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Phys 208 > Renal > Flashcards

Renal Flashcards

1
Q

What are the 3 pressures that govern filtration from glom capillaries into renal tubules?

A

hydrostatic pressure (favour), colloid osmotic (oppose), Bowman’s hydrostatic (opposes)

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2
Q

What is the normal glomerular filtration rate?

A

180L/day (plasma vol = 3L, filter 60x a day)

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3
Q

two factors that influence GFR?

A

net filtration pressure and filtration coefficient

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4
Q

renal blood flow and blood pressure

A

net filtration pressure

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5
Q

surface area of glom caps available for filtration and permeability of interface tween caps and Bowman cap

A

filtration coefficient

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6
Q

GFR is primarily regulated by renal afferent and efferent ____

A

arterioles

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7
Q

if afferent arteriole resistance is decreased and efferent stays the same, then RBF would ___, hydrostatic pressure would ___, and GFR would ____

A

all would increase

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8
Q

What are the 2 autoregulatory mechanisms that maintain a relatively stable GFR in the face of normal BP fluctuations?

A

1) myogenic response of afferent arterioles (stretch activated channels–>contract muscle)
2) tubuloglomerular feedback

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9
Q

these cells are activated by ^ NaCl, sense distal tubule flow with cilia and release paracrines affecting afferent arteriole diameter

A

macula densa

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10
Q

when is sympathetic activation affecting GFR?

A

conditions of severe dehydration or hemorrhage (will override autoregulation)

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11
Q

what are the 2 important hormones modulating arteriole resistance?

A

angiotensin 2 (constrict), prostaglandins (dilate)

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12
Q

what are the 2 types of transport involved in reabsorption?

A

transepithelial (transcellular) and paracellular

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13
Q

NaKATPase is found on ___ side, Na-Gluc symport and ENaC is found on ____

A

basolateral; apical

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14
Q

urea undergoes ___ reabsorption while plasma proteins undergo ____

A

passive; endocytosis

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15
Q

example of a receptor binding plasma protein

A

megalin

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16
Q

what is the max rate of transport that occurs when all available carriers occupied?

A

saturation

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17
Q

The transport rate at saturation is called the….

A

transport max

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18
Q

The plasma concentration of solute when first begins to appear in urine

A

renal threshold

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19
Q

condition where glucose appears in your urine

A

gluco/glycosuria

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20
Q

what is a renal corpuscle?

A

the initial blood filtering portion of nephron, consisting of glomerulus and bowman’s capsule

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21
Q

what is secretion?

A

the transfer of cules from xtracell fluid to lumen of nephron (usually active)

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22
Q

amount excreted=___

A

amount filtered-amount reabsorbed + amount secreted

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23
Q

how are organic anions removed?

A

through tertiary indirect active transport

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24
Q

penicillin is given with ___, which is preferentially secreted by OAT transporter

A

probenecid

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25
Q

Clearance of X=

A

excretion rate of X (mg/min) / [X] plasma (mg/mL plasma)

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26
Q

inulin is completely ___ and not ___

A

filtered; reabsorbed

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27
Q

GFR=

A

excretion rate inulin / inulin plasma lvl

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28
Q

using inulin is impractical, so clinicians use ______ to measure GFR, although it slightly ____ GFR

A

creatinine; overestimates

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29
Q

urea has net ___ while penicillin has net ___

A

reabsorption; secretion

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30
Q

filling the bladder activates stretch receptors, initiating the ___ reflex

A

micturition

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31
Q

internal sphincter is __ muscle while external sphincter is ___ muscle. At rest they are ___

A

smooth; skeletal; contracted

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32
Q

_____ and ____ determine ECF volume and osmolarity

A

H2O and Na+

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33
Q

The ___ lose water and help remove H+ and ___ by excreting CO2

A

lungs; HCO3

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34
Q

__ balance can cause probs with cardiac/muscle function

A

K+

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35
Q

in hypotonic solution, cell is ____, in hypertonic solution, cell is ___

A

lysed; shrivelled

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36
Q

fluid/electrolyte balance is integrative, involves ____, ___, ___ systems and __ responses

A

respiratory, cardiovascular, renal; behavioural

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37
Q

water makes up ____ of body weight; ___ in intracell, __ in xtracell

A

50-60%; 1/3; 2/3

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38
Q

what is insensible water loss?

