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AUBF > Renal Function > Flashcards

Renal Function Flashcards

1
Q

How much does a kidney weigh?

A

150 g

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2
Q

What are the dimensions of a kidney?

A

12.5 cm x 6 cm x 2.5 cm

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3
Q

How long is the ureter?

A

25 cm

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4
Q

When is the bladder nerve reflex initiated?

A

When 150 mL of urine accumulates

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5
Q

What is the length of the urethra in women and men?

A

Women: 4 cm, Men: 24 cm

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6
Q

How often is urine emptied into the bladder from the ureters?

A

Every 10-15 seconds

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7
Q

How is urine classified?

A

Fluid kidney biopsy

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8
Q

What is the basic structural and functional unit of the kidney?

A

Nephron

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9
Q

How many nephrons are there in each kidney?

A

1 to 1.5 million

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10
Q

What are the two types of nephrons and their functions?

A

Cortical: Reabsorption and excretion; Juxtamedullary: Concentration of urine

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11
Q

What are the components of a nephron?

A

Glomerulus and renal tubules

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12
Q

What is the order of urine formation?

A

Glomerulus > PCT > Loop of Henle > DCT > Collecting Duct > Calyx > Renal Pelvis > Ureter > Bladder > Urethra

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13
Q

What percentage of total cardiac output do the kidneys receive?

A

0.25

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14
Q

What is the order of renal blood flow (RAGE PVR)?

A

Renal artery > Afferent arteriole > Glomerulus > Efferent arteriole > Peritubular capillaries > Vasa recta > Renal vein

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15
Q

What is the total renal blood flow in both kidneys?

A

1200 mL/min

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16
Q

What is the total renal plasma flow?

A

600-700 mL/min

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17
Q

What is the working portion of the kidney?

A

Glomerulus

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18
Q

Where is the glomerulus located?

A

Bowman’s capsule

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19
Q

What cells are attached to the glomerular basement membrane?

A

Podocytes

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20
Q

What structure resembles a sieve and acts as the kidney’s working portion?

A

Glomerulus

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21
Q

What is the molecular weight cutoff for glomerular filtration?

A

<70,000 kDa

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22
Q

What percentage of filtered plasma is excreted in urine?

A

0.01

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23
Q

What are the components of the glomerular filtration barrier?

A

Capillary endothelium, Trilayer basement membrane, Filtration diaphragm

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24
Q

What are the layers of the trilayer basement membrane?

A

Lamina rara interna, Lamina densa, Lamina rara externa

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25
Q

Where is the filtration diaphragm found?

A

Between the podocytes of Bowman’s space

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26
Q

How does the glomerulus repel albumin?

A

Shield of negativity (repels same charge)

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27
Q

What is the specific gravity of glomerular filtrate?

A

1.01

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28
Q

What substances are filtered by the glomerulus?

A

Salts, Water, Amino acids, Glucose, Urea

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29
Q

What is the first kidney function affected by renal disease?

A

Tubular reabsorption

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30
Q

Question

A

Answer

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31
Q

What is the renal threshold for glucose?

A

160-180 mg/dL

32
Q

What is the major site of reabsorption of plasma substances (65%)?

A

Proximal Convoluted Tubule (PCT)

33
Q

Where does renal concentration begin?

A

Descending and ascending loop of Henle

34
Q

Where is solute concentration highest in the nephron?

A

Loop of Henle (renal medulla)

35
Q

Which part of the nephron is highly impermeable to water?

A

Ascending loop of Henle

36
Q

What is the movement of substances across cell membranes into the bloodstream by electrochemical energy called?

A

Active transport

37
Q

What is the movement of molecules across a membrane by diffusion due to a physical gradient called?

A

Passive transport

38
Q

Which substances are transported via active transport?

A

Glucose, amino acids, salts, sodium, chloride

39
Q

Which substances are transported via passive transport?

A

Water, urea, sodium

40
Q

Where does active transport occur for glucose

A

amino acids

41
Q

Where does active transport occur for sodium?

