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Alimentary (MEDI302) > Renal > Flashcards

Renal Flashcards

1
Q

What is the function of the kidneys?

A 
Excrete metabolic waste, foreign chemicals
Secrete and metabolise hormones
Regulate pH
Control blood pressure
Gluconeogenesis
Regulate water and electrolyte excretion
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2
Q

What waste products are excreted by the kidneys?

A

Urea
Creatinine
Bilirubin
Hydrogen

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3
Q

What hormones are secreted by the kidney?

A

Erythropoetin

Renin

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4
Q

Why is erythropoetin secreted by the kidneys?

A

In response to low blood O2 in the kidneys, to increase erythrocyte production

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5
Q

What ions do the kidneys regulate?

A 
Sodium
Chloride
Potassium
Hydrogen
Calcium
Phosphate
Magnesium
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6
Q

What are the nephrons function?

A

Filtration
Reabsorption
Secretion
Excretion

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7
Q

What determines capacity for filtration?

A

The size and charge of the barrier

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8
Q

Name 4 reasons why proteinuria is clinically significant

A

Hypertension
Diabetes
Pre-eclampsia
As an annual check-up

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9
Q

What can cause microalbuminuria?

A

Early diabetes
Hypertension
Glomerular hyperfiltration

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10
Q

What is microalbuminuria?

A

Urine excretion of 30-150mg albumin per day

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11
Q

What 3 factors determine glomerular filtration rate?

A

+ Glomerular hydrostatic pressure

  • Glomerular colloid osmotic pressure
  • Bowman’s capsule pressure
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12
Q

What is hydronephrosis?

A

Dilation of the renal pelvis caused by urinary retention due to the obstruction of the free flow of urine

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13
Q

What factors affect the glomerular capillary hydrostatic pressure?

A

Constriction of afferent and efferent arterioles

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14
Q

How much of the cardiac output is directed to the kidneys?

A

22%

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15
Q

Why is so much oxygen and nutrients directed to the kidneys?

A

It is used for renal tubular sodium reabsorption

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16
Q

What are the key regulators of GFR?

A

Sympathetic nervous system
Hormones
Autocoids

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17
Q

How does the sympathetic nervous system control GFR?

A

Innervation of vasculature

Noradrenaline

18
Q

What is EDNO and what does it do?

A

Endothelial-Derived Nitric Oxide

Protects against excessive vasoconstriction

19
Q

What is the role of prostaglandins in the kidneys?

A

Increased glomerular filtration rate

20
Q

What is the myogenic mechanism?

A

Autoregulation of GFR and renal blood flow
The response to increased arterial pressure
> stretch of blood vessels
> increased Ca++ entry and intracellular Ca++
> increased vascular resistance
» increased blood flow and GFR

21
Q

What is the macula densa?

A

A collection of cells in the wall of the distal convoluted tubule.
Sensitive to sodium chloride concentration, increasing renin release and decreasing the blood flow in the afferent arteriole to decrease the GFR etc.

22
Q

What are the 2 reabsorption (transport) pathways?

A

Paracellular

Transcellular

23
Q

Outline the primary active transport of Na+ in the proximal tubule

A
  1. Active transport via the Na+/K+ pump across the basolateral surface
  2. Establish concentration and electrochemical gradient for Na+
  3. Na+ transport into the epithelial cell from the lumenal surface
24
Q

Outline the 2 secondary active transport mechanisms

A

Co-transport of glucose and amino acids with Na+ ions driven by electrochemical gradient
Counter-transport driving a movement of a 2nd substrate in the opposite direction

25
Q

Why can creatinine be used as diagnostic tools for assessing kidney function?

A

All creatinine should be excreted

26
Q

What is transported in the proximal tubule?

A

Out: Na+, Cl+, HCO3-, K+, H2O, glucose, amino acids
In: H+, organic acids, bases

27
Q

What are the transport characteristics of the thin and thick loops of Henle?

A

Both ascending limbs impermeable to water

Thin descending limb permeable to water.

28
Q

How is tubular reabsorption regulated?

A 
Hormones - aldosterone, angiotensin, ADH
Sympathetic nervous system
Arterial pressure
Glomerulotubular balance
Peritubular physical forces
Osmotic factors
29
Q

How does aldosterone regulate tubular absorption?

A

Acts in the collecting tubule and duct:

Increase NaCl and H2O reabsorption, and K and H secretion

30
Q

How does angiotensin II regulate tubular reabsorption?

A

Acts in the proximal and distal tubules, collecting tubule

Increase NaCl reabsorption, and H secretion

31
Q

How does ADH regulate tubular reabsorption?

A

Acts in the distal tubule onwards

Increases H2O reabsorption

32
Q

What is hydronephrosis?

A

When there is a blockage in the kidneys/ureters, so urine builds up, changing the pressure in the glomeruli.

33
Q

What is polyuria?

A

When too much urine is being passed

34
Q

What is glucosuria?

A

When glucose is found in the urine

35
Q

What is the macula densa sensitive to?

A

Concentrations of NaCl in the distal convoluted tubule

36
Q

Where is the macula densa?

A

In the wall of the thick ascending arm of the loop of Henle, at the transition to the distal convoluted tubule

37
Q

Where is renin secreted?

A

By the kidneys

38
Q

Name the systems/organs responsible for fluid output

A 
Kidneys
Lungs
Feces
Sweat
Skin
39
Q

Outline the response to low oxygen levels received by the kidneys

A

Stimulated to release erythropoietin
Increased erythrocyte production
Increased oxygen delivered to kidneys

40
Q

Outline the blood supply to the kidneys

A

Aorta > renal arteries > segmental arteries > interlobar arteries > arcuate arteries > interlobular arteries > glomerulus > intertubular capillaries

41
Q

What (approximate) percentage of the cardiac output is taken by the kidneys?

A

22%

42
Q

What is the role of juxtaglomerular cells?

A

Secrete renin in response to a drop in blood pressure; stimulated by the macula densa cells

Alimentary (MEDI302) (7 decks)

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