Renal - Embryo, Anatomy and Physio

Question 1

Embryo: Interim functioning kidney for 1st trimester? later becomes?

Answer 1

Mesonephros. Later part of male genitals

Question 2

Nephrogeneisis. Begins? Ends?

Answer 2

week 5 - week 32/26.

Question 3

3 embryological structures in kidney development?

Answer 3

pronephros - degenerates by week 4
Mesonephros - first tri
Metanephros - becomes part of adult kidney

Question 4

2 part of metanephros and what they give rise to?

Answer 4

Metanephric mesenchyme - glomerulus through DCT

Uteric Bud - : COLLECTING DUCT to ureter,

Question 5

Most common site of hydronephrosis in fetus?

Answer 5

hydronephrosis = obstruction

Urteropelvic junction.

Question 6

Embyronic kidney syndrome that causes facial deformities, and pulmonary hypoplasia resulting in death?

Answer 6

Potter’s. Oligohydramnios (little amniotic fluid because baby can’t pee) leads to compression of fetus.

Question 7

bilateral renal agenesis - cause of death? other causes?

Answer 7

Potter’s symdrome. Death from lung hypoplasia. ARPKD, problem with posterior urethral valves

Question 8

turner’s. Kidney’s function normally but get trapped where?

Answer 8

horseshoe kidney. Under inferior mesenteric artery.

Question 9

Ultrasound shows nonfunctioning fetal kidney consisting of cysts and connective tissue. Cause? Sx?

Answer 9

Multicystic dysplastic kidney. Abnormal interaction between ureteric bud and metanephric mesenchyme. If unilateral, no Sx, as other kidney compensates.

Question 10

Kidney transplant. Which kidney taken? Why?

Answer 10

Left - longer renal vein

Question 11

Water under the bridge. Bridge is?

Answer 11

Uterine artery in females, Vas Deferens in males

Question 12

More water in ICF or ECF?

Answer 12

Intracellular - 40% body weight

Extracellular - 20% body weight

Question 13

ECF consists of (and % of total body weight)?

Answer 13

Plasma (5%), and interstitial fluid (15%)

Question 14

Radioactive albumin. Could be used to measure?

Answer 14

Plasma volume

Question 15

Pt with alubuminuria, hypoproteinemia, edema and hyperlipidema. What is lost?

Answer 15

Nephrotic syndrome. Heparin sulfate (charge barrier) lost.

Question 16

Pt losing protein in urine. Liver pumps out?

Answer 16

Lipids - hyperlipidemia

Question 17

Size barrier in kidney composed of?

Answer 17

Epithelial layer - podocytes

Question 18

Clearance of substance x?

Answer 18

(Ux/Px)*V

Question 19

Cx<GFR means?

Answer 19

net resorption

Question 20

Normal GFR?

Answer 20

100 ml/min

Question 21

Creatinine: absorbed or secreted?

Answer 21

Slightly excreted. C>GFR (therefore overestimates GFR)

Question 22

GFR = (2 formulas)

Answer 22

C of inulin [(U/P)*V]

Kf [P-glomeulus - P-bowmans - Osmotic-glomerulus)]

Question 23

Substance that is used to measure effective renal plasma flow? why?

Answer 23

PAH - filtered and actively secreted

Question 24

Effective renal plasma flow formula?

Answer 24

Ux/Px * V, where x=PAH

Question 25

Renal Blood flow formula?

Answer 25

RPF/(1-Hct) Since RBF*(1-HCT) = RPF

Question 26

True RPF vs ERPF calculation?

Answer 26

True is about 10% higher

Question 27

Filtration fraction? Normal value?

Answer 27

GFR/RPF; 20%

Question 28

Estimate GFR with? RPF?

Answer 28

Creatinine. PAH

Question 29

Filtered load? | Secreted load?

Answer 29

GFR*Px | V*Ux

Question 30

substance that constricts EA? Effect on RPF, GFR, FF?

Answer 30

ATII - down, up, up

Question 31

Substance that dilates AA? Effect on RPF, GFR, FF?

Answer 31

NSAIDS; up, up, no change

Question 32

AA constriction . Effect on RPF, GFR, FF?

Answer 32

down, down, no change

Question 33

increased plasma protein concentraion. Effect on RPF, GFR, FF?

Answer 33

no change, decreased, decreased

Question 34

decreased plasma protein concentration. Effect on RPF, GFR, FF?

Answer 34

no change, up, up

Question 35

Constriction of uterer. Effect on RPF, GFR, FF?

Answer 35

no change, down, down

Question 36

Glucouria begins at what level of plasma glucose? when are transporters fully saturated?

Answer 36

160; 350

Question 37

Pregancy and PCT resorption?

Answer 37

reduced resorption of glucose and AAs - glucouria and aminoaciduria

Question 38

Resorption of AA dependent of?

Answer 38

Na-dependent transporters

Question 39

Kidney resorption defect. Results in a rash, diarrhea, and mental confusion. Deficiency?

Answer 39

Pellegra from Hartnup's disease. Deficiency of tryptophan transporter.