A

non-urinated or fecal water loss, evaporation from skin, exhalation from lungs

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39
Q

what is diuresis?

A

removal of XS urine

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40
Q

what are the two hormones in the distal tubule that affect permeability to water and solutes?

A

aldosterone and vasopressin

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41
Q

vasopressin controls ___ reabsorption by adding or removing ____

A

water; water pores

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42
Q

how does AVP induce AQP2 ?

A

vasopressin leaves brain, binds to G-protein coupled receptor–>cyclic AMP phosphorylate aquaporins in storage vesicles, exocytosis of these vesicles

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43
Q

What stim control vasopressin secretion?

A

mainly increased plasma osmolarity, also decreased volume and pressure of blood–happens more when sleeping so don’t have to get up to pee

44
Q

where is AVP produced and secreted?

A

Magnocellular neurosecretory cells

cell body of neuron–>vesicles transported down axon and stored in posterior pit.->release to blood

45
Q

what affects the AP firing rate?

A

stretch sensitive neurons

46
Q

high osmolarity in ____ _____ necessary to create concentration gradient moving water out of collecting duct; this is obtained through _______ systems

A

medullary interstitium; countercurrent exchange systems

47
Q

countercurrent xchange sys found in ________ of mammals and birds to reduce ____

A

flippers, tails, wings; heat loss

48
Q

the loop of henle is referred to as the ________ and the peritubular capillaries of the ___ nephrons are referred to as _______

A

countercurrent multiplier; juxtmedullary; countercurrent exchanger

49
Q

the ____ transporter moves Na, K, and 2 Cl into the ___ cells

A

NKCC2; epithelial

50
Q

why is NKCC2 a target of loop diuretic drugs?

A

prevents the generation of hypertonic interstitial space

51
Q

why doesn’t water entering interstitium dilute hypertonic medulla?

A

vasa recta pick up solute to create hypertonic blood, so the water moves into blood instead of interstitial space

52
Q

about half the solute in medulla interstitium is ___

due to reabsorption in the ___ portion of nephron, creating a recycling loop

A

urea; distal

53
Q

thirst regulator located in ____ of brain

A

hypothalamus

54
Q

unknown receptors in ______ respond to water by decreasing thirst and decreasing VP release

A

mouth/pharynx

55
Q

which hormones increase desire to ingest Na?

A

aldosterone, angiotensin 2

56
Q

when would ^ volume and ^ osmolarity happen?

A

eating salty foods and drinking liquids at same time (salt>water)

57
Q

when would ^ volume but no change in osmolarity happen?

A

if salt and water ingested is = to isotonic solution

58
Q

when would ^ volume and v osmolarity occur/

A

drinking pure water without ingesting (kidney can’t excrete pure water)

59
Q

when would no volume change and ^ osmolarity occur?

A

eat salt without drinking water (kidneys concentrate urine)

60
Q

when would no volume change and v osmolarity happen?

A

in exercise, through sweat

61
Q

when would v volume and ^ osmolarity happen?

A

heavy exercise or diarrhea (extreme dehydration)–>inadequate perfusion

62
Q

when would v volume and no change in osmolarity happen?

A

hemorrhage (need IV/transfusion)

63
Q

when would v volume and v osmolarity happen?

A

uncommon–>incomplete compensation for dehydration

64
Q

what are the three homeostatic responses to severe dehydration?

A

1) conserving fluid
2) trigger cardio reflexes ^ BP
3) stimulate thirst

65
Q

what are the 4 compensatory mechanisms that overlap to overcome dehydration?

A

1) cardio mechanisms
2) renin-angiotensin system
3) renal mechanisms
4) hypothalamic mechanisms

66
Q

H+ concentration of normal arterial plasma is very ___ and is expressed on a ____ scale

A

low; logarithmic

67
Q

normal pH of body is ___

A

7.40, slightly alkaline

68
Q

this condition depresses the CNS

A

acidosis

69
Q

this condition causes neurons to become hyperexcitable, and can cause sustained contractions paralyzing muscles

A

alkalosis

70
Q

what is the largest source of acid on a day to day basis?

