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Small Animal Medicine > Renal - Physiology and Diagnostics > Flashcards

Renal - Physiology and Diagnostics Flashcards

1
Q

What is the functional subunit of the kidney?

A

The nephron

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2
Q

True or False: Nephron numbers increase over time.

A

False - they decrease over time; 10% drop in numbers every 10 years after the age of 40

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3
Q

What are the components of the nephron?

A

Glomerulus and tubules

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4
Q

What is the glomerulus?

A

a capillary bed

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5
Q

What is the glomerulus surrounded by?

A

Bowman’s capsule

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6
Q

What does the glomerulus produce?

A

ultrafiltrate

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7
Q

What surrounds the tubules of the nephron?

A

peritubular capillaries

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8
Q

What is the function of the tubules?

A

To transport and alter urine

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9
Q

Where is there high hydrostatic pressure in the nephron? What occurs here? Is it selective or non-selective?

A

In the globerulus, there is increased filtration and it is non-selective

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10
Q

Where is there low hydrostatic pressure in the nephron? What occurs here? Is this process selective or non-selective?

A

In the tubules, there is increased reabsorption and it is a selective process

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11
Q

What do the two different capillary systems allow for?

A

individual adjustments of filtration/reabsorption

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12
Q

What are the subsections of the tubule?

A

Proximal tubule, loop of henle, juxtaglomerular complex, distal tubule, connecting tubule, collecting tubule, and collecting duct

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13
Q

What is the volume and composition of urine dictated by?

A

Glomerular filtration rate, tubular reabsorption rate, and tubular secretion rate

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14
Q

What is the filtration fraction through the glomerulus?

A

20 percent

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15
Q

The ultra-filtrate that the glomerulus produces is almost identical to plasma except for what?

A

There is a lower protein content and a lower content of protein-bound molecules (calcium and FA)

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16
Q

What are the 3 layers of the glomerulus?

A

Fenestrated epithelium, basement mebrane, and podocytes (epithelial cells)

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17
Q

Decribe the fenestrated endothelium.

A

It is composed of large pores and is negatively charged

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18
Q

Describe the basement membrane of the glomerulus.

A

It is composed of a collagen/proteoglycan mesh and is negatively charged

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19
Q

Describe the podocytes of the glomerulus.

A

It is separated by slit pores and is negatively charged

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20
Q

What are the consequences for the ultrafiltrate?

A

Retention of larger, negatively charged molecules within the plasma

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21
Q

What can glomerular diseases cause (think about the ultrafiltrate)?

A

Urinary loss of larger proteins - albumin and antithrombin

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22
Q

What determines the glomerular filtration rate (GFR)?

A

Glomerular hydrostatic pressure, capsular hydrostatic pressure, glomerular oncotic pressure, and filtration coefficient

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23
Q

What mechanisms are involved in reapsorbtion/secretion in the tubules?

A

transporters and pinocytosis

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24
Q

What occurs in the proximal tubule?

A

reabsorption, pinocytosis, and secretion

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25
Q

What is reabsorbed in the proximal tubule?

A

65% of Na+ and water, and >98% glucose and amino acids

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26
Q

What molecules undergo pinocytosis in the proximal tubule?

A

larger molecules

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27
Q

What is secreted in the proximal tubules?

A

Oxalate, urate, catecholamines, and drugs such as penicillin

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28
Q

What inibitors works at the level of the proximal tubules?

A

Carbonic anhydrase inhibitors

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29
Q

Normally, the proximal tubules should reabsorb all glucose in the urine. What happens in the proximal tubules in diabetes mellitus patients?

A

They get overwhelmed by the amount of glucose in the urine and can only reabsorb so much (transport maximum is exceeded). This results in glucosuria

30
Q

What is Fanconi’s syndrome?

A

An inherited/acquired disease affecting fucntion of the proximal tubules

31
Q

What does Fanconi’s syndrome impair in the proximal tubules?

A

Reabsorption of proteins, glucose, aninoacids, and bicarbonate

32
Q

What disease can Fanconi’s syndrome progress to?

A

Chronic kidney disease

33
Q

What occurs in the thin descending and ascending portions of the Loop of Henle?

