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PHGY-210 > Renal - Lecture 2 > Flashcards

Renal - Lecture 2 Flashcards

1
Q

What is the first step of urine formation?

A

glomerular filtration

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2
Q

What passes freely through the filtration barrier of the glomerular space?

A

water and low-molecular weight substances

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3
Q

What does not get filtered by the glomerulus?

A

cells
proteins
protein-bound substances

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4
Q

What kind of proteins are not filtered by the glomerulus?

A

albumins and globulins (large proteins)

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5
Q

Seeing proteins and blood cells in the urine is a sign of what disease?

A

glomerular disease

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6
Q

___ bound to proteins do not get filtered in the glomerulus?

A

fats and calcium

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7
Q

The composition of the glomerular filtrate is almost identical to that of ___.

A

plasma

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8
Q

What is the major force that drives the glomerular filtration?

A

pressure in the capillary (Pgc)

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9
Q

What is the glomerular capillary blood pressure in glomerular filtration?

A

60 mmHg

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10
Q

What are the 2 opposing forces in the glomerular filtration?

A
  1. pressure in the Bowman’s space
  2. oncotic pressure
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11
Q

The pressure in the Bowman’s space pushes ___ the filtration.

A

back

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12
Q

What is the protein in the oncotic pressure that pulls the water back from the Bowman’s space?

A

albumin

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13
Q

What is the pressure in the Bowman’s space equal to?

A

15 mmHg

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14
Q

What is the osmotic force (oncotic pressure) equal to?

A

29 mmhg

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15
Q

What is the net glomerular filtration pressure formula?

A

glomerular capillary blood pressure - Bowman’s space pressure - oncotic pressure

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16
Q

What is the value of net glomerular filtration pressure?

A

16 mmHg

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17
Q

Why is there no oncotic pressure from the Bowman’s space?

A

because there are no proteins in the Bowman’s space

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18
Q

What is glomerular filtration rate?

A

the volume of fluid filtered from the glomeruli into Bowman’s space per unit time

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19
Q

What 3 things regulate the GFR?

A
  • net filtration pressure
  • membrane permeability
  • surface area available for filtration
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20
Q

What is the normal GFR of a 70 kg person?

A

180 L/day

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21
Q

What is the rate of the normal GFR in a 70 kg person?

A

125 mL/min

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22
Q

What is the NB plasma of a person who has a normal GFR of 180L/day?

A

3.5 L

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23
Q

How much plasma is filtered per day at glomeruli in someone who has a GFR of 180 L/day and a plasma volume of 3.5 L?

A

51

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24
Q

How can you decrease GFR? (2)

A
  • constrict afferent arterioles
  • dilating efferent arterioles
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25
Q

How can you increase GFR? (2)

A
  • constrict efferent arterioles
  • dilate afferent arterioles
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26
Q

What is filtered load?

A

total amount of any freely filtered substance per unit time

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27
Q

What is the formula for filtered load?

A

GFR x plasma concentration of the substance

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28
Q

Filtered load ___ amount excreted in the urine = net reabsorption

A

> (greater than)

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29
Q

Filtered load _ amount excreted in the urine = net secretion

A

< (less than)

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30
Q

Are there many GFR for many different substances?

A

no, it is unique to a person

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31
Q

What is filtered load unique to?

A

each substance in a person’s body

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32
Q

Reabsorption is the movement of substance from the ___ ___ to ___ ___.

A

tubular lumen
peritubular capillary

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33
Q

What is responsible for bringing oxygen and nutrients to the tubular epithelial cells?

A

peritubular capillary

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34
Q

Where do peritubular capillaries receive substances reabsorbed from the tubular lumen?

A

tubular lumen

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35
Q

What are the 2 membranes of the tubular epithelial cells?

A
  • basolateral membrane
  • laminal membrane
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36
Q

How can reabsorption happen? (2)

A

paracellularly and transcellular

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37
Q

A huge amount of water, sodium and glucose is filtered, but most of it is ___.

A

reabsorbed

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38
Q

Filtered loads are enormous, generally ___ than the amounts of the substance in the body.

A

greater

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39
Q

Reabsorption of waste products is relatively ___.

A

incomplete

40
Q

Reabsorption of most useful plasma components is relatively ___.

A

incomplete

41
Q

Reabsorption of some substances are not ___ while others are highly ___.

A

regulated

42
Q

Reabsorption of what substance are not regulated?

A

glucose, amino acids

43
Q

Reabsorption of what substance are highly regulated?

A

water, inorganic ions

44
Q

What are the 2 mechanisms of reabsorption?

A

diffusion and mediated transport

45
Q

Reabsorption by diffusion happens across what? What do they connect?

A

tight junctions
they connect the tubular epithelial cells

46
Q

What is an example of diffusion of reabsorption?

