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Physio > Renal Physio > Flashcards

Renal Physio Flashcards

1
Q

Which substances can measure ECF?

A

Sulfate
Inulin
Mannitol

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2
Q

Which substances can measure total body water?

A

Tritiated water
D2O
Antipyrine

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3
Q

Which substances can measure plasma?

A

Radioactive iodine serum albumin

Evans blue

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4
Q

What is the formula for computing interstitial fluid volume?

A

ECF-plasma

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5
Q

Formula for plasma osmolarity

A

2xNa+ Glucose/18 + BUN/2.8

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6
Q

Structural and Functional unit of the kidneys

A

Nephron

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7
Q

Types of Nephron:
75% of nephrons
Located in renal cortex with shorter loops of Henle
With peritubular capillaries

A

Cortical Nephron

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8
Q

Types of Nephron:
25% of nephrons
Located in the corticomedullary junction, longer loops of Henle and with Vasa Recta

A

Juxtamedullary Nephrons

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9
Q

What type of collagen is in the basement membrane?

A

Type IV

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10
Q

It is the main charge barrier of the glomerulus

A

Basement membrane

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11
Q

Cells in the renal corpuscle that are modified smooth muscles capable of phagocytosis

A

Intraglomerular Mesangial cells

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12
Q

Renal corpuscle cell that secretes renin

A

JG cells

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13
Q

Cells in the renal corpuscle found in the distal tubule that monitors Na concentration

A

Macula Densa

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14
Q

Macula densa also detects changes in?

A

BP

GFR

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15
Q

Cells of the renal corpuscle with unknown function

A

Lacis cell

Extraglomerular mesangial cell

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16
Q

Also known as the workhorse of the nephron

A

PCT

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17
Q

PCT reabsorbs 66% of filtered _________

A

K
Na
H2O

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18
Q

PCT reabsorbs 100% of filtered _________

A

Glucose

Amino acids

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19
Q

Part of the tubular system that is known as the countercurrent multiplier

A

Loop of Henle

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20
Q

The descending Loop of Henle is permeable to:
A. Water
B. Solutes

A

Water

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21
Q

The ascending Loop of Henle is permeable to:
A. Water
B. Solutes

A

Solutes

ASINding limb

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22
Q

Also known as the diluting segment

A

Thick ascending limb of Loop of Henle

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23
Q

This is inhibited by loop diuretics in the thick ascending limb

A

Na-K-2Cl symport

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24
Q

The cortical collecting tubule is also called?

A

Late distal tubule

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25
Q

The collecting duct is composed of the ________collecting tubule and he collecting duct

A

Medullary

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26
Q

Also called the CORTICAL diluting segment

A

Early distal tubule

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27
Q

Cells in the late distal tubule that reabsorb Na and secrete K

A

Principal cells

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28
Q

Cells in the late distal tubule that reabsorb K and secrete H

A

Intercalated cells

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29
Q

The site of regulation of final urine volume and concentration

A

Collecting duct

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30
Q

Part of the tubular system where ADH will act

A

Collecting duct

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31
Q

Most potent trigger for the release of ADH

A

Increased plasma osmolarity

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32
Q

Histology in the PCT that is for increase in surface area and transporters

A

Microvilli

Convolutions

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33
Q

The first part to die in the tubular system during Acute Tubular Necrosis

A

PCT

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34
Q

It is the volume of plasma cleared of a substance per unit of time

A

Clearance

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35
Q

Formula for Clearance

A

Urine concentration xVolume /Plasma concentration

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36
Q

If a substance has a high clearance, it will be found in the _____

A

Urine

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37
Q

If a substance has low clearance, it will be found in the ______

A

Blood

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38
Q

What substance has the highest clearance?

A

PAH

Para-aminohippuric acid

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39
Q

What substance has the lowest clearance?

A 
CHON
Na
Glucose
Amino acids 
HCO3
Cl
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40
Q

What substances has a clearance equal to the GFR?

A

Inulin

Creatinine

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41
Q

This substance is used to estimate Renal Blood Flow and Renal Plasma Flow

A

PAH

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42
Q

What substances are filtered alone and not secreted nor reabsorbed?

A

Inulin

Creatinine

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43
Q

What substances are filtered and 100% reabsorbed, never secreted?

