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Physiology > renal 4 - reabsorption, secretion, clearance > Flashcards

renal 4 - reabsorption, secretion, clearance Flashcards

1
Q

which substances are only filtered

A

inulin and creatinine* (slightly different, creatinine is very slightly secreted)

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2
Q

which substances are filtered and partially reabsorbed

A

electrolytes (Na, K)

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3
Q

which substances are filtered and completely reabsorbed

A

glucose, amino acids

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4
Q

which substances are filtered and completely secreted

A

organic acids (PAH, para-amino hippuric-acid) and bases

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5
Q

what is inulin and where is it found

A

polysaccharide found in fruits and veggies

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6
Q

which substances are completely or almost completely reabsorbed

A 
water sodium (99%)
glucose (100%)
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7
Q

is glucose physiologically regulated

A

no (not fine tuned hormonally)

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8
Q

is water physiologically regulated

A

yes (fine tuned hormonally)

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9
Q

is sodium physiologically regulated

A

yes (fine tuned hormonally)

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10
Q

how is reabsorption mediated (LUMEN INTO CAPILLARY)

which is major and minor

A 
mediated transport (transepithelial)MAJOR
diffusion across tight junction (paracellular)MINOR
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11
Q

how does sodium get across the luminal/apical side

how

A

passive diffusion
high [Na+] in lumen vs cell

depends on area
counter transport, cotransport (prox. con, tub)
diffusion via Na+ channel CCD

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12
Q

how does sodium get across the basolateral side

how

A

active transport by Na/K ATPase

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13
Q

how does sodium get across the luminal/apical side in the proximal convoluted tubule

A

cotransport

passive

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14
Q

how does sodium get across the luminal/apical side in the cortical collecting duct

A

diffusion via Na channel

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15
Q

how does sodium get across the basolateral side in the proximal convoluted tubule

A

na k atp pump active

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16
Q

how does sodium get across the interstitial fluid into the blood plasma

A

diffusion and bulk transport

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17
Q

how does sodium get across the filtrate and into the interstitial fluid plasma

A

mediated transport

diffusion then na k atp ase

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18
Q

what is the clearance of glucose

A

zero b/c non is voided in urine

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19
Q

where is glucose reabsorbed

A

in the poximal tubule

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20
Q

how is glucose reabsorbed

A

secondary active transport on the luminal side by SGLT

facilitated diffusion on the base-lateral side using GLUT

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21
Q

what is glucosuria

A

glucose in urine

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22
Q

when does glucose appear in the urine

A

above renal threshold

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23
Q

why does glucosurea happen

A

the transport proteins are saturated

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24
Q

what is transport maximum of glucose formula

A

limit of substance that can be transported/unit time

25
Q

what is renal threshold of glucose

A

the plasma concentration at which saturation occurs

26
Q

what happens at transport maximum of glucose

A

binding sites of transport proteins get saturated

filtered load exceeds the limit of reabsorption

27
Q

what is the renal threshold number

A

300mg/mL

28
Q

what is normal blood glucose levels

A

100-200mg/mL

29
Q

what happens in diabetes mellitus

A

capacity to reabsorb glucose is normal, but filtered load is beyond the threshold level to reabsorb glucose by the tubules
[glu]blood high
proteins all saturated

30
Q

what happens in renal glucosuria

A

mutation of Na/glu cotransporter that active reabsorbs glucose in prox. tubele

31
Q

how does glucose reabsorb in the prox tubules

A

active Na/glu cotransporter

32
Q

where does most of the water reabsorption happen

A

proximal convoluted tubule

33
Q

what does urea reabsorption depend on and why

A

water because water creates the concentration gradient which urea diffuses down (diffuse out of lumen)

34
Q

why does tubular secretion happen

A

whatever the body doesnt want, it gets another chance to get rid of

35
Q

what are commonly tubularly secreted substances

A

mostly H+ K+

choline, creatinine, penicillin

36
Q

how are things tubular secreted

A

active transport coupled to reabsorption of Na+ (based on na k atp pump)

37
Q

what is renal clearance

A

way of quantifying kidney function in removing substances from plasma

38
Q

units for renal clearance

A

volume of plasma removed from kiney/ unit time

ml/min or L/h

39
Q

what is the formula of clearance for substance S

A

S=UsV/Ps
Ps=plasma conc
Us=urinary conc

40
Q

what is the L/day of clearance of inulin

A

180L/day

41
Q

how can the clearance of inulin be used to measure GFR

A

Cin=GFR bc all is filtered out

GFF is inversly proportional to plasma concentration of inulin (GFR=UinV/Pin)

42
Q

what is creatinine

A

product of muscle metabolism

43
Q

how is creatinine handled in the kidneys

A

filtered, not reabsorbed, very slight secretion

44
Q

how can creatinine estimate GFR and what is the slight error

A

clearance of creatinine slightly over estimates GFR

45
Q

what does high creatinine mean

A

low GFR so the kidneys arent functioning right

46
Q

clearance of substance X>GFR

A

X undergoes secretion

more is cleared total than just by glom

47
Q

clearance of substance X

A

X undergoes reabsorption

more cleared by glom than is released

48
Q

how is Na transported in nephron

A

actively

Na K atp ase

49
Q

how is Cl transported in the nephrone

A

transported passively when Na is pumped out of the cell

50
Q

how is K transported in nephron

A

secreted into the tubules mainly by cells of the distal and collecting ducts

51
Q

where is the majority of solute excretion except for K+

A

proximal convoluted tubule

52
Q

where is most of the water and non waste plasma solutes reabsorbed

A

proximal convoluted tubule

53
Q

what does the loop of henle do

A

create osmotic gradient in medulla
reabsorb large amounts of ions
less water reabsorb

54
Q

what is the role of the distal convoluted tubule

what percent reabsorption

A

site of fine tuning of water and solute to produce urine

12-15%

55
Q

where is there little water reabsorbed but lots of ions reabsorbed

A

loop of henle

56
Q

where is there 80% reabsorptive and secretory activities

A

proximal tubules

57
Q

where is there 12% reabsorptive activities

A

distal tubule

58
Q

where are most reabsorptive and secretory activities happening`

A

proximal tubules

Physiology (32 decks)

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