Renal Physio Flashcards
1
Q
Which substances can measure ECF?
A
Sulfate
Inulin
Mannitol
2
Q
Which substances can measure total body water?
A
Tritiated water
D2O
Antipyrine
3
Q
Which substances can measure plasma?
A
Radioactive iodine serum albumin
Evans blue
4
Q
What is the formula for computing interstitial fluid volume?
A
ECF-plasma
5
Q
Formula for plasma osmolarity
A
2xNa+ Glucose/18 + BUN/2.8
6
Q
Structural and Functional unit of the kidneys
A
Nephron
7
Q
Types of Nephron:
75% of nephrons
Located in renal cortex with shorter loops of Henle
With peritubular capillaries
A
Cortical Nephron
8
Q
Types of Nephron:
25% of nephrons
Located in the corticomedullary junction, longer loops of Henle and with Vasa Recta
A
Juxtamedullary Nephrons
9
Q
What type of collagen is in the basement membrane?
A
Type IV
10
Q
It is the main charge barrier of the glomerulus
A
Basement membrane
11
Q
Cells in the renal corpuscle that are modified smooth muscles capable of phagocytosis
A
Intraglomerular Mesangial cells
12
Q
Renal corpuscle cell that secretes renin
A
JG cells
13
Q
Cells in the renal corpuscle found in the distal tubule that monitors Na concentration
A
Macula Densa
14
Q
Macula densa also detects changes in?
A
BP
GFR
15
Q
Cells of the renal corpuscle with unknown function
A
Lacis cell
Extraglomerular mesangial cell
16
Q
Also known as the workhorse of the nephron
A
PCT
17
Q
PCT reabsorbs 66% of filtered _________
A
K
Na
H2O
18
Q
PCT reabsorbs 100% of filtered _________
A
Glucose
Amino acids
19
Q
Part of the tubular system that is known as the countercurrent multiplier
A
Loop of Henle
20
Q
The descending Loop of Henle is permeable to:
A. Water
B. Solutes
A
Water
21
Q
The ascending Loop of Henle is permeable to:
A. Water
B. Solutes
A
Solutes
ASINding limb
22
Q
Also known as the diluting segment
A
Thick ascending limb of Loop of Henle
23
Q
This is inhibited by loop diuretics in the thick ascending limb
A
Na-K-2Cl symport
24
Q
The cortical collecting tubule is also called?
A
Late distal tubule
25
The collecting duct is composed of the ________collecting tubule and he collecting duct
Medullary
26
Also called the CORTICAL diluting segment
Early distal tubule
27
Cells in the late distal tubule that reabsorb Na and secrete K
Principal cells
28
Cells in the late distal tubule that reabsorb K and secrete H
Intercalated cells
29
The site of regulation of final urine volume and concentration
Collecting duct
30
Part of the tubular system where ADH will act
Collecting duct
31
Most potent trigger for the release of ADH
Increased plasma osmolarity
32
Histology in the PCT that is for increase in surface area and transporters
Microvilli
| Convolutions
33
The first part to die in the tubular system during Acute Tubular Necrosis
PCT
34
It is the volume of plasma cleared of a substance per unit of time
Clearance
35
Formula for Clearance
Urine concentration xVolume /Plasma concentration
36
If a substance has a high clearance, it will be found in the _____
Urine
37
If a substance has low clearance, it will be found in the ______
Blood
38
What substance has the highest clearance?
PAH
| Para-aminohippuric acid
39
What substance has the lowest clearance?
```
CHON
Na
Glucose
Amino acids
HCO3
Cl
```
40
What substances has a clearance equal to the GFR?
Inulin
| Creatinine
41
This substance is used to estimate Renal Blood Flow and Renal Plasma Flow
PAH
42
What substances are filtered alone and not secreted nor reabsorbed?
Inulin
| Creatinine
43
What substances are filtered and 100% reabsorbed, never secreted?
```
Na
Glucose
Amino acids
HCO3
Cl
```
44
What substance is filtered and secreted and not reabsorbed?
PAH
45
When the substance's clearance is less than the GFR, there is
Net reabsorption
46
When the substance's clearance is more than the GFR, there is
Net secretion
47
Substances that can be used to measure kidney function
Inulin
| Creatinine
48
Renal blood flow is ____% of the cardiac output
25%
49
If clearance is equal to GFR, there is
Filtration
50
Substances that cause vasodilation of renal arterioles : increased RBF
```
PGE2
PGI2
Bradykinin
NO
Dopamine
```
51
Substances that cause vasoconstriction of renal arterioles : decreased RBF
```
Sympathetic NS
Angiotensin II (preferentially efferent arterioles)
```
52
What substance vasodilates afferent arterioles and to a lesser extent vasoconstricts efferent arterioles but the net effect is increased RBF?
ANP
53
Formula for RBF
RPF/ 1- hematocrit
54
Normal GFR per minute
125ml/min
55
Normal GFR per day
180 L /day
56
Known as the counter current exchanger
Vasa recta
57
It is the amount filtered minus the amount reabsorbed plus amount secreted
Excretion
58
This describes fluid movement into or out of the capillary
Starling Forces
59
Highest possible filtration fraction occurs during
Vasoconstriction of the efferent arteriole
60
Effect on filtration fraction if there is an increase in plasma proteins
Decreased
Increased oncotic pressure= decreased GFR but no change in RPF
61
Effect on filtration fraction if there is ureteral stone
Decreased
Increased BCH Decreased GFR no change in RPF
62
Effect of vasoconstriction of afferent arterioles on filtration fraction
No change
Decreased GFR and decreased RPF
63
Severe vasoconstriction of efferent arteriole effect on GFR
Decreased
Albumin trapped-attract cations-attract water
64
Moderate vasoconstriction of efferent arteriole effect on GFR
Increased
65
Starling forces:
Not a starling force
Promotes GFR
Increased by histamine
Kf
| Filtration coefficient
66
Effect on GFR: increased or decreased?