A

Proximal and Distal Convoluted Tubules (PCT and DCT)

42
Q

Where does active transport occur for chloride?

A

Ascending loop of Henle

43
Q

Where does passive transport of water occur?

A

PCT, descending loop of Henle, and collecting duct (CD)

44
Q

Where does passive transport of urea occur?

A

PCT and ascending loop of Henle

45
Q

Where does passive transport of sodium occur?

A

Ascending loop of Henle

46
Q

What hormone regulates water reabsorption in the DCT and CD?

A

Anti-diuretic hormone (ADH/Vasopressin)

47
Q

What happens to ADH levels in diabetes insipidus?

A

Deficient ADH: Increased urine output

48
Q

What happens to ADH levels in SIADH?

A

ADH excess

49
Q

What hormone regulates sodium reabsorption in the DCT?

A

Aldosterone

50
Q

How does RAAS help in sodium and water reabsorption?

A

By lowering blood pressure

51
Q

What converts angiotensinogen to angiotensin I?

A

Renin

52
Q

Where is renin produced?

A

Juxtaglomerular cells in the afferent arteriole

53
Q

What converts angiotensin I to angiotensin II?

A

Angiotensin Converting Enzyme (ACE)

54
Q

What are the actions of RAAS?

A

1) Dilates afferent arterioles and constricts efferent arteriole; 2) Stimulates sodium reabsorption in PCT; 3) Triggers adrenal cortex to release aldosterone; 4) Stimulates ADH release for water reabsorption

55
Q

What are the functions of tubular secretion?

A

1) Regulation of acid-base balance by secreting hydrogen ions; 2) Elimination of waste products not filtered by the glomerulus

56
Q

Where are non-filtered substances removed

A

and H* ions exchanged for Na* ions?

57
Q

What is renal tubular acidosis (RTA)?

A

Failure to produce an acid urine due to inability to secrete hydrogen ions

58
Q

What is the test used to evaluate glomerular filtration rate (GFR)?

A

Clearance test

59
Q

What is the most common clearance test?

A

Creatinine clearance

60
Q

What is the gold standard/reference method for clearance tests?

A

Inulin clearance

61
Q

What is a better marker for renal tubular function than GFR?

A

Beta2-microglobulin

62
Q

What is the molecular weight of cystatin C?

A

13,359 Da

63
Q

What is the formula for creatinine clearance?

A

UV/P x 1.73m^2/A

64
Q

What variables are included in the Estimated GFR formula (Cockcroft and Gault)?

A

Ethnicity, BUN, and serum albumin

65
Q

What is the recommended MDR IDMS Traceable formula for GFR by NKDEP?

A

GFR = 175 x serum creatinine^-1.154 x age^-0.203 x 0.742 if female x 1.212 if patient is Black

66
Q

What test evaluates tubular reabsorption?

A

Concentration test

67
Q

What are the obsolete tests for tubular reabsorption?

A

Fishberg test and Mosenthal test

68
Q

What is the specific gravity of urine after 12 hours on a restricted fluid diet (Fishberg test)?

A

1.022 or more

69
Q

What is the specific gravity of urine after 24 hours on a restricted fluid diet (Fishberg test)?

A

1.026 or more

70
Q

What factors influence specific gravity?

A

Number and density of particles in a solution

71
Q

What is influenced by the number of particles in a solution and preferred over S.G?

A

Osmolality

72
Q

What are the methods of osmolality measurement?

A

Freezing point osmometry and vapor pressure osmometry

73
Q

What is the normal osmolality value?

A

1-3x serum (275-900 mOsm/kg)

74
Q

What is the most commonly used/reference method for tubular secretion and renal blood flow?

A

p-aminohippuric acid test (PAH)

75
Q

What is an obsolete test for tubular secretion and renal blood flow?

A

Phenolsulfonapthalein (PSP)

76
Q

What is measured by urine pH, titratable acidity, and urinary ammonia tests?

A

Tubular secretion and renal blood flow

AUBF (26 decks)

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