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RUSVM Physiology II > Renal Physiology > Flashcards

Renal Physiology Flashcards

1
Q

________ is an enzyme produced by JG cells.

A

Renin is an enzyme produced by JG cells.

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1
Q

Inulin

A

Used to calculate GFR

Gold Standard by renal physiologists

Not used in veterinary medicine

Involves urine collection

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2
Q

There should never be _________ in the urine.

A

There should never be glucose in the urine.

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2
Q

The ____________ receives virtually all blood because it is where filtration and modification occur.

A

The cortex receives virtually all blood because it is where filtration and modification occur.

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2
Q

Water is unimpeded by the filtration apparatus thus is said to be __________.

A

Water is unimpeded by the filtration apparatus thus is said to be freely filterable.

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2
Q

Steroid effect on prostaglandins

A

Blocks PLA2 enzyme activity

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3
Q

Increased Creatinine primarily caused by

A

Decreased H2O in the blood

Decreased filtration by the kidney

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4
Q

Parasympathetic nervous system _______ heart rate.

A

Parasympathetic nervous system decreases heart rate.

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5
Q

Why do we calculate GFR?

A
  1. Acute Renal Disease
  2. Chart progression of Chronic Renal Disease
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5
Q

Water is not reabsorbed at the ___________.

A

Water is not reabsorbed at the ascending loop of henle.

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6
Q

______________: events in the renal tubules influence the RBF and GFR.

A

Tubuloglomerular Feedback: events in the renal tubules influence the RBF and GFR.

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6
Q

Relationship between plasma [creatinine] and GFR

A

Increased plasma [creatinine] = decreased GFR

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6
Q

SDMA

A

Used for earlier diagnosis of CKD

Put into blood stream all of the time by all cells during protein degredation

Excreted exclusively by kidney

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7
Q

___________: cells of the mascula densa maintain RBF by monitoring [Na+, K+ and Cl-]

A

Humoral Response: cells of the mascula densa maintain RBF by monitoring [Na+, K+ and Cl-]

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8
Q

Increased CHP due to systemic pressure = __________ GFR.

A

Increased CHP due to systemic pressure = increased GFR.

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8
Q

__________ causes increased PGC, increased GFR and decreased RBF.

A

Constriction of Efferent Arteriole causes increased PGC, increased GFR and decreased RBF.

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9
Q

Great increase in CHP due to efferent arteriole tone = ____________ GFR.

A

Great increase in CHP due to efferent arteriole tone = decreased GFR.

_________________

Increase in resistance decreases flow (occlusion)

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10
Q

Increased CHP due to afferent arteriole tone = ___________ GFR.

A

Increased CHP due to afferent arteriole tone = increased GFR.

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10
Q

Increased [Na+, K+, Cl-] tells the mascula densa that there is _________ GFR.

A

Increased [Na+, K+, Cl-] tells the mascula densa that there is increased GFR.

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11
Q

Podocytes are found within the viseral epithelium of ___________.

A

Podocytes are found within the viseral epithelium of Bowman’s Capsule.

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11
Q

What are the two types of nephrons in the kidney?

A

Cortical and Juxtamedullary

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12
Q

_________ is the most important parameter in determination of normal renal function

A

GFR is the most important parameter in determination of normal renal function

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13
Q

Juxtaglomerular (JG) cells are found in the _____________ of the kidney.

A

Juxtaglomerular (JG) cells are found in the afferent arteriole of the kidney.

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14
Q

NSAIDs effect on prostaglandins

A

Indescriminant COX blocker

Decrease blood flow to the kidney

Cause GI ulcer

Decrease blood clotting

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15
Q

Layers of the “filter”

A
  1. Fenestrations
  2. Basement Membrane
  3. Filtration slits
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16
Q

Under normal conditions ________ is essentially zero.

A

Under normal conditions BSCOP is essentially zero.

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18
Q

Amount of plasma in should __________ the amount of plasma out of the kidney (in a normally hydrated animal.)

A

Amount of plasma in should equal the amount of plasma out of the kidney (in a normally hydrated animal.)

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19
Q

Describe the stretch reflex

A

Stimulus > Afferent Neuron > Brain > Preganglionic Neuron > Postganglionic Neuron > Effector Organ

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20
Q

Urine is produced when

A

All the time

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21
Q

___________ responds to decreased [Ca++] to maintain overall Ca++ homeostasis.

A

Parathyroid Hormone (PTH) responds to decreased [Ca++] to maintain overall Ca++ homeostasis.

