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Renal Flashcards

1
Q

What are the breakdown of your body fluids?

A

60% water
40% ICF
20% ECF (15% IF, 5% plasma)

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2
Q

What is the marker used for ECF

A
  1. Sulfate
  2. Inulin
  3. Mannitol
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3
Q

What is the marter for TBW

A
  1. Tritiated water

2. D2O antipyrine

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4
Q

What is the marker for plasma

A
  1. Radioactive Iodinated Serum Albumin

2. Evans blue

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5
Q

What is the marker for IF?

A

ECF-plasma volume indirect

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6
Q

What is the marker for ICF

A

TBW-ECF (indirect)

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7
Q

[Changes in ECF/ICF Compartments]

Loss of isotonic fluid in the feces initially comes from the ECF

A

ECF = same concentration, same volume

ICF = same concentration, same volume

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8
Q

[Changes in ECF/ICF Compartments]

Excessive sweating

A

ECF concentration increase,
volume decrease,

ICF concentration increase, volume decrease

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9
Q

[Changes in ECF/ICF Compartments]

adrenal insufficiency

A

ECF concentration decrease, volume decrease

ICF concentration decrease, volume decrease

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10
Q

[Changes in ECF/ICF Compartments]

infusion of isotonic NaCL

A

ECF concentration same, volume increase

ICF concentration same, volume increase

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11
Q

[Changes in ECF/ICF Compartments]

Excessive NaCl intake

A

ICF concentration increase, volume decrease

ECF volume increase, concentration increase

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12
Q

[Changes in ECF/ICF Compartments]

SIADH

A

ICF concentration decrease, volume increase

ECF concentration decrease, volume increase

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13
Q

[Type of nephron]

shorter loops of henle, with peritubular capillaries

A

cortical nephron

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14
Q

[Type of nephron]

longer loops of henle with vasa recta

A

juxtamedullary nephron

in the corticomedullary junction

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15
Q

which part of the nephron does filtration occur?

A

renal corpuscle or malphigian corpuscle

in the renal cortex

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16
Q

which part of the nephron does tubular reabsorption and secretion occur?

A

renal tubular system

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17
Q

The juxta countercurrent exchanger is located in the

A

Vasa recta

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18
Q

EPO is secreted in

A

interstitial cells in the peritubular/ cortical nephron

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19
Q

[Part of Glomerulus]

fenestrated

A

capillary endothelium

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20
Q

What is the charge of the basement membrane

A

negatively charge

deflects negatively charged proteins

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21
Q

What part of the renal corpuscle that is capable of phagocytosis

A

Mesangial cells (intraglomerular)

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22
Q

Which part of the mesangial cells capable of autoregulation, RAAS and EPO secretion?

A

Lacis Cells/ Extraglomerular Mesangial Cells

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23
Q

Which cell triggers RAAS?

A

Macula Densa in the Distal tubule

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24
Q

Which cells secrete renin?

A

Juxtaglomerular Cells

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25
Q

What gives rise to the glomerular tuft?

A

Afferent arteriole

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26
Q

What cell is found in the walls of the afferent arteriole?

A

Juxtaglomerular cell

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27
Q

What cell is found in the walls of the distal tubule?

A

macula densa

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28
Q

The cortical collecting tubule is part of the _____

A

distal tubule

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29
Q

The medullary collecting duct is part of the ____

A

collecting duct

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30
Q

The convulutions ands microvili present in the PCT is due to ____

A

increased number of carrier-mediated transport

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31
Q

Which part of the nephron is susceptible to hypoxia and toxins?

A

PRCT

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32
Q

The countercurrent multiplier is located in ____

A

loop of henle

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33
Q

The ascending limb of LOH is permeable to

A

solutes

ASINding limb

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34
Q

The descending limb of LOH is permeable to

A

water

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35
Q

What transporter is present in the thick ascending LOH?

A

NaK2Cl symport

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36
Q

Which part of the nephron is called the diluting segment?

A

Ascending LOH

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37
Q

Which distal tubule is seen in the cortex

A

early distal tubule

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38
Q

Which part of the nephron is referred to as the cortical diluting segment?

A

early distal tubule

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39
Q

What cells are found in the late distal tubule?

A
  1. Principal cells

2. Intercalated cells

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40
Q

What will be the response of principal cells if you increase your dietary K intake

A

Stimulate principal cells to secrete K

Low dietary K - stimulates intercalated cell to resorb

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41
Q

What is the action of principal cells in controlling the Na and K?

A

Principal cells

Reabsorb Na, Secrete K

Remember: PNR train - principal Na reabsorb

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42
Q

What hormone acts on the late distal tubule?

