Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Physiology BRS > Renal > Flashcards

Renal Flashcards

0
Q

What percentage of the TBW does interstitial fluid occupy?

A

Interstitial fluid:3/4 of ECF
ECF:1/3 of TBW
>interstitial fluid :3/12 TBW

It is an ultrafiltrate of plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What percentage of the TBW does plasma occupy?

A

Plasma is 1/4 of the ECF
ECF is the1/3 of the TBW
>plasma:1/12 TBW

It consists of albumin,globulins,Na,Cl,HCO3-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How can we measure TBW?

A 
#tritiated water
#D2O
#antupyrene
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How can we measure ECF?

A 
#sulfate
#inulin
#mannitol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How can we measure plasma?

A 
#radioiodinated serum albumin(RISA)
#evans blue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How is plasma osmolarity measured?

A

Posm=2Na+glucose/18+BUN/2,8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How much is the osmolarity difference between ECF and ICF at a steady phase?

A

They are equal>water shifts between ECF and ICF

NaCl,mannitol:do not cross cell membranes >ECF!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What kind of changes in volume/osmolarity of blood fluids can cause no change in Hct?!

A

HYPERosmotic-CONtraction: sweating,fever,DM> [plasm.prot]^+H2O out of the RBC>unchanged Hct

"Opposite changes"
#HYPOsmotic-EXPansion: SIADH>[plasma.pr.]low+H2O into the RBC>unchanged Hct
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What kind of changes in volume/osmolarity of blood fluids do these changes cause?

  • SIADH
  • adrenal insufficiency
  • diarrhea
  • ^NaCl intake
  • isotonic NaCl infusion
  • DM
A
  • Hyposmotic expansion
  • Hyposmotic contraction
  • isotonic contraction
  • hyperosmotic expansion
  • isotonic expansion
  • Hyperosmotic contraction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the effect of prostaglandins E/I,bradykinin,NO,D in RBF?

A

They cause vasodilation of the renal arterioles >^RBF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is the effective Renal Plasma Flow measured?

A

RPF=Upah*V/Ppah

PAH:filtered +secreted
This equation underestimates true RPF by 10%❗️

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is Renal Blood Flow RBF measured?

A

RBF=RPF/1-Hct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is GFR measured?

A

GFR=Uinulin*V/Pinulin=Kf[(Pgc-Pbs)-(πgc-πbs)]

Inulin=FILTERED NOT SECRETED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is filtration fracture estimated?

What effect does it have on the reabsorption in the proximal tubule!

A

Filtration fracture =GFR/RPF

Normally=0,2—>20%of RPF is filtered

#^FF=^[protein] of peri tubular capillary=^reabsorption in the proximal tubule.
#low FF=low[protein] of the peritubular capillary=low reabsorption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the components of glomerular filtration barrier?

A 
#fenestrated capillary endothelium>SIZE BARRIER
#fused basement membrane>NEGTIVE CHARGE BARRIER:loss in the nephrotic syndrome!
#epithelial layer>podocyte foot
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the connection between a substance x and GFR ,as far as it’s clearance is concerned?

A

Cx>GFR=net tubular secretion of X
Cx<GFR=net tubular absorption
Cx=GFR=No secretion/no reabsorption.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does Pgc change across the length of the capillary?

A

Pgc is CONSTANT across the length do the capillary

-^by the dilation of the afferent capillary or constriction of the efferent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does πgc change along the length of the capillary?

A

Πgc increases across the length of the capillary>filtration of H2O>[protein]^

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does angII/sympathetic stimulation/prostaglandins affect FF?

A
  • ang II=constriction of the efferent>^GFR,same RPF>^FF
  • sympathetic=constriction of the afferent>low GFR,low RPF>same FF
  • prostaglandins=dilation of the afferent>^GFR,^RPF>same FF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How can Pbs be increased?

A

By constriction of the ureters(stone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does juxtaglomerular apparatus consist of?

A 
#mesangial cells
#JG cells=modified smooth cells of the afferent arteriole)>renin
#macula densa=NaCl sensor at the DCT>adenosine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How is filtered load/excretion rate/reabsorption/secretion estimated?