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22
Q

Describe the vascular network of the nephron

A

Afferent Arteriole → Glomerulus → Efferent Arteriole → 1. Peritubular Capillaries or 2. Vasa Recta

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24
Q

Regulation and maintenance of plasma concentration within homeostatic norms is acheived by

A

Filtration

Secretion

Reabsorption

Excretion

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24
Q

Kidney produces ________ to combat the constant influence of vasoconstrictors.

A

Kidney produces prostaglandins to combat the constant influence of vasoconstrictors.

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25
Q

The urinary system is composed of _________, _________, ___________, and ________.

A

The urinary system is composed of kidneys, Ureters, Urinary bladder, and Urethra.

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25
Q

Describe the synthesis of creatine

A
  1. Kidney: AA1 + AA2 = Dipeptide
  2. Dipeptide released into bloodstream
  3. Taken up by Liver: Dipeptide + AA3 = Creatine
  4. Creatine released into the blood stream
  5. Taken up by Skeletal Muscle: Creatine + Phosphate = Creatine-P
  6. Creatine-P spontaneously falls apart to form Creatinine (waste molecule)
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26
Q

Iohexol

A

Contrasting agent that can be used to calcualte GFR

Single injection (and a few timed blood draws)

Take plotted results and calculate AUC

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28
Q

25 hydroxycholecalciferol is converted to 1,25 dihydroxycholecalciferol (calcitriol) by the enzyme _____________.

A

25 hydroxycholecalciferol is converted to 1,25 dihydroxycholecalciferol (calcitriol) by the enzyme 1 alpha hydroxylase.

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29
Q

Renal Autoregulation mechanisms

A

Direct Myogenic Response

Humoral Response

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30
Q

Increased blood pressure is due to:

A
  1. Vasoconstriction
  2. Stroke Volume
  3. Heart Rate
  4. Volume of Fluid
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31
Q

______ is virtually unchanged in the glomerulus, has an overal higher pressure than other capillaries.

A

CHP is virtually unchanged in the glomerulus, has an overal higher pressure than other capillaries.

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32
Q

Freely filterable substances have a filterability coefficient of _______.

A

Freely filterable substances have a filterability coefficient of 1.0.

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33
Q

When skeletal muscle is at rest what happens to creatine?

A

ATP is invested into creatinine for “storage” forming creatine-P

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34
Q

Functions of the kidney

A

Regulate and maintain plasma concentration

Regulate and maintain blood volume and pressure

Calcitriol

Catabolism

Gluconeogenesis

Synthesis of Erythropoietin

Synthesis of Creatine

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35
Q

Effects of decreased blood pressure on vessels includes

A

Vasoconstriction where needed

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36
Q

Effects of decreased blood pressure on the kidney include

A

Decreased GFR

Increased Reabsorption of H2O

Decreased urine flow

Increased Renin (thus vasoconstriction)

38
Q

Effects of decreased blood pressure on the heart include

A

Increased heart rate

Increased stroke volume

39
Q

___________ is the maintenance of a relatively constant renal blood flow and GFR despite changes in systemic blood pressure.

A

Renal Autoregulation is the maintenance of a relatively constant renal blood flow and GFR despite changes in systemic blood pressure.

40
Q

Oncotic pressures push water ________.

A

Oncotic pressures push water toward

40
Q

Requirements for a substance to be used to calculate GFR

A

Freely filterable

Not secreted

Not reabsorbed

Not metabolized

41
Q

____________ is a hormone that influences RBC production in the bone marrow.

A

Erythropoietin is a hormone that influences RBC production in the bone marrow.

42
Q

Slight increase in CHP due to efferent arteriole tone = _________ GFR.

A

Slight increase in CHP due to efferent arteriole tone = increased GFR.

__________________________

Increase in resistance causes increased CHP to compensate for decreased flow

44
Q

__________ is the most important regulator of homeostatic norms (according to Dr. Reich)

A

Filtration is the most important regulator of homeostatic norms (according to Dr. Reich)

44
Q

Mascula densa are cells of the ________.

A

Mascula densa are cells of the distal tubule.