A

Aldosterone

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43
Q

What is the action of Intercalated cells in controlling the K and H?

A

Intercalated cell

Reabsorb K
Secrete H

Remember: IKR
Intercalated K reabsorb

i know right

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44
Q

ADH increases urea reabsorption by

A

increasing the production of urea transporter type 1

increasing urine volume

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45
Q

What is the response of the body if you increase ADH

A

Inc aquaporin 2 channels leading to increased intravascular volume

Increase VR, Inc CO, BP

46
Q

In the countercurrent mechanism, which part of the nephron creates graded osmolarity?

A

Loop of Henle

47
Q

In the countercurrent mechanism, which part of the nephron creates preserves the graded osmolarity?

A

Vasa recta

maintains by circulating water and solutes around

48
Q

What are the factors that enables the LOH to make a graded osmolarity?

A
  1. Shape of LOH
  2. Slow flow
  3. Characteristics of the limb: ASINding
  4. Presence of NaK2Cl symport
49
Q

[Basic movements in urine formation]

movement from glomerular capillaries to bowman’s capsule

A

Filtration

50
Q

[Basic movements in urine formation]

movement from tubules to interstitium to peritubular capillaries

A

Reabsorption

51
Q

[Basic movements in urine formation]

movement from peritubular capillaries to interstitium to tubules

52
Q

What is the formula for excretion?

A

Excretion = Amount filtered - (amount reabsorbed + secreted)

53
Q

____ refers to when the substance appear in the urine since some nephrons exhibit saturation

A

Renal Threshold

54
Q

____ refers to all excess substance appear in the urine since all nephrons exhibit saturation

A

Renal Transport Maximum

55
Q

Glucose reabsorption occurs using what transporter?

A

SGLT2 in PCT

56
Q

What is the renal threshold for glucose reabsorption

A

200mg/dL

Some nephrons are saturated

57
Q

What is the renal transport maximum for glucose reabsorption?

A

> 375mg/dL

all nephrons saturated

58
Q

If 200 mg/dL of PAH is filtered, what will be the the resulting plasma concentration

A

0

since PAH is filtered, secreted, not reabsorbed

59
Q

What ionic form of weak acid predominates in an acidic urine?

A

HA form predominates

Alkalinize the urine so that A- predominates

60
Q

What ionic form of weak base predominates in an acidic urine?

A

BH+ form predominates, it is more excreted

61
Q

A high clearance substance will mostly be found ind ____

A

urine

e.g.PAH

62
Q

A low clearance substance will most likely be found in the ____

A

Blood

i.e. CHON, Na, Gluc

63
Q

Arrange in descending order according to relative clearance

Glucose, Na, Urea, Inulin K, PAH

A

PAH > K > Inulin > urean > Na > glucose, amino acod HCO3

Remember: PaKI UNa GA

64
Q

What substance is more concentrated at the end of PCT than at the start of PCT?

A

creatinine

65
Q

How many percent of CO goes as part of the renal blood flow?

66
Q

What substances vasodilate the renal arterioles?

A

Increases RBF

  1. PGE2
  2. PGI2
  3. Bradykinin
  4. NO
  5. Dopamine

Remember: NOD BradIE

67
Q

What substances vasoconstrict the renal arterioles?

A

Decreases RBF

  1. Sympathetic NS
  2. Angiotensin II
68
Q

What substance estimates the renal plasma flow?

A

PAH

underestimates true RPF by 10% due to RPF

69
Q

What will be the effect to the RPF if you

vasoconstrict the efferent arteriole?

A

decrease RPF

Increase RBF

70
Q

What will be the effect to the RPF in the presence of ureteral stone

A

no change

but GFR decreases

71
Q

What will be the effect to the RPF if you

vasodilate the afferent arteriole

A

decrease RPF

GFR decreases

72
Q

An increase in GF and RBF is due to vasodilation of:

A
  1. Vasodilation of afferent

2. Vasodilation of efferent arteriole

73
Q

What is the BP range that maintains the constant GFR of >125 mL/min

A

BP 80-200mmHg

74
Q

What are the responses of the kidney to a BP <80mmHg to increase the GFR?

A
  1. Macula Densa increases secretion of Ang II then efferent arteriole constriction
  2. NO vasodilates afferent arteriole
75
Q

Wha are the responses of the kidney to a BP >200mmgHg?

A
  1. Macula densa increases secretion of adenosine, thereby constricting the afferent arteriole
76
Q

what is the normal GFR?