A 
Na
Glucose
Amino acids
HCO3
Cl
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44
Q

What substance is filtered and secreted and not reabsorbed?

A

PAH

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45
Q

When the substance’s clearance is less than the GFR, there is

A

Net reabsorption

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46
Q

When the substance’s clearance is more than the GFR, there is

A

Net secretion

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47
Q

Substances that can be used to measure kidney function

A

Inulin

Creatinine

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48
Q

Renal blood flow is ____% of the cardiac output

A

25%

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49
Q

If clearance is equal to GFR, there is

A

Filtration

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50
Q

Substances that cause vasodilation of renal arterioles : increased RBF

A 
PGE2
PGI2
Bradykinin
NO
Dopamine
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51
Q

Substances that cause vasoconstriction of renal arterioles : decreased RBF

A 
Sympathetic NS
Angiotensin II (preferentially efferent arterioles)
52
Q

What substance vasodilates afferent arterioles and to a lesser extent vasoconstricts efferent arterioles but the net effect is increased RBF?

A

ANP

53
Q

Formula for RBF

A

RPF/ 1- hematocrit

54
Q

Normal GFR per minute

A

125ml/min

55
Q

Normal GFR per day

A

180 L /day

56
Q

Known as the counter current exchanger

A

Vasa recta

57
Q

It is the amount filtered minus the amount reabsorbed plus amount secreted

A

Excretion

58
Q

This describes fluid movement into or out of the capillary

A

Starling Forces

59
Q

Highest possible filtration fraction occurs during

A

Vasoconstriction of the efferent arteriole

60
Q

Effect on filtration fraction if there is an increase in plasma proteins

A

Decreased

Increased oncotic pressure= decreased GFR but no change in RPF

61
Q

Effect on filtration fraction if there is ureteral stone

A

Decreased

Increased BCH Decreased GFR no change in RPF

62
Q

Effect of vasoconstriction of afferent arterioles on filtration fraction

A

No change

Decreased GFR and decreased RPF

63
Q

Severe vasoconstriction of efferent arteriole effect on GFR

A

Decreased

Albumin trapped-attract cations-attract water

64
Q

Moderate vasoconstriction of efferent arteriole effect on GFR

A

Increased

65
Q

Starling forces:
Not a starling force
Promotes GFR
Increased by histamine

A

Kf

Filtration coefficient

66
Q

Effect on GFR: increased or decreased?

Afferent arteriole vasodilation

A

Increased

67
Q

Effect on GFR: increased or decreased?

Afferent arteriole vasoconstriction

A

Decreased

68
Q

Effect on GFR: increased or decreased?

Efferent arteriole vasodilation

A

Decreased

69
Q

Effect on GFR: increased or decreased?

Efferent arteriole moderate vasoconstriction

A

Increased

70
Q

Effect on GFR: increased or decreased?

Efferent arteriole severe vasoconstriction

A

Decreased

71
Q

Effect on GFR: increased or decreased?

GC hydrostatic pressure increased

A

Increased

72
Q

Effect on GFR: increased or decreased?

GC hydrostatic pressure decreased

A

Decreased

73
Q

Effect on GFR: increased or decreased?

GC oncotic pressure increased

A

Decreased

74
Q

Effect on GFR: increased or decreased?

GC hydrostatic pressure decreased

A

Increased

75
Q

It is the fraction of renal plasma flow that is filtered

A

Filtration fraction

76
Q

Normal filtration fraction

A

20%

77
Q

Formula for filtration fraction

A

GFR/RPF

78
Q

Auto regulation of renal blood flow occurs at BP range of

A

80-200mmHg

79
Q

Renal blood flow remains constant through this mechanism where renal afferent arterioles reflexively respond to stretch by contracting

A

Myogenic mechanism

80
Q

Effect of angiotensin II on efferent arteriole

A

Vasoconstriction

81
Q

Macula densa secretes these in response to decrease in BP

A

Angiotensin II

NO

82
Q

NO dilates renal ______ arterioles during decreased BP

A

Afferent

83
Q

Secreted by macula densa if BP is high

A

Adenosine

84
Q

Effect of adenosine during increased BP

A

Vasoconstriction of afferent arteriole

85
Q

Renal threshold of glucose

A

200mg

86
Q

Renal transport maximum of glucose

A

375mg

87
Q

The following causes hypokalemia by causing shift of K into cells

A

Insulin
B adrenergic agonists
Alkalosis (exhange for intracellular H)
Hypo osmolarity

88
Q

Causes of decreased K secretion by principal cells

A

Low K diet
Hypoaldosteronism
Acidosis
K sparing diuretics

89
Q

PCT reabsorbs ____% of filtered urea

A

50%

90
Q

Renal tubule that Secretes urea via simple diffusion

A

Thin descending limb of LH

91
Q

Normal plasma calcium

A

2.4 mEq/L

92
Q

How many percent of Calcium is filtered?