45
Q

_____________: stretch stimulus received and responded to by the afferent arteriole.

A

Direct Myogenic Response: stretch stimulus received and responded to by the afferent arteriole.

46
Q

Most protein in plasma is produced by the _______.

A

Most protein in plasma is produced by the liver.

46
Q

Prostaglandins are produced by _________ enzyme.

A

Prostaglandins are produced by COX-1 enzyme.

47
Q

Ultrafiltration results in a filtrate free of

A

Cells, large molecules and large anions

48
Q

_________ is nearly freely filterable and used as the gold standard indicator substance to calculate GFR.

A

Inulin is nearly freely filterable and used as the gold standard indicator substance to calculate GFR.

50
Q

Major target of PTH is the _________.

A

Major target of PTH is the proximal tubule.

51
Q

Reabsorption Pressures

A

Bowman’s Space Hydrostatic Pressure (BSHP)

Plasma Colloid Oncotic Pressure (PCOP)

51
Q

Cells of the mascula densa secrete ________ substances.

A

Cells of the mascula densa secrete vasoconstriction substances.

52
Q

Increased renal blood flow = ________ GFR.

A

Increased renal blood flow = increased GFR.

53
Q

At the afferent arteriole the GFR is net _________ wherease at the efferent arteriole the GFR is net ________ due to change in [Protein].

A

At the afferent arteriole the GFR is net filtration wherease at the efferent arteriole the GFR is net reabsorption due to change in [Protein].

54
Q

___________ causes increased PGC​, increased GFR and increased RBF.

A

Dilation of Efferent Arteriole causes increased PGC​, increased GFR and increased RBF.

56
Q

_________ nephrons have a LoH that is entirely in the cortex.

A

Cortical nephrons have a LoH that is entirely in the cortex.

57
Q

Driving force for filtration of plasma at the glomerulus is _____________.

A

Driving force for filtration of plasma at the glomerulus is hydrostatic pressure.

58
Q

Calculation of GFR when using Iohexol

A

Amount of Iohexol injected (mg) / AUC (mg x time/mL)

59
Q

___________ causes decreased PGC, decreased GFR and increased RBF.

A

Dilation of Afferent Arteriole causes decreased PGC​, decreased GFR and increased RBF.

60
Q

When there is skeletal muscle damage it is common to see elevated _______ and ________ in blood sample. You do not see elevated _________ and _________.

A

When there is skeletal muscle damage it is common to see elevated myoglobin and creatine in blood sample. You do not see elevated creatinine and creatine-p.

61
Q

Angiotension II causes _______ of the afferent and efferent arterioles.

A

Angiotension II causes vasoconstriction of the afferent and efferent arterioles.

63
Q

When skeletal muscle is active what happens to the creatine?

A

Creatine-P releases its phosphate to ADP to make ATP quickly

64
Q

Atrial Naturetic Polypeptide (ANP) causes ______, ________ GFR and _______ reabsorption.

A

Atrial Naturetic Polypeptide (ANP) causes vasodilation, increased GFR and decreased reabsorption.

65
Q

Increased [Protein] in bowman’s space causes increased _______.

A

Increased [Protein] in bowman’s space causes increased BSCOP.

67
Q

__________ is the most abundant protein in plasma.

A

Albumin is the most abundant protein in plasma.

69
Q

Nephrons receive ______ of renal blood flow.

A

Nephrons receive 90% of renal blood flow.

71
Q

___________ is important in the homeostatic regulation of calcium.

A

Calcitriol is important in the homeostatic regulation of calcium.

72
Q

Erythropoietin is produced in response to ________.

A

Erythropoietin is produced in response to anemia.

73
Q

_______________ causes decreased PGC, decreased GFR, and decreased RBF.

A

Constriction of Afferent Arteriole causes decreased PGC, decreased GFR, and decreased RBF.

75
Q

Filtration pressures

A

Capillary Hydrostatic Pressure (CHP)

Bowman’s Space Colloid Oncotic Pressure (BSCOP)

76
Q

Hydrostatic pressures push water _______.

A

Hydrostatic pressures push water away.

77
Q

Renal components of volume and pressure homeostasis.

A

JG cells

Mesangial cells

Podocytes

Renin

Mascula densa

78
Q

___________ receptors respond to epinephrine and norepinephrine.

A

Androgenic receptors respond to epinephrine and norepinephrine.

