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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
If a substance has a molecular weight less than or equal to 20 angstroms it is _____
Freely filtered
26
If a substance has a molecular weight greater than or equal to 50 angstroms it is _____
completely blocked
27
If a substance has a filterability of 1, it is _____
Freely filtered
28
If a substance has a filterability of 0, it is _____
Not filtered
29
______: product of the permeability and surface area of the capillaries; usually high
Capillary filtration coefficient (Kf):
30
_____: Balance of hydrostatic and colloid osmotic forces acting across the capillary membrane.
NFP:
31
GFR is ____ because of high hydrostatic pressure and high Kf .
high
32
GFR is high because of ____ hydrostatic pressure and ____ Kf .
high; high
33
What is NFP under normal conditions?
10 mmHg
34
What pressure is missing in the Starling's forces in the kidney?
Colloid osmotic pressure in the interstitial fluid
35
Why is there no Colloid osmotic pressure in the interstitial fluid?
No proteins in Bowman's capsule
36
What is the hydraulic conductivity multiplied by surface area?
Kf
37
____ = hydraulic conductivity x surface area –400x higher than any other capillary bed –Normally not highly variable. –Alterations not used to regulate GFR
Kf
38
Diseases can ____ Kf –Thickened basement membrane: hypertension, diabetes mellitus –Decreased capillary surface area: glomerulonephritis.
lower
39
Decreased capillary surface area is called _______
glomerulonephritis
40
Does Kf regulate or impact GFR?
Impact
41
Primary control point for GFR. | Determinant of GFR most subject to physiological control.
Hydrostatic pressure of glomerulus (Pg)
42
What are the 3 factors that influence Pg?
Arterial pressure (buffered by autoregulation) Afferent arteriolar resistance Efferent arteriolar resistance
43
____ is a hydrostatic pressure: | Not a physiological regulator of GFR (normally changes as a function of GFR).
Hydrostatic pressure of Bowman's capsule (Pb)
44
What 2 diseases affect GFR via Pb?
- Tubular obstruction (kidney stones and tubular necrosis) | - Urinary tract obstruction (prostate hypertrophy/ cancer)
45
Increases along length of glomerular capillary:–Affected by filtration fraction.Opposes hydrostatic pressure.GFR decreases along length of capillary.
Glomerular Capillary Colloid Osmotic Pressure (πG)
46
How is πG affected by more fluid entering into the nephron?
Increased πG
47
πG is proportional to _____ multiplied by _____
πG α ([protein]plasma)(FF)
48
Hydrostatic Pressure in Glomerular capillaries can be altered by altering the resistance of the ____ and _____; Leads to changes in GFR
afferent and efferent arterioles
49
Constriction of the afferent arteriole or dilation of the efferent arteriole has what effect of GFR?
Decreases GFR
50
Dilation of the afferent arteriole or constriction of the efferent arteriole has what effect of GFR?
Increase GFR
51
Would an increase or decrease in Kf decrease GFR?
Decrease
52
Would an increase or decrease in Pb decrease GFR?
Increase
53
Would an increase or decrease in πG decrease GFR?
Increase
54
Would an increase or decrease in Pg decrease GFR?
Decrease
55
Would an increase or decrease in MAP decrease Pg which decreases GFR?
Decrease
56
Would an increase or decrease in Re decrease Pg which decreases GFR?
Decrease
57
Would an increase or decrease in Ra decrease Pg which decreases GFR?
Increase
58
Renal blood flow is ___ % of total cardiac output
20%
59
What is the equation to calculate Renal blood flow?
RBF = (Pa-Pv)/Total Renal Vascular Resistance
60
____ resistance is regulated by factors acting on afferent and/or efferent arterioles (70% of total intrarenal resistance).
Vascular
61
Blood flow in medulla < ___% of total RBF
10%
62
Which nephrons have vasa recta?
Juxtamedullary nephrons
63
T/F: Very low flow in vasa recta contributes to generation of osmotic gradient for concentration/dilution
True
64
____ consumption reflects ATP consumption
O2 `
65
____ consumption reflects active transport.
ATP
66
High RBF causes ____ Energy Cost of Active Transport
High
67
What are the 4 primary active transporters active in control of renal blood flow?
Na+-K+-ATPase H+-ATPase H+-K+-ATPase Ca++-ATPase
68
Prevents moment to moment changes in GFR)
Autoregulation (
69
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
Myogenic autoregulation
70
Myogenic regulation works in response to an increase stretch of the walls of vessels due to an increase in bp by causing _______
arterioles to constrict
71
______ Function: Helps ensure a nearly constant delivery of Na+ and Cl- to the distal nephron Prevents spurious fluctuations in renal excretion Juxtaglomerular Apparatus
Tubuloglomerular Feedback (TGF)
72
The ____ includes afferent arteriole, efferent arteriole and segment of thick ascending limb of loop of henle?
Juxtaglomerular apparatus
73
What 2 types of cells is the JGA made up of?
Juxtaglomerular cells (JG) and Macula Densa cells
74
Where are the macula densa cells found in the JGA?
Wall of thick ascending limb
75
Part of JGA: - Primarily in walls of afferent arterioles - Secrete Renin
Juxtaglomerular cells (JG)
76
Part of JGA: In close contact with JG cells Sense [Na+] and [Cl-] in filtrate
Macula densa
77
What are the 3 Stimuli for Renin Release?
Decreased BP, Decreased RBF, and Decreased NaCl Delivery to Macula Densa (TGF Response)
78
How does increased renin release affect GFR?
Increases GFR
79
Is endothelin a vasoconstrictor or dilator in control of RBF and GFR?
Vasoconstrictor
80
Is Prostaglandin a vasoconstrictor or dilator in control of RBF and GFR?
Dilator
81
Is NO a vasoconstrictor or dilator in control of RBF and GFR?
Dilator
82
Is bradykinin a vasoconstrictor or dilator in control of RBF and GFR?
Dilator
83
Is Dopamine a vasoconstrictor or dilator in control of RBF and GFR?
Both
84
Is SNS innervation and epi a vasoconstrictor or dilator in control of RBF and GFR?
Constrictor
85
Is renin-angiotensin system a vasoconstrictor or dilator in control of RBF and GFR?
Constrictor
86
Is ANP a vasoconstrictor or dilator in control of RBF and GFR?
Dilator
87
How do the following factors affect GFR and RBF?1.High Protein Diet 2.High Blood Glucose levels
Increase GFR and RBF
88
1.High Protein Diet 2.High Blood Glucose levels Cause a _____ delivery to macula densa
Reduced
89
Rate at which substances enter the nephron
Filtered Load (Fx) of a Substance
90
Rate at which substances are excreted
Excretion rate (Ex) of a substance
91
Determines the volume of blood cleared of a substance in a given amount of time
Clearance rate (Clx) of a substance
92
What is the equation used to calculate Filtered Load (Fx) of a Substance?
Fx = (GFR) ([X]plasma)
93
What is the equation used to calculate Excretion rate (Ex) of a substance?
Ex = (Uv)([X]urine); where Uv =Urine Flow Rate
94
What is the equation used to calculate Clearance rate (Clx) of a substance?
Clx = Ex/[X]plasma
95
Clearance of what 2 substances is used as index of GFR?
Creatinine and Inulin
96
Clearance of what substance is used as index of RBF?
PAH

Phys exam 5 (9 decks)

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