77
Q

[Starling force]

promotes GFR; water pressure in the GC

increased by vasodilation of afferent arteriole or moderate vasoconstriction of efferent

A

GC hydrostatic pressure

78
Q

[Starling force]

opposes GC hydrostatic pressure and GFR; water pressure at the BS increased by ureteral obstruction

A

BS Hydrostatic pressure

79
Q

[Starling force]

opposes GFR; proteins attracting warer; increased by plasma protein concentration

A

GC oncotic pressure

80
Q

[Starling force]

increased by histamine

81
Q

Feedback mechanism used for autoregulation of GFR

A

Tubuloglomerular feedback

82
Q

The macula densa detects changes in what _____

A

increase or decrease in GFR

83
Q

What is the first line of defense of the body to regulate K

A

movement of K across ECF and ICF?

84
Q

What causes K efflux leading to hyperkalemia?

A
  1. Insulin deficiency
  2. Beta adrenergic antagonist
  3. Acidosis
  4. Hyperosmolarity
  5. Hyperosmolarity
  6. Digitalis
  7. Exercise
  8. Cell lysis
85
Q

What causes K influx leading to hypokalemia?

A
  1. Insulin
  2. Beta adrenergic agonist
  3. Alkalosis
  4. Hypoosmolarity
86
Q

What are the causes of distal K secretion?

A
  1. high K diet
  2. Hyperaldosteronism
  3. Alkalosis
  4. Thiazide diuretics
  5. Loop diuretics
  6. Luminal anionis
87
Q

What causes decreased distal K secretion?

A
  1. Low K diet
  2. Hypoaldosteronism
  3. Acidosis
  4. K sparing diuretics
88
Q

What drug is an aldosterone antagonist thereby decreasing K secretion to the urine?

A

spironolactone

AE: gynecomastia

89
Q

What compound increases the maximum urine osmolality?

90
Q

Hyper/hypocalcemia can cause arrythmias

A

hypercalcemia

91
Q

____ binds with calcium in the intestine; stimulated by vit D

92
Q

What drug class increases Ca reabsorption?

A

PTH, Thiazide

93
Q

What drug class decreases Ca reabsorption?

A

loop diuretics

94
Q

What cotransporter reabsorbs phosphate in the PCT?

A

Na-PO4 cotransporter

95
Q

What hormone inhibits Phosphate reabsorption?

A

PTH

can cause phosphaturia and increase urinary cAMP

96
Q

What is the relationship of Calcium and Magnesium?

A

Hypercalcemia causes hypomagnesemia

Hypocalcemia causes hypermagnesemia

97
Q

What electrolyte is not reabsorbed in the PCT?

98
Q

Magnesium is reabsorbed in which part of the nephron?

99
Q

Water deprivation stimulates the osmoreceptors in which part of the brain?

A

anterior hypothalamus

100
Q

What is the response of the posterior pituitary during water deprivation?

A

increases ADH scretion

101
Q

What happens to the urine osmolarity in water deprivation test

A

Increase urine osmolarity, urine volume decreases

102
Q

Which part of the nephron wherein the filtrate is isotonic to plasma in the presence of ADH?

A

cortical collecting tubule

103
Q

Which part of the nephron wherein solute free water is produced?

A

diluting segment of kidney or areas where NaCl is reabsorbed but not water

  1. TAL LH
  2. EDT
104
Q

The presence of ADH means that the free water will be ___ (positive or negative?

A

negative

since free water is reabsorbed, water is not excreted

105
Q

What causes hyponatremia in patients with Small Cell Lung CA?

A

Arginine Vasopressin (SIADH)

106
Q

What is the hallmark of Diabetes Insipidus?

A

increased free water clearance

107
Q

What are examples of body fluid buffers?

A
  1. CO2 + H2O = H2CO3
  2. Phosphate buffer system
  3. Intracellular proteins
108
Q

What are the effects of acidosis to the levels of cakcium and potassium

A

Hypercalcemia

HyperKalemia

109
Q

What are the causes of HAGMA?

A
  1. Methanol
  2. Uremia
  3. DKA
  4. Paraldehyde
  5. Propylene Glycol
  6. Iron
  7. Isoniazid
  8. Idiopathic Acidosis
  9. Lactic Acidosis
  10. Ethylene Glycol
  11. Ethanol
    12, Salicylic Acid
110
Q

What are the causes of NAGMA

A
  1. Hyperalimentation
  2. Acetazolamide
  3. RTA
  4. Diarrhea
  5. Ureteroenteric fistula
  6. Pancreaticoduodenal fistula

Physiology (47 decks)

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