79
Q

Coxhib effect on prostaglandin

A

Blocks COX 2 better than COX 1

81
Q

_______, ________ and ________ store urine but do little to change its volume or composition.

A

Ureters, Urethra and Urinary Bladder store urine but do little to change its volume or composition.

82
Q

Increased BSCOP= _________ GFR.

A

Increased BSCOP= increased GFR.

84
Q

_________ nephrons have LoH in the medulla because they are responsible for urine concentrating.

A

Juxtamedullary nephrons have LoH in the medulla because they are responsible for urine concentrating.

85
Q

Gluconeogenesis occurs in

A

Kidney (proximal tubule)

Liver

86
Q

The kidney receives _______ of cardiac output.

A

The kidney receives 20% of cardiac output.

87
Q

Obstruction and edema are causes of increased __________.

A

Obstruction and edema are causes of increased BSHP.

88
Q

__________ causes vasoconstriction, increased reabsorption of of water and decreased GFR

A

ADH (Vasopressin) causes vasoconstriction, increased reabsorption of of water and decreased GFR

89
Q

Animal can lose ______ of nephrons before increased [creatinine] in plasma.

A

Animal can lose 75% of nephrons before increased [creatinine] in plasma.

91
Q

Stored glycogen lasts for less than _________.

A

Stored glycogen lasts for less than 24 hours.

93
Q

___________: “Capillary Tuft”- Capillary bed in the nephron which is invested with a specialized basement membrane and surrounding space lined by viseral epithelium of podocytes and parietal epithelium that merges with proximal tubule.

A

Glomerulus:“Capillary Tuft”- Capillary bed in the nephron which is invested with a specialized basement membrane and surrounding space lined by viseral epithelium of podocytes and parietal epithelium that merges with proximal tubule.

94
Q

Increased PCOP = _____ GFR

A

Increased PCOP = decreased GFR

95
Q

There should always be _________ in the urine.

A

There should always be protein in the urine.

96
Q

Practitioners rely on __________ as the indicator of filtering ability of the kidney

A

Practitioners rely on [creatinine] as the indicator of filtering ability of the kidney

97
Q

Any substance that is freely filterable exists at the same concentration in _______ and in _________.

A

Any substance that is freely filterable exists at the same concentration in plasma and in bowmans space.

98
Q

Gluconeogenesis

A

Making glucose from a non-carbohydrate source

99
Q

Glomerular Filtration Rate = ____________

A

Glomerular Filtration Rate =

Kf (CHP + BSCOP) - (BSHP + PCOP)

Kf (Sum Filtration) - (Sum Reabsorption)

100
Q

Sympathetic nervous system ______ heart rate.

A

Sympathetic nervous system increases heart rate.

101
Q

Creatine ⇔ Creatine-P is catalyzed by ___________.

A

Creatine ⇔ Creatine-P is catalyzed by Creatine Kinase.

102
Q

Synthesis of creatine requires normal function of the _________ and ________.

A

Synthesis of creatine requires normal function of the liver and kidney.

102
Q

Methods of evaluating GFR

A
  1. [Creatinine] in plasma
  2. Inulin
  3. Iohexol
  4. SDMA (coming in 2015!)
104
Q

Renal Clearance = _______

A

Renal Clearance = GFR

105
Q

Single Nephron GFR

A

Loss of nephron may be masked to some extent by increased filtration at remaining nephrons

106
Q

Increased blood flow = _______ blood pressure

A

Increased blood flow = increased blood pressure

107
Q

_________ allows the kidney to fight sympathetic stimulation during times of decreased blood pressure.

A

Autoregulation allows the kidney to fight sympathetic stimulation during times of decreased blood pressure.

108
Q

________ increases significantly from afferent arteriole to efferent arteriole ends of the glomerular capillary.

A

PCOP increases significantly from afferent arteriole to efferent arteriole ends of the glomerular capillary.

109
Q

Increased BSHP = _______ GFR.

A

Increased BSHP = decreased GFR.

110
Q

GFR(mL/min) = ______________

A

GFR(mL/min) =

Urine Flow (mL/min) [X] Urine (mg/mL)

[X] plasma (mg/mL)

RUSVM Physiology II (7 decks)

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