Renal Physiology

Question 1

Histo descending loop of Henle

Answer 1

simple squamous

Question 2

Histo ascending limb of Henle

Answer 2

simple cuboidal

Question 3

pain from urinary bladder

Answer 3

pelvic splanchnic nerve –> S2-4

Question 4

osmolality XXXX in the descending limb

Answer 4

increases dramatically

Question 5

Toxicities of furosemide (OHHH)

Answer 5

• Ototoxicity
• Hypokalemia
• Hypocalcemia
• Hypomagnesemia

Question 6

Toxicities of furosomide (DANG)

Answer 6

• Dehydration
• Allergy (sulfa)
• Nephritis (interstitial)
• Gout

Question 7

Mneumonic for toxicities of fusosemide

Answer 7

OHHH DANG

Question 8

Pressure of glomerular capillaries

Answer 8

high

Question 9

pressure of peritubular capillaries

Answer 9

low

Question 10

Site for PTH-driven calcium reabsorption in the kidney?

Answer 10

DCT

Question 11

RBF is what % of CO

Answer 11

20%

Question 12

cell types in collecting tubules

Answer 12

principal cells and intercalated cells

Question 13

Principal cells

Answer 13

resorb Na+ and H2O & secrete K+

Question 14

site of aldosterone control

Answer 14

Principal cells (inc Na reabsorp + K+ secretion);
also inc H+ secretion by interacalated cells

Question 15

Efferent limb of the micturition reflex

Answer 15

Parasympathetic innervation of bladder: S2-4 –>pelvic splanchnic nn..

Question 16

Micturition reflex causes

Answer 16

Contraction of the detrusor m & relaxation of the internal urethral sphincter.

Question 17

PTH –> kidney mediator of vit D

Answer 17

1-α-hydroxylase

Question 18

(CH2O) = V – Cosm

Answer 18

free water clearance (ability to dilute the urine)

Question 19

actions of angiotensin II

Answer 19

• inc BP
• inc Na/H ex & bicarb reabs in PCT
• inc aldosterone
• ind ADH
• stim hypothal

Question 20

Use of what class of diuretic leads to CH2O = 0?

Answer 20

Loop

Question 21

renal cells that make EPo

Answer 21

interstitial fibroblasts

Question 22

Which cells secrete renin?

Answer 22

JGA smooth muscle

Question 23

three embryological remnants connect to bladder apex

Answer 23

mediaN, mediaL, & lateral umbilical ligaments

Question 24

3 stimuli for renin production

Answer 24

Dec RBP
Dec NaCL to DCT sensed by macula densa
Inc sympathetic tone

Question 25

ACE inhibitors for HTN

Answer 25

decrease angiotensin sympathetic activity

Question 26

Ph buffers are most effective within

Answer 26

1.0 pH unit of the pKa

Question 27

Angotensin II ↑ Na/H ex & HCO3- reabs

Answer 27

PCT

Question 28

ACE inhibitors for CHF

Answer 28

dec aldosterone --> dec intravascular volume

Question 29

ACE inhibitors examples

Answer 29

captopril, enalapril, lisinopril

Question 30

What determines reabsorption of water at the thin descending loop of Henle?

Answer 30

medullar hypertonicity & impermeability to Na+ --> passive reabsorption

Question 31

3 toxicities of spironolactone

Answer 31

hyperkalemia, gynecomastia, antiandrogen effects

Question 32

Reabsorption of filtered bicarb in PCT is directly coupled to renal H secretion via the action of

Answer 32

carbonic anhydrase & the Na/H+ antiporter.

Question 33

How do renal PCT cells create a low intracellular Na+ (gradient)?

Answer 33

Na/K ATPase on the basolateral membrane extrudes Na from renal tubular cells into the interstitium,

Question 34

Low intracellular Na facilitates movement of H into the renal PCT movement via

Answer 34

NA/H antiporter

Question 35

PCT luminal H+ may combine with HCO3- via XXX

Answer 35

luminal carbonic anhydrase, located in the brush border of the PCT

Question 36

CO2 in PCT lumen diffuses into PCT cell, where it is converted by

Answer 36

intracellular carbonic anhydrase back into H+ and HCO3-

Question 37

PCT intracellular bicarb is transported through the BL membrane back into IF (--> blood) by

Answer 37

???? I DON"T KNOW!!

Question 38

For each HCO3- filtered in the PCT, one XXXX is secreted into the renal tubular lumen.

Answer 38

H+

Question 39

Why hyperkalemia with ACE inhibitors?

Answer 39

decreased aldosterone effect (less K+ secreted by principal cells in the collecting tubules)

Question 40

toxicities of ACE inhibitors (CAPTO)

Answer 40

``` cough angioedema pregnancy contraindication taste of metal hypOtension ```

Question 41

toxicities of ACE inhibitors (PRIL)

Answer 41

Potassium elevation Rash Increased renin Low Angiotensin II

Question 42

Renal prostaglandins vasodilate afferent articles -->

Answer 42

inc GFR (maintain)

Question 43

NSAIDS inhibit renal prostaglandins -->

Answer 43

dec GFR

Question 44

anion gap metabolic acidosis (MUD)

Answer 44

Methanol *(formate), metformin Uremia Diabetic ketoacidosis

Question 45

ACE inhibitors treat what three conditions?

Answer 45

HTN, CHF, Diabetes

Question 46

Where is ACE made?

Answer 46

lungs

Question 47

ANP effect on renin

Answer 47

decrease

Question 48

ANP effect on GFR

Answer 48

increase

Question 49

net effect of ANP

Answer 49

increase diuresis and dec interstitial edema

Question 50

inc ANP levels are seen in patients with

Answer 50

pulmonary congestion

Question 51

Losartan MOA

Answer 51

blocks angiotensin II type 1 receptors

Question 52

Aliskerin MOA

Answer 52

Renin inhibitor