A

There is low metabolic activity - diffusion of urea, Na, and water occurs here

34
Q

What occurs in the thick ascending portion of the Loop of Henle?

A

25% of Na, Cl, K, Ca, Mg, and bicarbonate is reabsorbed

35
Q

What is the thick ascending portion of the Loop of Henle impermeable to?

A

water

36
Q

The Loop of Henle is the site of action of what?

A

Loop diuretics - furosemide

37
Q

What is reabsorbed in the early distal tubule?

A

5% of Na and Cl

38
Q

What is the early distal tubule impermeable to?

A

water

39
Q

The early distal tubule is the site of action of what?

A

Thiazide diuretics - Chlorothiazide

40
Q

What cells make up the late distal tubule?

A

Principle cells and intercalated cells

41
Q

What occurs in the principle cells of the late distal tubule?

A

Reabsorption of Na and secretion of K

42
Q

The principle cells of the late distal tubule are the site of action of what?

A

Anti-diuretic hormone, aldosterone, and spironolactone

43
Q

The principle cells in the late distal tubule are permeable to water only in the presence of what?

A

ADH

44
Q

What does aldosterone do?

A

Increase Na absorption and K secretion

45
Q

What occurs in the intercalated cells of the late distal tubule?

A

H secretion and bicarbonate absorption

46
Q

What is reabsorbed in the collecting duct?

A

<10% of Na and water

47
Q

What is secreted in the collecting duct?

A

Strong H secretion

48
Q

What massively increases permeability to water in the collecting duct?

A

ADH

49
Q

What is needed to form concentrated urine?

A

A concentration gradient between the interstitium and tubular lumen (Na and BUN) and antidiuretic hormone (and its receptors)

50
Q

What are the components of the concentration gradient that is needed to form concentrated urine?

A

Active Na, K, Cl transport in the thick ascending Henle
Active ion transport in the collecting ducts
Facilitated urea diffusion in the medullary collecting ducts
Limited water diffusion in the distal tubules

51
Q

What is ADH produced by? Released by?

A

It is produced by the hypothalamus and released by the posterior pituitary

52
Q

What triggers the release of ADH?

A

Increased plasma osmolality and decreased blood volume/blood pressure

53
Q

What is the effect of ADH?

A

Inceased vascular tone and water conservation

54
Q

What does high medullary osmolality allow for in regards to water?

A

osmotic pull

55
Q

Where is the juxtaglomerular apparatus located?

A

at the early distal tubule where it has contact with afferent and efferent arterioles

56
Q

What does the juxtaglomerular apparatus regulate?

A

Systemic blood pressure and glomerular filtration rate

57
Q

What are the two cell types of the juxtaglomerular apparatus?

A

Macula densa cells and juxtaglomerular (glanular) cells

58
Q

What occurs in the macula densa cells if GFR decreases due to decreased BP?

A

Na decreases in the distal tubules and signals the afferent arterioles to dilate

59
Q

What does dilation of afferent arterioles do?

A

Increases glomerular hydrostatic pressure and increases GFR

60
Q

Where are the juxtaglomerular cells located?

A

In the walls of the afferent and efferent arterioles

61
Q

What do juxtaglomerular cells secrete and in response to what?

A

They secrete renin in response to decreases in GFR

62
Q

When is the renin-angiotensin system activated?

A

When there is a drop in blood pressure and fluid volume

63
Q

When the RAAS is activated, what is released from the kidney? What does it do?

A

Renin is released to convert angiotensinogen (from the liver) into angiotensin I

64
Q

What converts angiotensin I into angiotensin II? Where is it released from?

A

ACE - released from the lings

65
Q

What does angiotensin II act on and what does it do?

A

It acts directly on the blood vessels stimulating vasoconstriction
It acts directly on the adrenal gland to stimulate release of aldosterone

66
Q

What does aldosterone do?

A

It acts on the kidneys to stimulate reabsorption of salt and water

67
Q

What vessels does Angiotensin II work on especially?

A

the efferent arterioles

68
Q

What is the end systemic result of the RAAS?

A

Maintenance of blood pressure and GFR

69
Q

What drugs interfere with the RAAS?

A

Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB)

70
Q

What are the possible side effects of RAAS inhibitors?

A

Decreased GFR and BP

Small Animal Medicine (100 decks)

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