A

CO2 from aerobic metabolism

71
Q

pH homeostasis depends on these three mechanisms:

A

1) buffers (first line of defence)
2) ventilation (75% of disturbances)
3) renal regulation of H+ and HCO3 (slowest)

72
Q

includes proteins like hemoglobin, phosphate ions and HCO3 (cules that moderate but don’t prevent changes in pH)

A

buffer systems

73
Q

plasma bicarbonate concentration approx ____ times concentrated as plasma H+

A

600 000

74
Q

extracellular buffer system is ____, intracellular is ____

A

bicarbonate; cell proteins, phosphate ions, hemoglobin

75
Q

hypoventilation results in ___ shift; hyperventilation results in ___ shift

A

right; left

76
Q

_______ chemoreceptors sense change in plasma H and PCO2, signal to ____ to adjust ventilation

A

peripheral and central; respiratory control centre

77
Q

kidney handles ____% of pH disturbances both directly and ____

A

25; indirectly (changing rate at which HCO3 buffer is reabsorbed or excreted)

78
Q

H+ cannot be ___, it enters the tubule via ___ only

A

filtered; secretion

79
Q

during acidosis, XS H is buffered by ____ in tubule cells or _____ in lumen

A

ammonia phosphate ions

80
Q

the ___ tubule secretes H+ back into nephron and ____ HCO3

A

proximal; reabsorbs

81
Q

____ is metabolized to ammonium and HCO3

A

glutamine

82
Q

the ___ nephron controls acid excretion

A

distal

83
Q

Type A intercalated cells for ____; Type B intercal cells for ____

A

acidosis; alkalosis (getting rid of base/buffer)

84
Q

intercal cells have lots of ___, bicarbonate chloride transporter, 2 kinds H+ATPase

A

carbonic anhydrase

this is not a super important concept

85
Q

acidosis can result in _______, alkalosis in ____

A

hyperkalemia; hypokalemia

86
Q

once disturbance causes change in plasma pH, buffers are ineffective so need to rely on ____ and ___ compensation

A

respiratory; renal

87
Q

occurs when alveolar hypoventilation results in CO2 retention

A

respiratory acidosis

88
Q

what causes resp acidosis?

A

asthma, skel muscle disorders (muscular dystrophy), COPD, emphysema

89
Q

compensation for respiratory acidosis/alkalosis must happen via ____

A

renal mech (HCO3 and H+)

90
Q

why breathe into paper bag when hyperventilate?

A

rebreathe exhaled CO2 to ^ plasma CO2 lvl

91
Q

occurs when diet/metabolic input H+ exceeds H+ excretion

A

metabolic acidosis

92
Q

two kinds of metabolic acidosis?

A

lactic acidosis (anaerobic metabolism), ketoacidosis (xcess breakdown fat/a.a. in low carb diets)

93
Q

metabolic acidosis can occur from excessive HCO3 loss, through ____

A

diarrhea

94
Q

metabolic acidosis/alkalosis can be resolved through ____ and ____ mechanisms

A

respiratory; renal

95
Q

metabolic alkalosis can be caused commonly by:

A

excess vomiting, excess ingestion of antacids (bicarbonates)

96
Q

what are the kiney functions?

A

homeostatic reg of water/ions, xcell fluid vol, BP, osmolarity, produce hormones, pH, waste excretion

97
Q

what gives urine yellow colour?

A

urobilinogen

98
Q

urinary system receive ____ cardiac output

A

20-25%

99
Q

what is the functional unit of kidney?

A

nephron

100
Q

80% nephrons are _____, 20% are _____

A

cortical; juxtamedullary

101
Q

the interactions between the bowman’s capsule and proximal tubule is called:

A

juxtaglomerular apparatus

102
Q

2 capillary beds arranged in series is referred to as a :

A

portal system

103
Q

order of vascular components?

A

renal artery–>afferent arterioles–>glomerulus–>efferent arterioles–>peritubular capillaries–>renal veins

104
Q

order of tubular component?

A

bowman’s cap–>prox tubule–>descending loop of Hen–>ascending loop of Hen–>distal tubule–>collecting duct

105
Q

____ is responsible for creating dilute urine

A

loop of Henle

106
Q

70% of reabsorption occurs here:

A

prox tubule

107
Q

what is the triple filtration barrier/

A

capillary endothelial cells, basal lamina, podocyte endfeet

Phys 208 (10 decks)

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