A

60%

93
Q

These drugs increases Ca reabsorption

A

PTH

Thiazides

94
Q

This drug decreases Ca reabsorption

A

Loop diuretics

95
Q

How much Phosphate is absorbed by the PCT?

A

85% of filtered phosphate

96
Q

Reabsorption of phosphate is inhibited by

A

PTH

97
Q

50% of magnesium is stored in the bones and ____% is excreted daily

A

10%

98
Q

65% of reabsorption of Magnesium occurs in

A

TAL of LH

99
Q

This electrolyte competes with magnesium for reabsorption in TAL of LH

A

Calcium

100
Q

Hypercalcemia causes this effect on magnesium

A

Hypomagnesemia

101
Q

Hypocalcemia causes this effect on magnesium

A

Hypermagnesemia

102
Q

Graded osmolarity in the renal interstitium is created by

A

The countercurrent multiplier LH

103
Q

Graded osmolarity in the renal interstitium is supplemented by

A

Urea recycling

104
Q

Graded osmolarity in the renal interstitium is maintained by

A

Countercurrent exchanger: vasa recta

105
Q

Estimates the ability to concentrate or dilute the urine

A

Free water clearance

106
Q

Formula for free water clearance

A

Urine flow rate- osmolar clearance
V-Cosm

Cosm= UV/P

107
Q

PTH causes this effect on calcium and phosphate

A

Increased calcium reabsorption and decreased phospate reabsorption–urine

PTH- phosphate trashing hormone

108
Q

Situations where there is negative free water clearance

A

SIADH

Water deprivation

109
Q

Difference of water deprivation and SIADH is in their

A

Plasma osmolarity

Increased in water deprivation
Decreased in SIADH

110
Q

Plasma osmolarity in SIADH is increased or decreased?

A

Decreased

111
Q

Plasma osmolarity in water deprivation is increased or decreased?

A

Increased

112
Q

hormone that decreases Na reabsorption

A

ANP

BNP

113
Q

Hormones that decrease water and Na reabsorption

A

Dopamine
Uroguanylin
Guanylin

114
Q

MOA of ANP and BNP on distal tubule and collecting ducts for decreased reabsorption of sodium

A

CGMP

115
Q

pH compatible with life

A

6.8-8

116
Q

An increase in H levels will cause an increase in which electrolytes?

A

Hypercalcemia

Hyperkalemia

117
Q

Anion gap formula

A

Na-(HCO3+ Cl)

118
Q

There is an increase in this electrolyte in NAGMA to maintain electroneutrality

A

Chloride

119
Q

HAGMA conditions

MUDPILES

A 
Methanol
Uremia
DKA
Paraldehyde Propylene Glycol
Iron Isoniazid
Lactic acidosis 
Ethylene glycol, ethanol
Salicylic acid
120
Q

NAGMA conditions

HARD UP

A 
Hyperalimentation
Acetazolamide
RTA
Diarrhea
Ureteroenteric fistula
Pancreaticoduodenal fistula
121
Q

Diarrhea causes this acid base abnormality

A

Metabolic acidosis

122
Q

Vomiting causes this type of acid base abnormality

A

Metabolic alkalosis

123
Q

All tubules except diluting segments are acted upon by this type of diuretic

A

Osmotic diuretics

124
Q

Carbonic anhydrase inhibitors act on the

A

PCT

125
Q

Thiazide diuretics act on the

A

Distal tubule

126
Q

Thiazides causes increased

Hyper GLUC

A 
Hyper
Glycemia
Lipidemia
Uricemia
Calcemia
127
Q

This type of diuretic decreases calcium levels

A

Loop diuretic

Physio (8 decks)

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