Renal final

Question 1

Kidney absorption

Answer 1

-Bowman:
-PCT: 80% reabsorption
-Loop: 6% reabsorption, H2O and salt conversion
-DCT: 9%, some secretion
-Collecting tubule: 4%

Question 2

Proximal tubule

Answer 2

-secrete glucose, aas, ions

Question 3

Henle’s Loop

Answer 3

-

Question 4

Sources of renal failure

Answer 4

-HTN and diabetes
-NSAIDs, ACE/ARBs, cyclosporine
-ischemia, sepsis, nephrotoxinss
-bladder obstruciton

Question 5

NSAID effect on GFR

Answer 5

-afferent resistance reduced
-dec prostaglandins

Question 6

ACE/ARB effect on GFR

Answer 6

-efferent resistance reduced
-dec angiotensin

Question 7

Nephr I tic syndromes

Answer 7

-Inflammation
-hematuria
-immediate onset

Question 8

nephrOtic syndrom

Answer 8

-pOdOcyte damage
-prOteinuria

Question 9

Glomerulonephritis

Answer 9

-inflammation of glomeruli
-acute or chronic
-infecction, drug, autoimmune induced

Question 10

Pyelonephritis

Answer 10

-inflammation of kidney tissue
-flank pain and painful urination
-white cells in urine
-caused by bacteria
-could lead to sepsis

Question 11

Interstitial nephritis

Answer 11

-injury to renal tubules
-undetected until sig dec in function
-mostly caused by antibiotics (PENICILLIN)

Question 12

Autosomal Dominant (adult) polycystic kidney disease

Answer 12

-cysts
-PKD1 or 2 mutation
-blood in urine
-HNT an UTI is fatal, renal transplant needed

Question 13

Autosomal recessive (childhood) poycystic kidney disease

Answer 13

-PKHD1 mutation (fibrocystin)
-young pt die quickly
-pt who survive get liver cirrhosis

Question 14

Nephrolithiasis

Answer 14

-kidney stones
-saturation of calcium
-hematauria and pain

Question 15

kidney stone tx

Answer 15

-analgesics
-hydration
-lithotripsy
-surgery

-prevention=limit Ca, diuretics

Question 16

Diuretics

Answer 16

1. block carbonic anhydrase (PCT)
2. Osmotic diuretic
3. blocks Na-K-Cl (loop)
4. blocks Na-Cl (DCT)
   5a. inhibts Na channels (collecting duct)
   5b. MRAs

Question 17

OAT and OCT

Answer 17

-diffusion out of capillaries to peritubular space
-transport across membrane
-secretion across luminal membrane
-competitive
-probenecid used to saturate OAT and slow PCN activity
-furosemide, thiazides, NSAIDs use OAT

Question 18

Carbonic anhydrase inhibitor drugs

Answer 18

-sulfanilamide group
-acetazolamide
-dichlorphenamide
-methazolamide

Question 19

carbonic anhydrase inhibitor uses

Answer 19

-low efficacy as diuretic but can be used for mountain sickness bc metabolic acidosis
-acetazolamide

Question 20

Osmotic diuretic drugs

Answer 20

-Mannitol
-descending loop of henle
-shift osmotic flow from blood to urine

Question 21

Loop diuretics

Answer 21

-inc Na-K-Cl excretion
-ascending loop (more sodium reabsorption)
-most potnent and good for edema
-furosemide, bumetanide, ethacrynic acid (not sulfa)
-ototoxicity, hypokalemia

Question 22

Thiazide diuretics

Answer 22

-inhibit Na-Cl in DCT
-enhance potency of CA-I

Question 23

Potassium sparing diuretics

Answer 23

-late DCT and collecting duct
-weak diuretics
-amiloride and triameterene
-HYPERkalemia!