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Liz's Clinical Chemistry Module 3 > Renal Function > Flashcards

Renal Function Flashcards

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1
Q

List the 4 components of the urinary system

A
  • Kidney
  • Ureter
  • Bladder
  • Urethra
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2
Q

Anatomy of the kidney

- Vascular supply

A
  • Efferent arteriole → outgoing blood
  • Afferent arteriole → incoming blood
  • Peritubular capillaries
  • Vasa recta
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3
Q

Anatomy of the kidney

- Location of the medulla

A
  • Loops of Henle

- Collecting ducts

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4
Q

Anatomy of the kidney

- Location of cortex

A

Where glomeruli are on outside edge

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5
Q

Anatomy of the kidney

- Location of the calices

A

Where the collecting ducts dump

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6
Q

Anatomy of the kidney

- Location of the renal pelvis

A

Trunk that will empty into the ureter

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7
Q

Microscopic anatomy of the nephron in anatomical order starting w/ the glomerulus and ending w/ collecting ducts

A

Afferent arteriole → efferent arteriole → blood filtered in glomerulus → proximal convoluted tubules → loops of Henle → distal convoluted tubules → collecting ducts

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8
Q

List the 3 functions of the kidney

A
  • Excretion
  • Homeostatic regulation
  • Endocrine
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9
Q

List 2 plasma constituents that are not normally filtered through the glomerulus

A
  • High molecular weight plasma proteins

- Cells

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10
Q

Rate in mL/minute that substances are filtered through the kidney’s glomeruli

A

GFR

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11
Q

Normal GFR in mL/minute

A

125-130 mL/min

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12
Q

Two clinical uses for the measurement of GFR

A
  • Measure of number of functioning nephrons

- Sensitive and specific marker of changes in overall renal function

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13
Q

Three forces which determine normal glomerular filtration pressure

A
  • Hydrostatic of blood
  • Fluid pressure (glomerular hydrostatic pressure)
  • Plasma oncotic pressure (colloid)
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14
Q

Net movement of substance against a concentration or electrical gradient requires energy expenditure

A

Mechanism of active tuberular absorption

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15
Q

Substance moves by simple diffusion as a result of a concentration or electrical gradient; no energy expenditure

A

Mechanism of passive tuberular absorption

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16
Q

List 10 substances reabsorbed in teh PCT

A
  • Na+
  • HCO3-
  • Glucose
  • Amino acids
  • Proteins
  • Phosphate
  • Sulfate
  • Mg2+
  • Ca2+
  • Uric acid
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17
Q

What is the specific renal threshold for glucose?

A

About 160 mg/dL

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18
Q

Countercurrent mechanism

- Major purpose

A

Purpose is to remove water from the filtrate on the way down the descending loop making it very salty at the bottom of the loop. Then, on the way up the ascending loop, active reabsorption of sodium and chloride ions occurs. OR like a water heater, allows for the reabsorption of H2O, Na, Cl, and urea with less energy expenditure

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19
Q

Countercurrent mechanism

- Location in the nephron

A

Loops of Henle

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20
Q

Countercurrent mechanism

- Differentiation in the histology of the descending and ascending limbs

A
  • Descending: permeable to water so there is passive water and urea reabsorption
  • Ascending: impermeable to water so there is active reabsorption of sodium and chloride
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21
Q

Countercurrent mechanism

- Movement of Na, Cl, urea, and H2O in or out of the renal tubules

A
  • Sodium: out
  • Chloride: out
  • Urea: in
  • Water: out
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22
Q

List 3 distinct regulatory functions of the DCT

A

Responisble for acid-base, water, and electrolyte balance control in the nephron so…

  • Sodium reabsorption
  • Potassium secretion
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23
Q

List 4 substances that are normally reabsorbed in the DCT?

A

Reabsorption of sodium, chloride, bicarbonate, and water

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24
Q

List 4 substances that are normaly secreted in the DCT

A

Secretion of potassium, hydrogen ions, ammonium, and uric acid

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25
Q

Specific hormone that exerts its effect on the DCT

A

Aldosterone

26
Q

What substances are normally reabsorbed in the collecting ducts?

A

↑ or ↓ water adsorption is controlled here

27
Q

What hormone exerts its effect on the collecting duct?

A

Antidiuretic hormone (ADH/vasopressin)

  • Presence causes water reabsorption by widening pores
  • Absence causes ↓ water readsorption
28
Q 
Juxtaglomerular apparatus (JGA)
- Function
A

Regulated the function of each nephron

29
Q 
Juxtaglomerular apparatus (JGA)
- Location
A

Found b/w the vascular pole of the glomerulus and the returning DCT of the same nephron

30
Q 
Juxtaglomerular apparatus (JGA)
- Specific functions of granular cells
A

Secrete renin, which is an enzyme that is the starting point for the renin-angiotensin-aldosterone system (RAAS)

31
Q 
Juxtaglomerular apparatus (JGA)
- Specific functions of macula densa cells
A

Regulate [Na] and [Cl] by sensing (NaCl) in the DCT

32
Q 
Juxtaglomerular apparatus (JGA)
- Specific functions of mesangial cells
A

Receive stimulation from sympathetic nervous system to modulate actions of the JGA

33
Q 
Juxtaglomerular apparatus (JGA)
- Importance of its location
A

Location is critical to its function in regulating renal blood flow and the glomerular filtration rate

34
Q

3 basic procedures involved in renal excretion

A
  • Filtration
  • Reabsorption
  • Secretion
35
Q

In FILTRATION, are substances being conserved in the blood or are they excreted in the urine?