A

urea reabsorption in the proximal tubule

47
Q

Urea is ___ filtered at glomerulus.

A

freely

48
Q

Where does water reabsorption occur?

A

in the proximal tubule

49
Q

Urea concentration in the tubular fluid becomes ___ during reabsorption in the proximal tubule.

A

higher

50
Q

Where does urea diffuse into?

A

the ISF and peritubular capillaries

51
Q

Reabsorption by mediated transport occurs across which cells?

A

tubular cells

52
Q

What does mediated transport of reabsorption require the participation of?

A

transport proteins

53
Q

What is mediated transport usually coupled to?

A

the reabsorption of sodium

54
Q

What moves from the tubular lumen to the tubular epithelial cells?

A

sodium, glucose, amino acids

55
Q

What moves out of the tubular epithelial cells to the peritubular capillary?

A

sodium

56
Q

What drives the movement of sodium, glucose and amino acids from the tubular lumen to the tubular epithelial cell?

A

low concentrations of sodium

57
Q

What are the proteins that helps molecules travel called?

A

cotransporter

58
Q

What is transport maximum?

A

when the membrane transport proteins become saturated, the tubule can not reabsorb the substance any more.

59
Q

What happens to transport maximum in individuals with uncontrolled diabetes mellitus?

A

it is exceeded

60
Q

What is the result of exceeded transport maximum in individuals with diabetes mellitus?

A

glucose appears in the urine (glucosuria)

61
Q

Tubular secretion moves substances from ___ ___ into the ___ ___.

A

peritubular capillaries
tubular lumen

62
Q

Tubular secretion is the opposite of ___.

A

reabsorption

63
Q

What is tubular secretion mediated by? (2)

A

diffusion and transcellular mediated transport

64
Q

In tubular secretion, most important substances secreted by the tubules are:

A

hydrogen ions and potassium

65
Q

Tubular secretion is usually coupled to the reabsorption of ___.

A

sodium

66
Q

In order to excrete waste products, the GFR must be very ___.

A

large

67
Q

The filtered volume of water and the filtered loads of all the nonwaste plasma solutes are very ___.

A

large

68
Q

What does the proximal tubules reabsorb?

A

most of the filtered water and solutes

69
Q

What is the proximal tubule a major site of secretion for?

A

various solutes except K+

70
Q

What does Henle’s loop reabsorb relatively large quantities of?

A

major ions (less water)

71
Q

The volume of water and masses of solutes reaching the DCT and CD are relatively ___.

A

small

72
Q

What does the DCT/CD determine?

A

the final amounts of water and masses in the urine

73
Q

Where are most homeostatic controls exerted?

A

DCT/CD

74
Q

How does the DCT/CD determine the final amounts of water and masses excreted in the urine?

A

by adjusting the rates of reabsorption and secretion

75
Q

What is clearance?

A

the volume of plasma from which that substance is completely removed by the kidneys per unit time

76
Q

What is the formula for clearance?

A

mass of S excreted per unit time / plasma concentration of S

77
Q

What is the formula for mass of S excreted per unit time?

A

urine concentration os S x urine volume per unit time

78
Q

What can clearance be used to measure/estimate?

A

glomerular filtration rate

79
Q

How is inulin administered?

A

intravenously

80
Q

Where is inulin freely filtered?

A

glomerulus

81
Q

Is inulin reabsorbed, secreted, or metabolized by the tubule?

A

no

82
Q

What is the clearance of inulin equal to?

A

the volume of plasma originally filtered

83
Q

CNin=

A

GFR

84
Q

What is the most accurate marker of GFR?

A

Cin

85
Q

Why is inulin clearance not convinient?

A

because you have to infuse it

86
Q

How do you calculate amount of inulin excreted in the urine?

A

urine volume x inulin concentration in the urine

87
Q

How do you calculate Cin?

A

amount of inulin excreted in the urine divided by concentration of inulin in plasma

88
Q

What is creatinine?

A

a waste product produced by muscle

89
Q

Where is creatinine filtered freely?

A

glomerulus

90
Q

Is creatinine reabsorbed?

A

no

91
Q

Where is creatinine secreted in small amounts?

A

tubule

92
Q

What is creatine clearance used as a clinical marker for?

A

GFR

93
Q

What is the formula for creatinine clearance?

A

urine concentration of creatinine (Ucr) multiplied by urine volume divided by plasma concentration of creatinine (Pcr)

94
Q

Clearance of a substance > GFR
It is ___ at the tubule

A

secreted

95
Q

Clearance of a substance < GFR
It is ___ at the tubule

A

reabsorbed

96
Q

What is an example of clearance > GFR (secretion)?

A

para-amino-hippurate marker of renal plasma flow

PHGY-210 (36 decks)

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