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MET2 > Renal Excretory Function > Flashcards

Renal Excretory Function Flashcards

1
Q

3 parts of the glomerular filtration barrier

A

Capillary endothelium
Basement membrane
Podocyte foot processes

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2
Q

What protein is lost into urine in nephrotic syndrome

A

Albumin

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3
Q

Where is the plasma concentrated to an ultra filtrate

A

Bowman’s capsule

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4
Q

First step of urine formation

A

Production of plasma ultrafiltrate

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5
Q

What determines what substances enter the ultrafiltrate

A

Net filtration pressure
Podocyte slit pores
Molecule size
Molecule charge

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6
Q

What molecules moves freely at the glomerulus

A

Water
Electrolytes
Urea
Amino acids

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7
Q

GFR

A

Total amount of fluid filtered through the glomerulus

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8
Q

What happens to the majority of fluid filtered in the glomerulus

A

Reabsorbed

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9
Q

Why is creatinine used to measure GFR

A

Freely filtered by glomerulus
Not reabsorbed
Measurable
Produced by body
Already at steady state conc in blood

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10
Q

Does creatinine clearance over or under estimate GFR by 10-20%

A

Overestimates

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11
Q

Why does creatinine clearance overestimate GFR by 10-20%

A

Peritubular capillaries secrete creatinine

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12
Q

Creatine clearance calculation

A

(Urine conc x urine vol) / plasma conc

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13
Q

How can GFR be measured

A

Creatinine clearance
Nuclear medicine scan

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14
Q

How can GFR be estimated

A

MDRD equation - CAGE
Cockcroft gault equation

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15
Q

What variables are needed to out into the MDRD equation for estimating GFR

A

CAGE
creatinine
Age
Gender
Ethnicity

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16
Q

What can make GFR from creatinine clearance unreliable

A

Raised serum creatinine in muscular individuals
Low serum creatinine in malnourished individuals
Raised serum creatinine in individuals on drugs that inhibit Tubular creatinine secretion

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17
Q

Does raised serum creatinine cause an over or underestimattion of GFR

A

Underestimate

18
Q

Is the brush border on the apical or baso lateral side of tubule cells

A

Apical

19
Q

What limits water and solute movement between tubular cells

A

Tight junctions

20
Q

How does urea move from the tubular lumen to interstitium in the proximal tubule

A

Passive diffusion

21
Q

How do sodium phosphate glucose and amino acids move from the tubular lumen into tubular cells in the proximal tubule

A

Secondary active transport

22
Q

How many Na ions are transported from the tubular cell to the interstitium for very 2 K ions transported from the interstitium to the tubular cell in the proximal convoluted tubule

A

3

23
Q

Are sodium and potassium transported by primary or secondary active transport in the proximal convoluted tubule

A

Primary

24
Q

What do defects in the apical Na/cystine cotransporter In the proximal tubule cause

A

Cystinuria

25
Q

What do defects in the Na/glucose cotransporter in the proximal tubule cause

A

Renal glycosuria

26
Q

What do defects in the basolateral Na/HCO3 cotransporter in the proximal tubule cause

A

Proximal RTA

27
Q

What do defects in the apical Na/K/2Cl cotransporter in the thick ascending loop of henle cause

A

Bartter type 1

28
Q

What do defects in the apical Na-Cl cotransporter in the distal tubule cause

A

Gitelman’s

29
Q

What are the 2 parts of the proximal tubule

A

Proximal convoluted tubule - 1st 2/3
Proximal straight tubule - final 3rd

30
Q

Where does 80% of solute reabsorbance occur

A

Proximal tubule

31
Q

What is pumped out of the descending loop of henle

A

Water

32
Q

What substances leave the ascending loop of henle

A

Sodium
Potassium
Chloride
Calcium
Magnesium

33
Q

How is high solute concentration maintained deep in the medulla

A

Vasa react carry salt from top of medulla to deep medulla

34
Q

What is the thick ascending limb impermeable to

A

Water

35
Q

What ion is transported by both secondary active and paracellular transport in the ascending loop of henle

A

Sodium

36
Q

Function of the distal nephron

A

Potassium excretion
Na delivery to collecting duct regulated
Urine acidification

37
Q

What determines urine conc in the collecting tubule

A

ADH

38
Q

Renal threshold

A

Concentration of a substance dissolved in the blood above which the kidneys begin to remove it into the urine

39
Q

What happens when the renal threshold of a substance is exceeded

A

Some of the substance remains in urine

40
Q

What is the renal threshold for glucose

A

10mmol/L

41
Q

Osmotic diuresis

A

Excess solute in the tubular fluid attracts water and increases urine volume

MET2 (25 decks)

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