A

Filtered load=GFRP
Excretion rate=UV
Reabsorption=filtered-excreted
Secretion=excreted-filtered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does filtered load affect reabsorption?

A

^filtered load>^reabsorption

23
Q

At what point does the glucose reabsorption stop and we start seeing glucosuria..?under what condition is glucosuria considered “normal”?

A

(heterogeneity of nephrons)

Normal pregnancy may cause glucosuria+aminoaciduria

24
Q

How is amino acids clearance determined?

A

They are ~100%reabsorbed in the PCT via Na-cotransport

25
Q

What is the Hartnup disease?

A

ARecessive
Deficiency of neutral amino acids transporters>I.e. tryptophane> low niacin(B3)>pellagra-like symptoms=3D:Diarrhea,Dementia,Dermatitis

26
Q

Before the Tm point,PAH clearance equals…?

A

Filtration+secretion~>RPF

Once the Tm for secretion is exceeded >all carriers are satires >flat excretion rate

27
Q

What is the correct order of relative clearances of the several components of plasma?

A

PAH>K(in high diet)>inulin>urea>Na>glucose,amino acids,HCO3-

28
Q

What alteration can we do to the urine pH in order to increase excretion of salicylic acid and morphine?

A

salicylic acid:weak acid>alkalization of the urine=^A->low reabsorption

29
Q

What does TF/P ratio stands for?

A

TF/P=1

TF/P ratio=compares the concentration of a substance in tubular fluids with the concentration in plasma

-no reabsorption of the substance
-reabsorption was proportional to H2O reabsorption=ίδιες συγκεντρώσεις
#TF/P1
-H2Oreabsorption>reabsorption of the substance
-secretion of the substance

30
Q

What is the TF/P ration for Cl in the PCT?

A

It is >1 because reabsorption of Cl is proportionally less than reabsorption of H2O=σταθερή γραμμή

31
Q

What is the TF/P ration in the bowman space for any freely filtered substance?

A

It is 1

32
Q

What is the TF/P ratio for inulin across the tubule length?

A

Inulin is filtered but neither reabsorbed nor secreted.thus,the m(inulin) I the TF Is fixed throughout the tubules.but,as we move toward the collecting duct H20reabsorption steadily increases>lower V left in the tubules>steady increase in the [inulin]tf>steady increase in the TF/p ratio

33
Q

How can TF/P inulin be used to measure H20 reabsorption?

A

[inulin]tf is determined solely by how much water remains in the TF
Fraction of filtered H20reabsorbed=1-1/TF/Pinulin

34
Q

What are the 7causes of shifting K outside of cell>^K+?

A 
#Digitalis
#hyperOsmolarity
#Lysis(Ca,exercise)
#Acidosis>counter transport of H/K
#b-blockers
#^blood Sugar
35
Q

What are the 4 causes that shift K into cells?>Hypokalemia ?

A 
#hyposmolarity
#alkalosis
#b-adrenergic agonist
#insulin
36
Q

What are the 6 causes of increased distal K secretion?

A 
#Hyperaldosteronism
#^K diet
#alkalosis
#thiazide diuretics
#loop diuretics
#luminal anions
37
Q

What are the 4 causes of decreased distal K secretion?

A 
#low K diet
#low aldosterone
#acidosis#K sparing diuretics
38
Q

What kind of diuretics could be used to treat hypercalcemia?

A

Loop diuretics>block Na reabs>block Ca-Na cotransport

39
Q

What kind of diuretics could be used to treat idiopathic hypercalciuria?

A

Thiazide diuretics>^Ca reabsorption>low Ca secretion>lower Ca in the urine

40
Q

What part of the nephron is considered a concentrating segment?

A

Thin descending >impermeable to Na/passively reabsorbs H2O

41
Q

What parts of the nephron are considered diluting?

A

Thick ascending>impermeable to H2O

DCT>cortical diluting segment>imper,enable to H2O

42
Q

How is free water clearance estimated?

A

Ch2o=V-Cosm

 ➕:loss of H20 >low ADH>hyposmotic urine
    #high H2O intake
    #cental diabetes insipidus
    #nephrogenic diabetes insipidus
➖:no loss of H2O>^ADH>hyposmotic urine
    #SIADH
    #water deprivation

0⃣:treatment with loop diuretics>no contraction/no dilution

43
Q

What is the main difference between SIADH and water deprivation as far osmolarity is concered?

