Brainscape's Knowledge GenomeTM

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


See full index

Renal/Endo/repro > Renal > Flashcards

Renal Flashcards

1
Q

Effective solutes

A

Solutes which cannot passively diffuse across cell membranes.

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

Tonicity

A

Relative concentration that determines the direction and extent of H2O diffusion. Na+ sets tonicity.

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

Effective circulating volume

A

Blood volume that is required for adequate perfusion of the vital signs.

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

Total blood osmolality equation

A

2(Na+)+(blood glucose/18)+(BUN/2.8)

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

Effective osmolality equation

A

2(Na+)+(Blood glucose/18)

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

Renal circulation receives….of cardiac output.

A

20%

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

Renal function is mediated by 3 things:

A

1) internal mechanisms 2) extra and intrarenal endocrine systems 3) ANS (specifically SNS since kidneys are not innervated by PSNS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Filtration

A

Movement of plasma constituents from glomerulus into Bowman’s capsule.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Reabsorption

A

The movement of constituents from the tubule luminal fluid (forming urine) into the renal interstitium; and/or recycling of these substances back into circulation.

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

Secretion

A

Movement of constituents from the renal circulation, interstitium, and/or tubule epithelium into the forming urine.

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

Renal Clearance

A

Volume of blood that can be 100% cleared of a solute per unit time.

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

GFR

A

Rate at which filtrate from the glomerulus into Bowman’s capsule.

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

Do cationic or anionic substances cross the glomerular filtration barrier easier?

A

Since glomerular filtration barrier carries a net negative charge, then cationic substances tend to cross the barrier with less resistance than anionic substances.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Normal GFR values: Young men Young women

A

Young men: 130 Young women: 120

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

GFR

A

High risk for the development of cardiovascular disease

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

GFR

A

Indicates renal failure and would require replacement via dialysis or kidney transplant.

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

Basal Scr

A

0.4-1.5

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

Factors increasing Scr

A

Black race Kidney Disease Large muscle mass Crushing injury Ingestion of meat Ketoacidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Factors decreasing Scr

A

Hispanic and Asian race Low muscle mass Vegetarian diet Malnutrition

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

Filtered Load

A

Amount of solute filtered into Bowman’s capsule per unit time.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Fractional excretion

A

Ratio of solute excreted:filtered load Cx/GFR

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

Tubular glomerular feedback (TGF) system

A

Regulated by concentration of Na+ in the forming urine as it reaches thick ascending limb in the region of macula Densa. Macula Densa is in close approximation with JG apparatus from afferent arteriole.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Macula Densa

A

Population of specialized cells in the region of the TAL that can sense levels of NaCl.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Juxtaglomerular apparatus

A

Region of modified smooth muscle cells of the afferent arteriole next to the Densa macula that secretes renin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

TGF system mechanism

A

As GFR is increased to limit, lots of H2O and NaCl end up in the forming urine. Elevated NaCl delivery stimulates macula Densa depolarization. Macular cells secrete factors including ATP, adenosine, and thromboxane. Factors target afferent arteriole and causes vasoconstriction. This lowers Glomerular P and down modulates GFR.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Pressure natriuresis

A

In the event of an exaggerated volume expansion, sensitivity of TGF mechanism is decreased. Thus, high glomerular P and increased GFR are maintained to restore euvolemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Where are angiotensinogen and ACE found in the kidney?

A

Angiotensinogen is expressed within proximal tubule cells and ACE is present within the proximal tubule brush border.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

In extra renal RAS, where are renin, angiotensinogen, and ACE found?

A

Renin is still produced by the JG cells in the kidney. Angiotensinogen is produced and secreted by hepatocytes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

ACE2

A

Enzyme expressed in renal and cardiac tissues that converts AII into angiotensin (1-7)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Angiotensin 1-7

A

They bind to Mas, g coupled receptor, and stimulates vasodilation, blocks proliferation, and promotes bradykinin production.

31
Q

Renin

A

Protein hormone secreted by JG cells and catalyzes the conversion of angiotensinogen into Angiotensin I. It is regulated by SNS tone (JG cells express B1 receptors), distension of the afferent arteriolar epithelium (elevated BP), signals from macula Densa, ANP, and negative feedback by AII.

32
Q

Plasma renin activity (PRA)

A

Indicator of RAS activity. Example: volume depletion leads to lowered BP which causes the secretion of renin leading to increase in PRA.

