Renal & Acid-base Flashcards
Normal plasma osmolarity is:
a. 220 mOsm/L
b. 180 mOsm/L
c. 320 mOsm/L
d. 280 mOsm/L
d. 280 mOsm/L
What is the osmolarity and osmotic pressure of a 7.2% saline solution?
a. 2460 mOsm/L and 47,478 mmHg
b. 2200 mOsm/L and 35,320 mmHg
c. 3000 mOsm/L and 51,348 mmHg
d. 1800 mOsm/L and 28,220 mmHg
a. 2460 mOsm/L and 47,478 mmHg
Hypo-osmotic dehydration can occur with:
a. Sweating during heavy exercise
b. Primary loss of sodium such as diarrhea or vomiting or aldosterone deficiency
c. Reduced secretion of ADH
d. Excess of sodium in ECF
b. Primary loss of sodium such as diarrhea or vomiting or aldosterone deficiency
Excessive secretion of ADH can lead to:
a. Hyperosmotic overhydration
b. Hypo-osmotic dehydration
c. Hypo-osmotic overhydration
d. Hyperosmotic dehydration
c. Hypo-osmotic overhydration
Three major factors that cause increased capillary filtration of fluid and protein into the interstitium:
a. Increased capillary permeability, increased capillary hydrostatic pressure and decreased plasma colloid osmotic pressure
b. Decreased capillary permeability, increased plasma colloid osmotic pressure and increased capillary hydrostatic pressure
c. Decreased plasma colloid osmotic pressure, increased capillary permeability, and decreased capillary hydrostatic pressure
d. Increased capillary permeability, decreased capillary hydrostatic pressure and decreased plasma colloid osmotic pressure
a. Increased capillary permeability, increased capillary hydrostatic pressure and decreased plasma colloid osmotic pressure
Name safety factors that prevent fluid accumulation in interstitial spaces:
a. high compliance of interstitium, ability of lymph flow to decrease and washdown of interstitial fluid protein concentration
b. ability of lymph flow to increase to up to 10- fold, high compliance of interstitium and washdown of interstitial fluid protein concentration
c. low compliance of interstitium, washdown of interstitial fluid and ability of lymph flow to increase up to 10- fold
d. ability of lymph flow to increase to 10- to 50-fold, low compliance of interstitium and washdown of interstitial fluid protein concentration
d. ability of lymph flow to increase to 10- to 50-fold, low compliance of interstitium and washdown of interstitial fluid protein concentration
Describe the difference in mechanisms that cause pitting and non-pitting edema.
In pitting edema, free fluid accumulates around proteoglycan “brush piles” and when you press on it, you can push fluid out of the area and then it flows back in when pressure is removed. Non-pitting edema involves either fibrinogen accumulation in free fluid or cellular swelling.
Albumin is restricted from glomerular filtration due to its:
a. Molecular diameter
b. Negative charge
c. Molecular weight
d. All of the above
e. Only a and b
b. Negative charge
The net filtration rate is a summary of which forces?
a. Glomerular hydrostatic pressure b. Bowman’s capsule pressure c. Glomerular oncotic pressure
Which of the following forces favor filtration?
a. Glomerular hydrostatic pressure and Bowman’s capsule colloid osmotic pressure
b. Glomerular colloid osmotic pressure and Bowman’s capsule hydrostatic pressure
c. Bowman’s capsule hydrostatic pressure and glomerular oncotic pressure
d. b and c
a. Glomerular hydrostatic pressure and Bowman’s capsule colloid osmotic pressure
Under normal circumstances, glomerular hydrostatic pressure is 60mmHg and Bowman’s capsule colloid osmotic pressure is zero.
Forces that opose filtration are Bowman’s capsule hidrostatic pressure (18mmHg) and glomerular capillary osmotic pressure (32mmHg).
Increased afferent arteriolar resistance results in:
a. Decreased GFR
b. Increased GFR
c. Decreased glomerular hydrostatic pressure d. Increased glomerular hydrostatic pressure
e. a and c
f. b and c
e. a and c
Moderately increased efferent arteriolar resistance results in:
a. Increased resistance and decreased GFR
b. Decreased glomerular hydrostatic pressure
c. Increased glomerular hydrostatic pressure and increased GFR
d. Severe constriction and reduced GFR
c. Increased glomerular hydrostatic pressure and increased GFR
Which of the following hormones and autocoids increase GFR?
a. Norepinephrine and endothelin
b. EDNO and prostaglandins
c. Epinephrine and EDNO
d. Blockage of PGs and Angiotensin II
b. EDNO and prostaglandins
EDNO (endothelium-derived Nitrus Oxide) is released by vascular endothelium it allows kidneys to excrete normal amount of Na and water and decreases vascular resistance.
Pg cause vasodilation and increase blood flow and GFR
Angiotensin II constricts efferet arterioles.
Endothelin is a powerful vasoconstrictor decreasing GFR, it is tipically released during many disease states.
Ne and E constrict peripheral arteries, decreasing GFR
Describe how a high-protein diet can contribute to increased GFR and renal blood flow.
- Increased protein breakdown leads to increased amino acid in the bloodstream. Increasd amino acid reasborption in the kidney tubules stimulates increased sodium reabsorption in the proximal tubules
- Decreased sodium delivered to the macula densa
- The tubulo-glomerular feedback mechanism mediates a decrease in resistance of afferent arterioles
- Decreased afferent arteriolar resistance raises renal blood flow and increases GFR
Urolithiasis can result in:
a. Increased glomerular osmotic pressure
b. Increased Bowman’s capsule hydrostatic pressure
c. Decreased GFR
d. a and c
e. b and c
f. All of the above
e. b and c
A(n) ______ in sodium chloride concentration at the macula densa cells causes ________ resistance in the afferent arterioles.
a. Increase, increase
b. Decrease, decrease
c. Increase, decrease
d. Decrease, increase
b. Decrease, decrease