Afferent arteriole vasodilation
Increased
67
Effect on GFR: increased or decreased?
Afferent arteriole vasoconstriction
Decreased
68
Effect on GFR: increased or decreased?
Efferent arteriole vasodilation
Decreased
69
Effect on GFR: increased or decreased?
Efferent arteriole moderate vasoconstriction
Increased
70
Effect on GFR: increased or decreased?
Efferent arteriole severe vasoconstriction
Decreased
71
Effect on GFR: increased or decreased?
GC hydrostatic pressure increased
Increased
72
Effect on GFR: increased or decreased?
GC hydrostatic pressure decreased
Decreased
73
Effect on GFR: increased or decreased?
GC oncotic pressure increased
Decreased
74
Effect on GFR: increased or decreased?
GC hydrostatic pressure decreased
Increased
75
It is the fraction of renal plasma flow that is filtered
Filtration fraction
76
Normal filtration fraction
20%
77
Formula for filtration fraction
GFR/RPF
78
Auto regulation of renal blood flow occurs at BP range of
80-200mmHg
79
Renal blood flow remains constant through this mechanism where renal afferent arterioles reflexively respond to stretch by contracting
Myogenic mechanism
80
Effect of angiotensin II on efferent arteriole
Vasoconstriction
81
Macula densa secretes these in response to decrease in BP
Angiotensin II
| NO
82
NO dilates renal ______ arterioles during decreased BP
Afferent
83
Secreted by macula densa if BP is high
Adenosine
84
Effect of adenosine during increased BP
Vasoconstriction of afferent arteriole
85
Renal threshold of glucose
200mg
86
Renal transport maximum of glucose
375mg
87
The following causes hypokalemia by causing shift of K into cells
Insulin
B adrenergic agonists
Alkalosis (exhange for intracellular H)
Hypo osmolarity
88
Causes of decreased K secretion by principal cells
Low K diet
Hypoaldosteronism
Acidosis
K sparing diuretics
89
PCT reabsorbs ____% of filtered urea
50%
90
Renal tubule that Secretes urea via simple diffusion
Thin descending limb of LH
91
Normal plasma calcium
2.4 mEq/L
92
How many percent of Calcium is filtered?
60%
93
These drugs increases Ca reabsorption
PTH
| Thiazides
94
This drug decreases Ca reabsorption
Loop diuretics
95
How much Phosphate is absorbed by the PCT?
85% of filtered phosphate
96
Reabsorption of phosphate is inhibited by
PTH
97
50% of magnesium is stored in the bones and ____% is excreted daily
10%
98
65% of reabsorption of Magnesium occurs in
TAL of LH
99
This electrolyte competes with magnesium for reabsorption in TAL of LH
Calcium
100
Hypercalcemia causes this effect on magnesium
Hypomagnesemia
101
Hypocalcemia causes this effect on magnesium
Hypermagnesemia
102
Graded osmolarity in the renal interstitium is created by
The countercurrent multiplier LH
103
Graded osmolarity in the renal interstitium is supplemented by
Urea recycling
104
Graded osmolarity in the renal interstitium is maintained by
Countercurrent exchanger: vasa recta
105
Estimates the ability to concentrate or dilute the urine
Free water clearance
106
Formula for free water clearance
Urine flow rate- osmolar clearance
V-Cosm
Cosm= UV/P
107
PTH causes this effect on calcium and phosphate
Increased calcium reabsorption and decreased phospate reabsorption--urine
PTH- phosphate trashing hormone
108
Situations where there is negative free water clearance
SIADH
| Water deprivation
109
Difference of water deprivation and SIADH is in their
Plasma osmolarity
Increased in water deprivation
Decreased in SIADH
110
Plasma osmolarity in SIADH is increased or decreased?
Decreased
111
Plasma osmolarity in water deprivation is increased or decreased?
Increased
112
hormone that decreases Na reabsorption
ANP
| BNP
113
Hormones that decrease water and Na reabsorption
Dopamine
Uroguanylin
Guanylin
114
MOA of ANP and BNP on distal tubule and collecting ducts for decreased reabsorption of sodium
CGMP
115
pH compatible with life
6.8-8
116
An increase in H levels will cause an increase in which electrolytes?
Hypercalcemia
| Hyperkalemia
117
Anion gap formula
Na-(HCO3+ Cl)
118
There is an increase in this electrolyte in NAGMA to maintain electroneutrality
Chloride
119
HAGMA conditions
MUDPILES
```
Methanol
Uremia
DKA
Paraldehyde Propylene Glycol
Iron Isoniazid
Lactic acidosis
Ethylene glycol, ethanol
Salicylic acid
```
120
NAGMA conditions
HARD UP
```
Hyperalimentation
Acetazolamide
RTA
Diarrhea
Ureteroenteric fistula
Pancreaticoduodenal fistula
```
121
Diarrhea causes this acid base abnormality
Metabolic acidosis
122
Vomiting causes this type of acid base abnormality
Metabolic alkalosis
123
All tubules except diluting segments are acted upon by this type of diuretic
Osmotic diuretics
124
Carbonic anhydrase inhibitors act on the
PCT
125
Thiazide diuretics act on the
Distal tubule
126
Thiazides causes increased
Hyper GLUC
```
Hyper
Glycemia
Lipidemia
Uricemia
Calcemia
```
127
This type of diuretic decreases calcium levels
Loop diuretic