33
Q

ACE promotes vasoconstriction by two ways:

A

1) production of AII 2) degradation of bradykinin

34
Q

Iso-, hypo-, and hyperosmolality define the osmotic state of the…

A

Extracellular fluid

35
Q

Renal AII response to Low BP

A

SNS tone increases

AII production increases

AII binds to AT1 receptors within efferent arteriolar vascular smooth muscle and induce vasoconstriction

AT1 receptors are couples to activation of NHE3, NKCC2, NCC, and ENaC channels increasing sodium reabsorption.

AII stimulates aldosterone production and secretion

36
Q

Pharmaceutical manipulation on renal function

A

ACE inhibitors (-prils) inhibit the conversion of angiotensin I into angiotensin II.

ARBs (-sartans) AT1 receptor blockers.

Renin Inhibitors (Aliskiren) block the action of renin and thus prevent the conversion of angiotensinogen into angiotensin I.

37
Q

ARB advantage over ACEI?

A

There is an ACE-indepedent pathway utilizing Chymases that converts AI into AII thus the patient might not respond to ACEI as well as ARBs.

38
Q

ACE escape

A

The body’s ability to use alterantive pathway such as the ACE independent Chymases to maintain AII levels in the body during the use of ACEi.

39
Q

Effect of Norepi on renal function

A

Norepi binds to the alpha1 receptors in both arterioles causing vasoconstriction and a collective reduction of GFR and renal perfusion to maintain plasma volume.

NE stimulates renin secretion from JG cells via B1 receptors.

NE to some degree stimulates Na+ and H2O reabsorption from the tubules.

40
Q

Effect of AVP on renal function

A

AVP binds to V1a receptors on peripheral arterioles to induce vasoconstriction.

Within nephron, AVP binds to the V2 receptors to induce epression and activation of AQP2.

AVP increases the rate of Na+ reabsorption from the TAL and DCT via NKCC (TAL), NCC (DCT), and ENaC (DCT).

AVP also binds to V1b receptors in corticotropes of anterior pituitary to secrete ACTH.

41
Q

Proximal tubule Sodium channels

A

Movement of sodium across the apical membrane s mediated by Na+-glucose cotransporters (SGLT1 and 2) and Na+-H+ exchangers (NHE-3).

Movement across basal membrane is through Na+/K+ ATPases, Na+-HCO3- symptorters, and GLUT1 & 2.

42
Q

Na+ transport in loop of Henle

A

Active transport in thin ascending limb

NKCC2 in TAL pumps Na+, Cl-, and K+ into tubular cell.

ROMK2 pumps K+ back into urine to drive NKCC2.

NHE-3 exchanges Na+ in for H+ out.

Na+/K+ ATPases and Cl-/HCO3- exchangers on basal membrane.

43
Q

Channels in the DCT

A

NCC on the apical side to transfer Na+ and Cl- out of urine and into tubular cell.

ENaC on apical side pumps Na+ out of urine and into tubular cell.

On the basal side, Na+/K+ ATPases pumps sodium out and into the interstitium.

44
Q

Part of the CCT that is targeted by aldosterone

A

Aldosterone-sensitive distal nephron (ASDN)

45
Q

Effects of AVP, aldosterone, and AII on principle cells of CCT

A

AVP recruits Na+/K+ ATPases into basal membrane and activates apical Na+ channel protein (ENaC).

AII also activates apical Na+ channel (ENaC)

Aldosterone activates the ENaC channels.

All three activate Na+/K+ ATPases on the basal side.

46
Q

Acetazolamide

A

Weak diuretic, carbonic anhydrase inhibitor that blocks the H+ formation and HCO3- reabsorption in the proximal tubule.

47
Q

Furosemide

A

Potent loop diuretic, fast acting, short lived and blocks NKCC2 in the TAL.

K+ and Ca2+ wasting.

48
Q

Thiazides

A

Weak diuretics blocks Na+ and Cl- reabsorption. Stimulates K+ secretion and Ca2+ reabsorption. Works on the DCT.

49
Q

Amiloride

A

Blocks ENaC channels in the CCT. K+ sparing.

50
Q

Sprionolactone and Eplerenone

A

Aldosterone anatagonists working on the CCT. K+ sparing diuretics.

51
Q

What stimulates aldosterone secretion?

A

Adrenal glomerulosa cells express AT1 so aldosterone secretion is based on AII levels and hyperkalemia.

52
Q

Salt-sensitive effect on the renal function curve

A

Salt sensitive is due to increases in dietary sodium induce elevation in BP.

The curve will shift to the right with lower slope

53
Q

Euvolemic Hyponatermia

A

Na+ contenet has not changed but something caused inordinate retention of H2O.

