Renal Physiology 2 Flashcards
1
Q
___________: only a fraction of the plasma presented to the glomeruli is filtered.
A
Filtration Fraction: only a fraction of the plasma presented to the glomeruli is filtered.
2
Q
________ of plasma is filtered.
A
20-30% of plasma is filtered.
3
Q
Filtration rate is measured in units of _______.
A
Filtration rate is measured in units of mL/min.
4
Q
Secretion, Reabsorption and Excretion are measured in units of _________.
A
Secretion, Reabsorption and Excretion are measured in units of mg/min.
5
Q
Excretion (E) = _______________
A
Excretion (E) = Filtration (F) + Secretion (S) - Reabsorption (R)
6
Q
___________: maximum rate at which nephron epithelium can remove substances from plasma and secrete them into filtrate
A
Transport Maximum: maximum rate at which nephron epithelium can remove substances from plasma and secrete them into filtrate
7
Q
Secretion transport is dependent on
A
Secretion transport is dependent on the number/density of membrane transporters that allow for secretion or reabsorption
8
Q
When transport maximum is reached, substances that should be secreted _____________.
A
When transport maximum is reached, substances that should be secreted accumulate in plasma.
9
Q
When transport maximum is reached, substances that should be reabsorbed __________.
A
When transport maximum is reached, substances that should be reabsorbed may be lost in urine.
10
Q
“Splay” in graphs of [Glucose] reflects what
A
Heterogenicity of nephrons
11
Q
Glucose in the urine can be due to:
A
Hemorrhage
Increased [Glucose} in plasma
Proximal tubule damage
12
Q
Explain how Fight or Flight response increases plasma glucose
A
SNS stimulation releases epinephrine that increases glycogenolysis at the liver.
13
Q
Why is the Fight or Flight response important in some species and not others in regards to [Glucose]
A
In some species the [Glucose] in plasma caused by the Fight or Flight response exceeds transport maximum
14
Q
In what species is the Fight or Flight Response important to be aware of in regards to [Glucose]
A
Bovine
15
Q
_______ is secreted when there is increased [Glucose] in plasma.
A
Insulin is secreted when there is increased [Glucose] in plasma.
16
Q
[Glucose] in plasma and Filtration of Glucose is a __________ relationship.
A
[Glucose] in plasma and Filtration of Glucose is a linear relationship.
17
Q
Normal [Glucose] in plasma for dog
A
70-100 mg/dL
18
Q
Glucose Transport Maximum of dog
A
180-200 mg/dL
19
Q
Decreased transport maximum means what in regards to the concentration of a substance in plasma.
A
More of the substance is excreted in urine when it is increased in plasma.
20
Q
The _________ is the major portion of the nephron responsible for reabsorption and secretion.
A
The proximal tubule is the major portion of the nephron responsible for reabsorption and secretion.
21
Q
The _______ does not modify osmolarity.
A
The Proximal Tubule does not modify osmolarity.
22
Q
__________ of water is reabsorbed at the proximal tubule.
A
50-80% of water is reabsorbed at the proximal tubule.
23
Q
_________ work at the proximal tubule to increase reabsorption of water.
A
NE, E, AGII work at the proximal tubule to increase reabsorption of water.
24
Q
Increased reabsorption at the proximal tubule can be due to
A
Decreased blood pressure
Increased osmolarity
25
\_\_\_\_\_\_\_ of water is reabsorbed at the dLoH
**20%** of water is reabsorbed at the dLoH
26
At the ______ there is more water reabsorption than osmolyte.
At the **dLoH** there is more water reabsorption than osmolyte.
27
The ________ is considered a passive structure.
The **dLoH** is considered a passive structure.
28
Filtrate at the dLoH is \_\_\_\_\_osmotic.
Filtrate at the dLoH is **hyper**osmotic.
29
Urea from the MCD is secreted at the \_\_\_\_\_\_\_\_.
Urea from the MCD is secreted at the **dLoH**.
30
The _______ puts solute into the interstitium.
