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Mini 3 Physio, Anatomy, etc. > Renal Physiology > Flashcards

Renal Physiology Flashcards

1
Q

Hypertonic Expansion

A

Hypertonic NaCl

NaCl tablets - no liquid involved

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2
Q

Isotonic Expansion

A

Isotonic Saline

Lactated Ringers Solution

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3
Q

Hypotonic Contraction

A 
Chronic sweating (NaCl depletion)
Adrenocortical Insufficiency (no NaCl retention)
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4
Q

Hypertonic Contraction

A

Sweating without fluid replacement

Diabetes Insipidus

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5
Q

Isotonic Contraction

A

Diarrhea

Hemorrhage (whole blood loss)

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6
Q 
ECF 14L
ICF 28L
TBW 42L
IF 10.5L
Plasma 3.5L

20-40-60 rule

A 
20% body weight 1/3 TBW
40% body weight 2/3 TBW
60% body weight (kg)
3/4 ECF
Plasma 1/4 ECF
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7
Q

Juxtaglomerular apparatus consist of

A

Macula densa - thick LOH meets DCT
Juxtaglomerular/granular cells - secrete renin
Extraglomerular mesangial cells - smooth muscle involved in blood flow via sym system

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8
Q

Filtration Fraction

A

GFR/RPF normally 20%

Constrict AA = smaller GFR & RPF same FF

Constrict EA = greater GFR, large FF

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9
Q

GFR

A

Kf x Pf

Controlled by BP and AA, EA resistance

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10
Q

Myogenic response

A

Fast

Increase MAP, greater Na+ influx -> Ca2+ -> SM contracts

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11
Q

Tubuloglomerular Feedback

A

Up to one minute

Increase MAP = increase GFR and Na & Cl to macula densa, increase in ATP & adenosine release via mesangial cells -> calcium increase -> vasoconstriction of AA (inhibit renin release via juxtagl. Cells) to decrease GFR

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12
Q

Function of ANP and BNP

A

Decrease Na reabsorption (CT)

Released during high blood volume, reduces blood pressure

ANP - (Atrium stretched)
BNP - (ventricle stretched - natriuretic peptide)

Both cause vascular relaxation of intraglomerular mesangial cells and AA and constriction of EA

Inhibit Renin release, inhibit ADH, inhibit aldosterone,

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13
Q

Inulin clearance

A

E=F

C inulin = GFR

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14
Q

Creatinine Clearance

A

E = F + S

All filtered, Never re absorbed

C creat = GFR

GFR inversely proportional to [serum]

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15
Q

PAH Clearance

A

Freely filtered, complete clearance

C pah = RPF = CV/P

True RPF = C pah/0.9

(90% truly cleared) - 5 vasa recta, 5 fat

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16
Q

Glucose Clearance

A

Completely reabsorbed

E = F-R = 0

17
Q

Loop diuretics

A

Inhibit Na/K/Cl symporter in Thick ALOH

18
Q

K Sparing Diuretics

A

Block Na+ or Aldosterone receptor to indirectly inhibit K+ secretion and excretion in the CT

19
Q

Principle cells controlled by

A

Hormone aldosterone (Na+ reabsorption)

20
Q

Na+ excretion depends on

A

Effective circulating volume (ECV), not [Na plasma]

21
Q

Renin release stimulated by:

A

Less AA stretch (low BP)
Less Na+/Cl delivery to macula densa
Sympathetic system
Decreased ANP/BNP

22
Q

Angiotensin II effects

A

Vasoconstriction of peripheral vessels (increase BP)
Thirst and salt intake desire
ADH secretion via anterior pituitary
Aldosterone release
Increase Na/K anti porter in PCT & TAL
Contracts AA & EA
Contract intraglomerular mensangial cells to decrease GFR

23
Q

Actions of Aldosterone

A

Increase Na reab. (Via principle cells luminal channels = Na, activates basolateral=Na/K)

Increase K secretion (via principle cells, luminal K channels)

Stimulate H ATPase of alpha-intercalated cells

24
Q

Sympathetic effects on Na+ Reab.

A

Renin release = Beta-1 receptor

AA & EA vasoconstriction via alpha-1

Na reab. At PCT via alpha-1

25
Q

Conn’s Syndrone

A

Hyperaldosterone = hypertension

Increased Na reabsorption at CT
Increased K secretion = hypokalemia
Increased H ATPase activity (increased H secretion, HCO reab.) = metabolic alkalosis

26
Q

Water diuresis

A

Increase in urine excretion caused by absence of ADH = hypotonic urine

27
Q

Anti diuresis

A

High ADH levels causing high water reabsorption In CT causing hypertonic urine

28
Q

What stimulates H+ secretion

A

Increased PCO2

Decreased pH

Increased Aldosterone

Increased Angiotensin II (which acts on Na/H on luminal side)

K+ wasting diuretics

29
Q

K+ Sparing Diuretics act on

A

Blocks Principle cell Na+ channels - making lumen more positive therefore excreting H+

Blocks aldosterone receptors

30
Q

Problems with respiratory acidosis

A

Sleep apnea

opiates

31
Q

Problems with respiratory alkalosis

A

Respiratory diseases

Pneumonia

32
Q

Problems associated with metabolic acidosis

A

Diarrhea
Lactic acidosis
Ketoacidosis

33
Q

Problems associated with metabolic alkalosis

A 
Antacid ingestion
Low vascular volume
High aldosterone
Vomiting
Loop/thiazide diuretics
34
Q

Intracellular buffers and extracellular buffers

A

Intra - proteins

Extra - phosphate and bicarbonate

35
Q

Anion Gap

A

(Na+) - ( HCO - Cl )

Cations - Anions

9-14 normal

36
Q

Renal response pH equation

A

pH = 6.1 + log [HCO]/[CO2]

37
Q

Hypotonic expansion

A
  1. H2o
  2. D5W
  3. SIADH

Mini 3 Physio, Anatomy, etc. (7 decks)

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