A

Going into forming urine from blood

36
Q

In REABSORPTION, are substances being conserved in the blood or are they excreted in the urine?

A

Capillary system taking substance into the blood

37
Q

In SECRETION, are substances being conserved in the blood or are they excreted in the urine?

A

From blood to the secretion

38
Q

Hypothalamic and ADH regulation of water balance

- 3 stimuli for the water output area of the hypothalamus

A
  • ↑ in extracellular water osmolarity
  • ↑ in angiotensin II
  • ↓ in baroreceptor and distension receptor activity
39
Q

Hypothalamic and ADH regulation of water balance

- Primary stimulus for ADH release

A

High blood pressure osmolarity

40
Q

Hypothalamic and ADH regulation of water balance

- Effect that ADH causes on the collecting ducts of the kidney

A

↑ pore size → absorb more water

41
Q

Sodium regulation

- Renal handling of sodium in every major portion of the nephron

A

Sodium is exchanged w/ H+ all along the nephron

42
Q

Sodium regulation

- Effect of the renin-angiotensin-aldosterone system

A

↑ Na+ reabsorption

43
Q

Sodium regulation

- Where aldosterone exerts its effect in the nephron

A

Control regulation in DCT

44
Q

Renin-angiotensin-aldosterone system

- Specific site in the nephron where renin is produced

A

Juxtaglomerular apparatus

45
Q

Renin-angiotensin-aldosterone system

- 3 specific stimuli for renin release

A
  • ↓ renal perfusion pressure
  • Sympathetic nerve stimulation
  • ↓ [Na] in DCT
46
Q

Renin-angiotensin-aldosterone system

- Biochemical conversions from angiotensinogen to angiotensin II

A
  • Renin converts angiotensinogen to angiotensin I in the liver
  • Angiotensin converting enzyme (ACE) converts angiotensin I to angiotensin II in the lungs
47
Q

Renin-angiotensin-aldosterone system

- Organs in which the conversion of angiotensinogen to angiotensin II occurs

A

Liver to the lung

48
Q

Renin-angiotensin-aldosterone system

- 4 physiological effects of angiotensin II

A
  • Most powerful vasoconstrictor
  • Affects water intake of hypothalamus
  • Affects water output and causes the release of ADH from hypothalamus
  • Causes aldosterone release from adrenal cortex
49
Q

Renin-angiotensin-aldosterone system

- Effect of aldosterone on serum sodium and potassium levels

A

DCT retains more sodium and secretes potassium (therefore ↓ potassium)

50
Q

Effect of BNP on sodium levels in the blood

A

BNP causes Na+ excretion

51
Q

The condition that may be assessed via BNP measurements

A

CHF

52
Q

The two substances that the kidney regulates to maintain acid-base balance and whether these substances are normally reabsorbed or secreted

A
  • Reabsorption of bicarbonate

- Secretion of hydrogen ions

53
Q

4 renal mechanisms by which the kidney maintains acid-base balance and the site in the nephron where these occur

A
  • React w/ filtered bicarbonate ions
  • React w/ filtered buffers to form titrateable acids
  • Reacts w/ secreted ammonia to form ammonium ions
  • Exchange w/ Na+
54
Q

Renal regulation of H+ and [HCO3-] according to

- Mechanism for the reaction of H+ w/ filtered HCO3-

A

?

55
Q

Renal regulation of H+ and [HCO3-] according to

- Mechanism for the reaction of H+ w/ phosphate buffers

A

?

56
Q

Renal regulation of H+ and [HCO3-] according to

- Mechanism for the reaction of H+ w/ secreted ammonia

A

?

57
Q

Renal regulation of H+ and [HCO3-] according to

- Mechanism for free H+ excretion

A

?

58
Q

List the 3 important hormonal functions of the kidney

A
  • Vitamin D metabolism
  • EPO production and release
  • Renin production in JGA that results in hormone release
59
Q

Microscopic structure which regulates the function of each nephron; named for its proximity to the glomerulus

A

JGA

60
Q

An enzyme that is the starting point for the RAAS

A

Renin

61
Q

Responsible for filtration of the blood; it’s selective permeability does not allow large molecular weight compounds to be filtered

A

Glomerulus

Liz's Clinical Chemistry Module 3 (7 decks)

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