The **aLoH** puts solute into the interstitium.
31
The ______ has no aquaporins.
The **aLoH** has no aquaporins.
32
\_\_\_\_\_\_\_ at the aLoH increase reabsorption of water by the dLoH
**NE and E** at the aLoH increase reabsorption of water by the dLoH
33
\_\_\_\_\_\_\_\_\_\_ increases the reabsorption of solute at the aLoH
**AcH and Aldosterone** increases the reabsorption of solute at the aLoH
34
\_\_\_\_\_\_\_\_\_ at the MCD increases the number of aquaporins and urea transporters
**ADH** at the MCD increases the number of aquaporins and urea transporters
35
\_\_\_\_\_\_\_\_\_\_ at the MCD decreases Na+ reabsorption.
**ANP** at the MCD decreases Na+ reabsorption.
36
\_\_\_\_\_\_\_\_\_\_ at the MCD increases Na+ reabsorption.
**Aldosterone** at the MCD increases Na+ reabsorption.
37
Osmolytes become non freely filterable when
Osmolytes become non freely filterable when **they are bound by plasma protein**
38
Secretion of organic molecules occurs only in the \_\_\_\_\_\_\_\_\_\_\_.
Secretion of organic molecules occurs only in the **proximal tubule**.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Exception: Urea is secreated in the dLoH
39
Reabsorption of organic molecules occurs only in the \_\_\_\_\_\_\_\_\_\_\_\_.
Reabsorption of organic molecules occurs only in the **proximal tubule**.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Exception: Urea at the MCD
40
Urea (increases/decreases) along the nephron.
Urea (**increases**/decreases) along the nephron.
41
At the dLoH [Urea] (increases/decreases)
At the dLoH [Urea] (increases/**decreases**)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
To allow for diffusion into the filtrate
42
After the aLoH filtrate is \_\_\_\_\_\_osmotic
After the aLoH filtrate is **hyp**osmotic
43
All medullary interstitium is \_\_\_\_\_\_osmotic.
All medullary interstitium is **hyper**osmotic.
44
Fractional Excretion = \_\_\_\_\_\_\_\_\_\_\_\_\_
Fractional Excretion =
## Footnote
**Clearance of X (mL/min) / GFR (mL/min)**
45
UrineX:UrineCreatinine
Test comparing the ratios of substances in urine to known normals
46
Elevated UrineProtein:UrineCreatinine can be caused by
Tubular Disease
Glomeruplopathies
Lower Urinary Tract Disease
47
UrineCortisol:UrineCreatinine is used as a diagnostic tool for
Cushings Disease
48
Osmolar Clearance = \_\_\_\_\_\_\_\_\_\_.
Osmolar Clearance = **Vu x Uosm / Posm**.
49
Free Water Clearance = \_\_\_\_\_\_\_\_\_\_\_\_\_\_
Free Water Clearance = **Vu - Osmolar Clearance**
50
Uosm _______ Posm:
Free water clearance = 0
No net gain or loss of plasma water
Isosmotic urine
Uosm **=** Posm
51
Uosm _______ Posm:
Free water clearance +
Net loss of plasma water
Hyposmotic urine
Uosm **\<** Posm
52
Uosm _______ Posm:
Free water clearance -
Net gain of plasma water
Hyperosmotic urine
Uosm **\>** Posm
53
As blood pressure decreases, the concentration of osmolytes in the urine \_\_\_\_\_\_\_\_\_\_.
As blood pressure decreases, the concentration of osmolytes in the urine **increases**
54
\_\_\_\_\_\_\_\_\_\_\_ urine = neither excretion nor reabsorption of solute free water and urine flow equals urine
**Isosmotic** urine = neither excretion nor reabsorption of solute free water and urine flow equals urine
55
\_\_\_\_\_\_\_\_\_\_ urine is divided into 2 virtual volumes; once contains solute and is isosmotic to plasma with urine flow rate equal to osmolar clearance and the second is solute free.
