Renal I

Question 1

kidney embryo

Answer 1

pronephros - degenerate
mesonephros - male - wolffian
metanephros - kidney

ureteric bud - from mesonephric duct

• grows into metanephros
• induce differentation

ureteric bud - canal system
metanephros - glomerulus > DCT

Question 2

association of potter

Answer 2

auto rec PKD

obstructive uropathy

B/L renal agenesis

Question 3

horseshoe kidney

Answer 3

caught on IMA

Question 4

association horseshoe kidney

Answer 4

edward
down
patau
turner

renal stone
hydronephrosis
renal cancer

Question 5

multicystic dysplastic kideny

Answer 5

abnormal interaction - metanephros and ureteric bud

Question 6

duplex collecting system

Answer 6

bifurcation ureteric bud - before enter metanephric

get Y shaped bifid ureter

more UTIs

Question 7

kidney transplanted

Answer 7

left

longer renal vein

Question 8

macula densa

Answer 8

in the distal convoluted tubule

Question 9

JG cells

Answer 9

by macula densa - near glomeruli

Question 10

ureter location

Answer 10

posterior to uterine a and vas deferens

water under bridge

Question 11

60 40 20 rule

Answer 11

body weight percentages

60% = total body water (42L)

• 40% is ICF
• 20% is ECF

ECF - 75% interstitium and 25% plasma
ICF - intracellular fluid and RBC volume

Question 12

ECF

Answer 12

plasma and interstitium

Question 13

ICF

Answer 13

intracellular and RBC volume

Question 14

glomeruli layers

Answer 14

endo - size barrier
BM - charge barrier -negative heparan sulfate
epithelium - podocytes

Question 15

clearance =

Answer 15

[urine] x flow rate / [plasma]

Question 16

inulin

Answer 16

estimate GFR

Question 17

creatinine clearance

Answer 17

approximate GFR measure

Question 18

PAH

Answer 18

para ammino hippuric acid

estimation of effective renal plasma flow

Question 19

renal blood flow

Answer 19

RPF / (1 - hematocrit)

Question 20

filtration fraction =

Answer 20

FF = GFR/RPF

Question 21

prostaglandin

Answer 21

dilate afferent arteriole

Question 22

ANG II

Answer 22

constrict efferent arteriole

Question 23

constriction of ureter

Answer 23

increased hydrostatic P - in filtrate

decreases GFR and FF

Question 24

glucose clearance

Answer 24

normal level - reabsorbed in PCT - Na glucose cotransport

levels of 200 - reach threshold
at 375 - reaches Tm

pregnancy - decreased PCT reabsorption of glucose - get glucosuria

Question 25

amino acid clearance

Answer 25

Na dependent - in PCT

Question 26

hartnup disease

Answer 26

auto recessive

deficient neutral AA transporter (tryptophan)
-proximal tubular cells and enterocytes

neutral aminoaciduria
decreased tryptophan > niacin

get pellagra

tx - high protein diet and nicotinic acid

Question 27

early PCT

Answer 27

brush border

reabsorb glucose, AA, bicarb, Na, Cl, P, K, H2O
-isotonic absorption

secrete NH3 - buffer H+

Question 28

PTH activity in kidney

Answer 28

early PCT - inhibit Na/P cotransport - P secretion

early DCT - increased Ca/Na exchange - Ca absorption

Question 29

AT II activity on kidney

Answer 29

stimulate Na/H exchange

increased Na, H2O, HCO3 reabsorption
-get contraction alkalosis

Question 30

thin descending loop of henle

Answer 30

passive reabsorb H2O

make urine hypertonic

Question 31

thick ascending loop of henle

Answer 31

reabsorb Na, K, Cl

induce paracellular absorption Mg and Ca
-due to lumen positive K backleak

makes urine less concentrated as ascend

Question 32

loop diuretic

Answer 32

act on thick ascending limb

inhibit Na/K/2Cl cotransporter

also get loss of Mg and Ca
-because they are coupled to Na/K/2Cl positive lumen potential

Question 33

early DCT

Answer 33

reabsorb Na and Cl

make urine dilute - hypotonic

Question 34

collecting tubule

Answer 34

reabsorb Na, exchange for K and H

Question 35

ADH activity on kidney

Answer 35

V2 receptor activation
> aquaporin channels to apical membrane

on a-intercalated cells

Question 36

aldosterone activity

Answer 36

act on mineralocorticoid receptor - increased protein synthesis

increased reabsorption of Na and secretion of K and H

principal cells - more ENaC channels

• Na reabsorbed - get lumen negative
• K loss to positive charge