A

Increase

54
Q

Would an increase or decrease in Pg decrease GFR?

A

Decrease

55
Q

Would an increase or decrease in MAP decrease Pg which decreases GFR?

A

Decrease

56
Q

Would an increase or decrease in Re decrease Pg which decreases GFR?

A

Decrease

57
Q

Would an increase or decrease in Ra decrease Pg which decreases GFR?

A

Increase

58
Q

Renal blood flow is ___ % of total cardiac output

A

20%

59
Q

What is the equation to calculate Renal blood flow?

A

RBF = (Pa-Pv)/Total Renal Vascular Resistance

60
Q

____ resistance is regulated by factors acting on afferent and/or efferent arterioles (70% of total intrarenal resistance).

A

Vascular

61
Q

Blood flow in medulla < ___% of total RBF

A

10%

62
Q

Which nephrons have vasa recta?

A

Juxtamedullary nephrons

63
Q

T/F: Very low flow in vasa recta contributes to generation of osmotic gradient for concentration/dilution

A

True

64
Q

____ consumption reflects ATP consumption

A

O2 `

65
Q

____ consumption reflects active transport.

A

ATP

66
Q

High RBF causes ____ Energy Cost of Active Transport

A

High

67
Q

What are the 4 primary active transporters active in control of renal blood flow?

A

Na+-K+-ATPase
H+-ATPase
H+-K+-ATPase
Ca++-ATPase

68
Q

Prevents moment to moment changes in GFR)

A

Autoregulation (

69
Q

Function of ______:
Keeps RBF and GFR relatively constant in spite of changes in MAP
Reflex vessel constriction in response to  MAP
Intrinsic to blood vessels

A

Myogenic autoregulation

70
Q

Myogenic regulation works in response to an increase stretch of the walls of vessels due to an increase in bp by causing _______

A

arterioles to constrict

71
Q

______ Function:
Helps ensure a nearly constant delivery of Na+ and Cl- to the distal nephron
Prevents spurious fluctuations in renal excretion
Juxtaglomerular Apparatus

A

Tubuloglomerular Feedback (TGF)

72
Q

The ____ includes afferent arteriole, efferent arteriole and segment of thick ascending limb of loop of henle?

A

Juxtaglomerular apparatus

73
Q

What 2 types of cells is the JGA made up of?

A

Juxtaglomerular cells (JG) and Macula Densa cells

74
Q

Where are the macula densa cells found in the JGA?

A

Wall of thick ascending limb

75
Q

Part of JGA:

  • Primarily in walls of afferent arterioles
  • Secrete Renin
A

Juxtaglomerular cells (JG)

76
Q

Part of JGA:
In close contact with JG cells
Sense [Na+] and [Cl-] in filtrate

A

Macula densa

77
Q

What are the 3 Stimuli for Renin Release?

A

Decreased BP, Decreased RBF, and Decreased NaCl Delivery to Macula Densa (TGF Response)

78
Q

How does increased renin release affect GFR?

A

Increases GFR

79
Q

Is endothelin a vasoconstrictor or dilator in control of RBF and GFR?

A

Vasoconstrictor

80
Q

Is Prostaglandin a vasoconstrictor or dilator in control of RBF and GFR?

A

Dilator

81
Q

Is NO a vasoconstrictor or dilator in control of RBF and GFR?

A

Dilator

82
Q

Is bradykinin a vasoconstrictor or dilator in control of RBF and GFR?

A

Dilator

83
Q

Is Dopamine a vasoconstrictor or dilator in control of RBF and GFR?

A

Both

84
Q

Is SNS innervation and epi a vasoconstrictor or dilator in control of RBF and GFR?

A

Constrictor

85
Q

Is renin-angiotensin system a vasoconstrictor or dilator in control of RBF and GFR?

A

Constrictor

86
Q

Is ANP a vasoconstrictor or dilator in control of RBF and GFR?

A

Dilator

87
Q

How do the following factors affect GFR and RBF?1.High Protein Diet
2.High Blood Glucose levels

A

Increase GFR and RBF

88
Q

1.High Protein Diet
2.High Blood Glucose levels
Cause a _____ delivery to macula densa

A

Reduced

89
Q

Rate at which substances enter the nephron

A

Filtered Load (Fx) of a Substance

90
Q

Rate at which substances are excreted

A

Excretion rate (Ex) of a substance

91
Q

Determines the volume of blood cleared of a substance in a given amount of time

A

Clearance rate (Clx) of a substance

92
Q

What is the equation used to calculate Filtered Load (Fx) of a Substance?

A

Fx = (GFR) ([X]plasma)

93
Q

What is the equation used to calculate Excretion rate (Ex) of a substance?

A

Ex = (Uv)([X]urine); where Uv =Urine Flow Rate

94
Q

What is the equation used to calculate Clearance rate (Clx) of a substance?

A

Clx = Ex/[X]plasma

95
Q

Clearance of what 2 substances is used as index of GFR?

A

Creatinine and Inulin

96
Q

Clearance of what substance is used as index of RBF?

A

PAH

Phys exam 5 (9 decks)

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