**Hyposmotic** urine is divided into 2 virtual volumes; once contains solute and is isosmotic to plasma with urine flow rate equal to osmolar clearance and the second is solute free.
56
\_\_\_\_\_\_\_\_\_\_ urine represents the volume of solute free water that would have to be added to urine to make it isosmotic to plasma, solute free water reabsorbed by the kidneys.
**Hyperosmotic** urine represents the volume of solute free water that would have to be added to urine to make it isosmotic to plasma, solute free water reabsorbed by the kidneys.
57
\_\_\_\_\_\_\_\_\_: quantifies the actual voluem of solute fre water that is being conserved by the animal over time.
**Free water clearance** : quantifies the actual voluem of solute fre water that is being conserved by the animal over time.
58
\_\_\_\_\_\_\_\_\_\_: ratio of the density of a volume of solution to the density of an identical volume of water.
**Specific Gravity (USG)**: ratio of the density of a volume of solution to the density of an identical volume of water.
59
Free water has a USG of \_\_\_\_\_\_\_.
Free water has a USG of **1.000**.
60
True/False: USG is a precise measure of osmolality
False
61
USG between ________ is the same osmolality as plasma.
USG between **1.018 - 1.020** is the same osmolality as plasma.
62
\_\_\_\_\_\_\_\_\_\_: urine excreted has an osmolality/SG essentially identical to plasma
**Isosthenuria**: urine excreted has an osmolality/SG essentially identical to plasma
63
\_\_\_\_\_\_\_\_: urine excreted is dilute
**Hyposthenuria** : urine excreted is dilute
64
\_\_\_\_\_\_\_\_\_: urine excreted is concentrated
**Hypersthenuria**: urine excreted is concentrated
65
Water Deprivation Test
Used to test renal function. USG is measured as water is deprived over a set amount of time. In normal animal, expect to see and increase in USG as time continues.
66
\_\_\_\_\_\_\_\_\_\_: accumulation of non protein nitrogen molecules.
**Azotemia**: accumulation of non protein nitrogen molecules.
67
\_\_\_\_\_\_\_: accumulation of waste products such that toxic effects manifest.
**Uremia** : accumulation of waste products such that toxic effects manifest.
68
\_\_\_\_\_\_\_\_\_ Azotemia is caused by derangements in before the kidney.
**Pre-Renal** Azotemia is caused by derangements in before the kidney.
69
\_\_\_\_\_\_\_\_ Azotemia is a result of kidney dysfunction.
**Renal** Azotemia is a result of kidney dysfunction.
70
\_\_\_\_\_\_\_ Azotemia is caused by derangement after the kidney
**Post-Renal** Azotemia is caused by derangement after the kidney
71
Osmolality increases in the \_\_\_\_\_\_\_
Osmolality increases in the **medulla**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
LoH and Collecting duct
72
2/3 loss of nephrons causes
2/3 loss of nephrons causes **decreased concentrating ability**
73
3/4 loss of nephrons causes
3/4 loss of nephrons causes **kidney failure**
74
Hyperkalemia can be caused by
Increased intake of K+ in diet
Tissue damage
Urinary blockage
75
Most common cause of hyperkalemia is \_\_\_\_\_\_\_\_\_\_.
Most common cause of hyperkalemia is **urinary blockage**.
76
\_\_\_\_\_\_\_\_\_ holds excess K+ until kidney can excrete it.
**Skeletal muscle** holds excess K+ until kidney can excrete it.
77
2 important non-protein nitrogen (NPN) molecules
Urea and Creatinine
78
Increased [PO42-] = _______ GFR
Increased [PO42-] = **decreased** GFR
79
\_\_\_\_\_\_\_\_\_\_\_ is important in PO42- homeostasis; decreases PO42- reabsorption.
**PTH** is important in PO42- homeostasis; decreases PO42- reabsorption.
80
\_\_\_\_\_\_\_\_\_\_\_ is an important site for reabsorption.