A

Water deprivation will have normal/high serum osmolarity
SIADH will have very low serum osmolarity due to the excess of H2O

Both pathologies have:

  • ^ADH SERUM
  • hyperosmotic urine
  • low urine flow rate
  • negative Ch2o
44
Q

What are the factors that stimulate renin secretion?

A 
#Low BP>JG cells
#low Na >macula densa
#^sympathetic tone(β1)
45
Q

Where is ACE mostly produced?

A

In the lungs(+kidneys)

46
Q

What are the 6 effects of ANGII ?

A 
#action on the AT1receptors>vasoconstriction>BP
#constriction of the efferent>^GFR,low RPF>^FF
#^aldosterone>^ENaC>^reabsorption of Na in the principal cells
                       >^excretion of K in the principal cells
                       >^excretion of H in the a-intercalated cells
     --->favorable gradient for reabsorption of Na and H2O
#^ADH>^V2(cAMP)>aquaporins>H2Oreabsorption
            >^V1(IP3)>vasoconstriction 
#^Na/H activity in PCT>^Na,HCO2,H2O reabsorption>contraction alkalosis
#hypothalamus>thirst
47
Q

Via what molecular do ANP,BNP act?

A

ANP(atria),BNP(Ventricles)>^cGMP>relax vascular smooth muscle>^GFR>renin

48
Q

What effect do NSAIDs have on the GFR?

A

NSAIDs block renal protective prostaglandins synthesis>less vasodilations>^constriction of the afferent>low GFR>acute renal failure

49
Q

What are the buffers for HCO3 reabsorption in the PCT?

How is it regulated?

A

Reabsorption of HCO3(production via carbonic anydrase)
Recycling of H+>conjunction with HCO3 in the lumen >CO2>diffusion back in the cell
Regulation:
#^filt.load>^reabsorption
#^Pco2>^reabsorption
#^ECF Volume>less reabsorption
^angII>^Na/H>^reabsorption:contraction alkalosis

50
Q

H+ can be buffers through ti titriated acid and NH3.

H2PO4- buffering depends on what?

A

After HCO3- is reabsorbed ,H+ is secreted in the lumen via H/ATPase (^via aldosterone)>+HPO4->H2PO4->excreted

It depends on
#the amount of urinary buffers(HPO4-)
#pK of the buffer
51
Q

H+ can be buffers through ti titriated acid and NH3.

NH3 buffering depends on what?

A

After HCO3- has been reabsorbed ,H+ is secreted in the lumen via H/ATPase(^via aldosterone)>+NH3>NH4+>excreted

NH3 is produced into the cells from glutamine>diffused in the lumen

Depends on:
#low pH of the urine>^gradient for diffusion of NH3>^excretion
#low pH of the plasma>^synthesis of NH3>^excretion
#^K>less production of NH3>less excretion of H+>renal tubular acidosis 4
52
Q

What are the causes of metabolic acidosis with ^anion gap?

A 
MUDPILES:
#methanol
#uremia>renal failure
#diabetic ketoacidosis
#propylene glycol
#iron tablets/isoniazid
#lactic acidosis >shock
#ethylene glycol
#salicylates
53
Q

What are the causes of metabolic acidosis with normal A-a gradient?

A 
HARDASS
#hyperalimentation
#addison
#renal tubular acidosis
#diarrhea
#acetazolamide
#spironolactone
#saline infusion
54
Q

What other electrolyte disturbance can respiratory alkalosis cause?

A

Hypocalcemia.

Because H+ and Ca2+ compete for binding sites on plasma proteins>low H+>^Binding Ca2+>les ionized Ca2+

55
Q

To maintain normal H+ balance !total daily excretion of H+ should equal the daily…..?

A

Fixed acid production plus fixed acid ingestion

56
Q

Why is it not recommended for marathon athletes to drink distillates water?

A

When the athlete is sweating>more loss of H2O than salt>hyperosmotic volume contraction>h2O comes out of the ICF towards ECF>if he consume more H2O>even more Vecf>hyposmotic plasma

Physiology BRS (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions