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Nephrology > Renal Blood Flow and Glomerular Filtration - Rao > Flashcards

Renal Blood Flow and Glomerular Filtration - Rao Flashcards

1
Q

What two vascular structures have the highest resistance in the nephron? What is a distant third?

A

Efferent Arteriole > Afferent Arteriole > Peritubular Capillary

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2
Q

What is the Gibbs Donnan effect?

A

4-5% more anions than cations present in filtrate because cations can bind negatively charged proteins in plasma

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3
Q

What is the equation for filtration fraction?

A

FF = GFR / RPF

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4
Q

Name one factor that can reduce GFR and one that can reduce RPF?

A

GFR - urethral obstruction

RPF - renal artery stenosis

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5
Q

What are the three filtration barriers in the glomerulus?

A

Capillary Endothelium
Basement Membrane
Epithelium (Podocyte monolayer)

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6
Q

What is an equation for GFR?

A

GFR = Kf x Net filtration pressure

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7
Q

What is Kf?

A

Filtration coefficient = hydraulic conductivity x surface area of glomerular capillary

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8
Q

What is the equation for net filtration pressure?

A 
(P g + Pi bs) - (Pi g + P bs)
g -glomerulus
bs - bowman's space
P - hydrostatic
Pi - oncotic
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9
Q

How does increased afferent or decreased efferent arteriole pressure effect GFR?

A

Decreases GFR

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10
Q

How does decreased afferent or increased efferent arteriole pressure effect GFR?

A

Increases GFR

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11
Q

How does increased afferent arteriole pressure affect GFR and RPF, respectively?

A

GFR - decrease

RPF - decrease

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12
Q

How does decreased afferent arteriole pressure affect GFR and RPF, respectively?

A

GFR - increase

RPF - increase

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13
Q

How does increased efferent arteriole pressure affect GFR and RPF, respectively?

A

GFR - increase

RPF - decrease

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14
Q

How does decreased efferent arteriole pressure affect GFR and RPF, respectively?

A

GFR - decrease

RPF - increase

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15
Q

How does increased hydrostatic pressure in bowman’s space affect GFR?

A

Decreases GFR (through decreased net filtration rate)

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16
Q

How does low capillary flow affect GFR?

A

Low capillary flow - Increased filtration fraction - Increased glomerular oncotic pressure - Decrease net filtration pressure - Decrease GFR

17
Q

How do GFR and RPF remain constant through a range of mean arterial pressures?

A

Change renal vascular resistance (particularly afferent arteriole)

18
Q

What is the mycogenic mechanism?

A

Major theory of GFR auto-regulation

Direct simulation of arteriolar smooth muscle

19
Q

What is the tubuloglomerular feedback mechanism?

A

Major theory of GFR auto-regulation
Juxtaglomerular apparatus (macula densa cells and juxtaglomerular cells)
Stimulated by GFR and tubular chloride
High flow / chloride causes decreased GFR

20
Q

How does high chloride in macula densa decrease GFR?

A

High chloride stimulates NA-K-2Cl cotransporter in JG cells
JG cells release ATP and AA metabolites
Smooth muscle contraction
Increase arteriolar resistance

21
Q

What activates the Renin Angiotensin System?

A

Decreased arterial pressure

Decreased ECF volume

22
Q

List the cascade of events from stimulation to effect of the RAS.

A

Decreased arterial pressure / ECF volume
Decreased glomerular hydrostatic pressure / GFR
Decreased chloride at macula densa
Renin secretion from juxtaglomerular cells
Increased angiotensin I
Increased angiotensin II (constricts arterioles and decreases GFR)
Aldosterone
Na and water retention

23
Q

How does sympathetic activation affect GFR?

A

Constrict afferent arterioles and decrease GFR

24
Q

How does adrenaline affect GFR?

A

Constrict arterioles (preferentially afferent) and decrease GFR

25
Q

How does Endothelin-1 affect GFR?

A

Constrict arterioles (afferent and efferent) and decrease GFR

26
Q

How does NO affect GFR?

A

Decrease vascular resistance and increase GFR

27
Q

How do prostaglandins affect GFR?

A

Decrease vascular resistance and increase GFR

28
Q

What is visible barrier breakdown and what is present in the urine?

A

Increased glomerular pore size

Protein (albumin) and cells

29
Q

What is invisible barrier breakdown and what is present in the urine?

A

Loss of charge selectivity

Protein (albumin)

30
Q

Define nephritic vs. nephrotic.

A

Nephritic - visible barrier breakdown; protein + cells in urine
Nephrotic - invisible barrier breakdown; protein in urine

Nephrology (18 decks)

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