**Proximal Tubule** is an important site for reabsorption.
81
Reabsorption at the ________ is isosmotic.
Reabsorption at the **proximal tubule** is isosmotic.
82
Major extracellular electrolyte/osmolyte of the proximal tubule is \_\_\_\_\_\_\_\_\_.
Major extracellular electrolyte/osmolyte of the proximal tubule is **Na+**.
83
Mechanisms of Reabsorption include:
Transporters
Solvent Drag
Diffusion
84
Movement of molecules at the proximal tubule are associated with the movement of \_\_\_\_\_\_.
Movement of molecules at the proximal tubule are associated with the movement of **Na+**
85
Na+ gradient is established by the \_\_\_\_\_\_\_\_\_.
Na+ gradient is established by the **Na+ - K+ ATPase**.
86
Proteins are _____________ by proximal tubule cells.
Proteins are **endocytosed and hydrolyzed** by proximal tubule cells.
87
[Urea] _________ in the filtrate as it courses through the proximal tubule.
[Urea] **increases** in the filtrate as it courses through the proximal tubule.
88
Secretion at the proximal tubule requires\_\_\_\_\_\_\_\_\_.
Secretion at the proximal tubule requires **membrane bound proteins**.
89
\_\_\_\_\_\_\_\_\_ of total remains of Na+, water and osmoles after reabsorption at the proximal tubule.
**1/3** of total remains of Na+, water and osmoles after reabsorption at the proximal tubule.
90
\_\_\_\_\_\_\_ of wanted electrolytes are reabsorbed at the proximal tubule.
**2/3** of wanted electrolytes are reabsorbed at the proximal tubule.
91
CO2 + H2O ⇔ H2CO3 is catalyzed by what enzyme.
Carbonic Anhydrase
92
"Leakiness" of tight junctions _________ along the length of the nephron.
"Leakiness" of tight junctions **decreases** along the length of the nephron.
93
Reabsorptive force attributable to ____________ pressure.
Reabsorptive force attributable to **plasma colloid oncotic** pressure.
94
\_\_\_\_\_\_\_\_\_\_\_\_: direct relationship betwen volume of fluid filtered at the glomerulus and volume of fluid reabsorbed at the proximal tubule.
**Glomertubular Balance**: direct relationship betwen volume of fluid filtered at the glomerulus and volume of fluid reabsorbed at the proximal tubule.
95
\_\_\_\_\_\_\_ is the most important extracellular anion in the proximal tubule.
**Cl-** is the most important extracellular anion in the proximal tubule.
96
Reabsorption of _________ occures only in the first half of the proximal tubule.
Reabsorption of **organic molecules** occures only in the first half of the proximal tubule.
97
Reabsorption of __________ occures the entire length of the nephron.
Reabsorption of **electrolytes** occures the entire length of the nephron.
98
True/False: At the proximal tubule the Na+-Bicarb symport is important in maintaining acid base.
False, there is no such thing as a Na+-Bicarb symport
99
Bicarb pumped into the plasma makes plasma _______ and the filtrate \_\_\_\_\_\_\_\_\_\_.
Bicarb pumped into the plasma makes plasma **alkaline** and the filtrate **acidic**.
100
Na+-K+ ATPase is stimulated by
Norepinephrine
Epinephrine
Angiotension II
101
It is more common for an animal to become more (acidic/alkaline).
It is more common for an animal to become more (**acidic**/alkaline).
102
True/False: Bicarb is freely filterable
True
103
Reabsorption at the LoH is not \_\_\_\_\_\_osmotic.
Reabsorption at the LoH is not **isos**osmotic.
104
Water is reabsorbed ________ in the dLoH.
Water is reabsorbed **passively** in the dLoH.
105
Solute is reabsorbed by _________ in the aLoH
Solute is reabsorbed by **active transport** in the aLoH
106
Due to H2O reabsorption in the dLoH filtrate becomes \_\_\_\_\_\_\_\_osmotic.
Due to H2O reabsorption in the dLoH filtrate becomes **hyper**osmotic.
107
Due to solute reabsorption in the aLoH filtrate becomes \_\_\_\_\_\_\_osmotic.
Due to solute reabsorption in the aLoH filtrate becomes **hyp**osmotic.
108
\_\_\_\_\_\_\_\_\_: protein secreted by the LoH to decrease the likelihood of bacterial attachment to urinary epithelium
**Uromodulin**: protein secreted by the LoH to decrease the likelihood of bacterial attachment to urinary epithelium
109
\_\_\_\_\_\_\_\_\_\_ is the most abundent protein found in urine.
**Uromodulin** is the most abundent protein found in urine.
110
\_\_\_\_\_\_\_\_ takes solute out of the medullary interstitium all the time.
**Vasa Recta** takes solute out of the medullary interstitium all the time.
111
Filtrate should be \_\_\_\_\_osmotic and interstitium should be \_\_\_\_\_osmotic.
Filtrate should be **hyp**osmotic and interstitium should be **hyper**osmotic.
112
Transport of urea into and out of the medullary interstitium is dependent on \_\_\_\_\_\_\_\_\_\_.
Transport of urea into and out of the medullary interstitium is dependent on **urea transporters**.
113
The aLoH is net reabsorptive of \_\_\_\_\_.
The aLoH is net reabsorptive of **K+**.
114
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_: medullary interstitium is all hyperosmotic, however it gets increasingly more hyperosmotic as it gets deeper into the medulla.
**Counter-Current Mechanism**: medullary interstitium is all hyperosmotic, however it gets increasingly more hyperosmotic as it gets deeper into the medulla.
115
\_\_\_\_\_\_\_\_: a drug used to block 2Cl- - Na+K+ symports; overdose can lead to dehydration.
**Lasix**: a drug used to block 2Cl- - Na+K+ symports; overdose can lead to dehydration.
116
\_\_\_\_\_\_\_\_\_\_\_\_ increases urea permeability in the collecting duct by increasing the number/density of urea transporters.
**ADH** increases urea permeability in the collecting duct by increasing the number/density of urea transporters.
117
\_\_\_\_\_\_\_\_ symport found in the aLoH is electroneutral.
**2Cl- - Na+K+** symport found in the aLoH is electroneutral.
118
\_\_\_\_\_\_\_ stimulates the addition of aquaporins in the MCD.
**ADH** stimulates the addition of aquaporins in the MCD.
119
\_\_\_\_\_\_\_\_\_\_ shut down urea transporters in the MCD.
**Cortisol** shut down urea transporters in the MCD.
120
\_\_\_\_\_\_\_\_\_\_ increase activity of Na+-K+ ATPase in the DCT, CCD, MCD.
**Aldosterone** increase activity of Na+-K+ ATPase in the DCT, CCD, MCD.
121
\_\_\_\_\_\_\_\_ decreases Na+ and H2O reabsorption at the MCD.
**ANP** decreases Na+ and H2O reabsorption at the MCD.
122
\_\_\_\_\_\_\_\_\_\_\_\_
Na+ - K+ ATPase
Na+
Na+ - Glucose/AA/PO4-
Na+ - Cl- Symport
Na+ - H+ Antiport
**Proximal Tubule**
Na+ - K+ ATPase
Na+
Na+ - Glucose/AA/PO4-
Na+ - Cl- Symport
Na+ - H+ Antiport
123
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Aquaporins
Urea Transporters
**dLoH and MCD**
Aquaporins
Urea Transporters
124
\_\_\_\_\_\_\_\_\_\_\_\_
Na+ - K+ ATPase
2Cl- -Na+K+ Symport
**aLoH**
Na+ - K+ ATPase
2Cl- -Na+K+ Symport
125
\_\_\_\_\_\_\_\_\_\_\_
Aquaporins
H+
H+ - K+ Antiport
HCO3- - Cl- Antiport
**DCT/ CCD**
Aquaporins
H+
H+ - K+ Antiport
HCO3- - Cl- Antiport
126
[Glucose] _____ at the PCT
[Glucose] **decreases** at the PCT
127
[Na+]/[Cl-] _______ at the PCT.
[Na+]/[Cl-] **decreases** at the PCT.
128
[Na+]/[Cl-] _______ at the dLoH.
[Na+]/[Cl-] **remains constant** at the dLoH.
129
[Na+]/[Cl-] _______ at the aLoH.
[Na+]/[Cl-] **decreases** at the aLoH.
130
[Na+]/[Cl-] _______ at the DT/CD.
[Na+]/[Cl-] **decreases** at the DT/CD.
131
[H2O] ________ from PCT to CD
[H2O] **decreases** from PCT to CD
132
[Urea] ______ at the PCT.
[Urea] **decreases** at the PCT.
133
[Urea] ______ at the dLoH.
[Urea] **increases** at the dLoH.
134
[Urea] ______ at the aLoH.
[Urea] **remains constant** at the aLoH.
135
[Urea] ______ from the DT to CD.
[Urea] **decreases** from the DT to CD.
136
[CREA] _______ at the PCT.
[CREA] **increases** at the PCT.
137
[CREA] _______ from dLoH to CD.
[CREA] **remains constant** from dLoH to CD.
138
A deficiency in _________ results in loss of solute and large volumes of water in dilute urine leading to the disease state of \_\_\_\_\_\_\_\_\_.
A deficiency in **ADH** results in loss of solute and large volumes of water in dilute urine leading to the disease state of **Diabetes Insipidus**.
139
Diabetes Insipidus can be a result of
Dysfunction of hypothalamus or neurohypophysis
or
Deficient/ dysfunctional ADH receptrors in the kidney
140
\_\_\_\_\_\_\_\_\_ Diabetes Insipidus is due to a dysfunction of the hypothalmus or neurohypophysis
**Central / Primary** Diabetes Insipidus is due to a dysfunction of the hypothalmus or neurohypophysis
141
\_\_\_\_\_\_\_\_ Diabetes Insipidus is caused by deficient or dysfunctional ADH receptors in the kidney.
**Nephrogenic** Diabetes Insipidus is caused by deficient or dysfunctional ADH receptors in the kidney.
142
\_\_\_\_\_\_\_\_\_\_ polydipsia occurs when the animals drinks too much.
**Primary** polydipsia occurs when the animals drinks too much.
143
\_\_\_\_\_\_\_\_ polydipsia is due to a problem in the kidney.
**Secondary** polydipsia is due to a problem in the kidney.
144
The ALoH is constantly putting solute into the interstititium because
The ALoH is constantly putting solute into the interstititium because **the vasa recta is constantly taking it out.**
145
\_\_\_\_\_\_\_\_\_\_\_\_: Condition in which Na+ and Cl- are not constantly resupplied to the interstitium leading to a persistant slight loss of osmolyte to vasa recta.
**Medullary Washout**: Condition in which Na+ and Cl- are not constantly resupplied to the interstitium leading to a persistant slight loss of osmolyte to vasa recta.
146
Medullary Washout occurs due to:
ALoH not putting solute into the intersitium (Lack of hormone vs receptor)
Liver Disease (decreased Urea)
147
Hyperadrenocorticism is also called \_\_\_\_\_\_\_\_.
Hyperadrenocorticism is also called **Cushings Disease**
148
Hypoadrenocorticism is also called \_\_\_\_\_\_\_\_.
Hypoadrenocorticism is also called **Addisons Disease**.
149
Hyperadrenocorticism is due to an increase in \_\_\_\_\_\_\_\_\_\_\_\_.
Hyperadrenocorticism is due to an increase in **cortisol**.
150
Hypoadrenocorticism is due to a decrease in \_\_\_\_\_\_\_\_\_.
Hypoadrenocorticism is due to a decrease in **Aldosterone**.
151
Diseases typically associated with Nephrogenic Diabetes Insipidus
Hypercalcemia
Hypokalemia
Glucosuria