Glucocorticoid deficiency, hypothyroidism or SIADH can cause this.

Urine [Na+] is elevated since water is not excreted.

54
Q

Hypovolemic Hyponatremia

A

Loss of TBW and Na+ with more Na+ lost than H2O.

GI fluid loss, hemorrhage, sweating, diuretics, mineralocorticoid deficiency.

Clinical signs of tachycardia, glattened neck veins, orthostatic hypotension.

Urine [Na+] is decresed while BUN is elevated due to decreased renal perfusion.

Treat by isotonic saline.

55
Q

Pseudohypoaldosteronism

A

Type I hypoaldsoteronism.

Fatal syndrome causes salt wasting

Due to mutations in the SCNN1 gene encoding ENaC protein. Na+ reabsorption will be impaired.

56
Q

What is the difference between neurogenic and nephrogenic?

A

Neurogenic is a loss in hormone production.

Nephrogenic is a mutation disrupting the expression of the hormone receptor.

57
Q

Diabetes Insipidus

A

Disruption in the AVP system in which body H2O and Na+ balances are often disrupted.

This could be due to loss of production of AVP or disrupted expression of V2R or AQP2.

Causes Polyruia of DILUTE urine, and polydipsia.

58
Q

Syndrome of inappropriate ADH secretion

A

Congenital: gain of function mutation in which V2R is activated in absense of AVP. Induced: excessive secretion of AVP.

Symptoms: Evolemic hypnatremia, highly concentrated urine (>100 osmolality), hyposmolality.

Treatment: Loop diuretics, fluid restrictions, Demeclocycline and lithium to block V2R mediated activation of AQP2.

59
Q

Type 1 RTA

A

Could be autoimmune or induced by certain drugs and toxins.

Net reduction in H+ secretion within collecting tubules. H+ ATPase and Cl-/HCO3- function impaired.

hyper or hypokalemia

Urine pH higher than 5.3

60
Q

Type 2 RTA

A

Urinary loss of HCO3-, glucose, amino acids, and phosphate from proximal RTA.

Defects in Na+/H+ ATPase, Na+/K+ ATPase, and carbonic anhydrase.

Vitamin D deficiency

Hyperaldosteronism can exacerbate the hypokalemia.

61
Q

Type 4 RTA

A

Hyperkalemic RTA due to Aldosterone deficiency or resistance in the collecting tubule.

H+ ATPase impaired.

NH4+ recycling, NH3 secretion impaired.

62
Q

Where are glucagon, insulin and somatostatin secreted from?

A

a cells: glucagon

b cells: insulin

gamma cells: somatostatin

63
Q

Function of insulin

A

Promote lipogenesis, glycogenesis, muscle anabolism, and cellular uptake of K+ and free fatty acids.

64
Q

Insulin bioactivity timeline

A

At very low levels of insulin, Cellular K+ uptake occurs,

Next, FFA uptake in adipocytes occurs to promote lipogenesis.

As insulin levels rise, impaired hepatic gluconeogenesis occurs.

Followed by peripheral glucose uptake in the liver to promote glycogenesis.

65
Q

Type 1 Diabetes Mellitus

A

Juvenile onset, hereditary autoimmune destruction of B cells.

Hypoinsulinemia, hyperglycemia

Polydipsia, polyuria, polyphagia

66
Q

Type 2 Diabetes Mellitus

A

Syndrome of metabolic obesity

Late onset with some genetic predisposition.

Hyperinsulinemia with insulin resistance.

Impaired glucose tolerance.

67
Q

Metformin

A

Biguanide

Impaires hepatic gluconeogenesis, intestinal glucose absorption and enhances peripheral glucose uptake.

68
Q

Thiazolidenediones (piglitazone)

A

Insulin receptor sensitizer

69
Q

Sulfonylureas

A

Insulin secretagogues, promotes insulin production

70
Q

SGLT inhibitors

A

Impedes glucose reabsorption from forming urine

71
Q

DPP-4 Inhibitor

A

Impedes degradation of glucagon-like peptide; GLP-1 promotes insulin secretion, inhibits glucagon secretion

72
Q

What do the kidneys utilize for gluconeogenesis?

A

Lactate, glutamine, and glycerol

73
Q

Nephrin

A

Transmembrane protein present within the slit diaphragm of glomerular podocytes. It helps in restricting protein filtration across the glomerulus.

Upregulated RAS activity impairs the activity of nephrin.

Renal/Endo/repro (5 decks)

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