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Renal II Cumulative Final > Renal Physiology Review > Flashcards

Renal Physiology Review Flashcards

1
Q

Fluid components highest in ECF

A

Na+
Cl-
HCO3-
Ca2+ (slightly)

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2
Q

Fluid components highest in ICF

A

K+
Organic anions
Protein
Mg2+

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3
Q

Protein levels are highest in the ____ and ____ compartments; membranes are impermeable to proteins so they don’t normally impact osmolarity but do exert _______ pressure

A

ICF; vascular; oncotic

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4
Q

Indicators used to measure TBW, ECF, and Plasma Volume

A

TBW = 3H2O, 2H2O, antipyrine

ECF = 22Na, 125-iothalamate, thiosulfate, INULIN

Plasma volume = 125I-albumin, Evans blue dye [albumin can be used because it should not cross PMs]

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5
Q

ICF and ISF are not measured directly. How are they calculated?

A

ICF = TBW - ECF

ISF = ECF - plasma

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6
Q

ECF osmolality is driven (primarily) by ___ and ____

ICF osmolality is primarily driven by _____

A

Na+; Cl-

K+

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7
Q

ICF, ECF, and osmolality changes with diarrhea, vomiting, or hemorrhage

A

ECF volume: decreases

ICF volume: no change

Osmolality: no change

[isosmotic volume contraction]

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8
Q

ICF, ECF, and osmolality changes with dehydration

A

Depends on the cause!

Isosmotic dehydration caused by hemorrhage, burns, vomiting, diarrhea, hemorrhage — ECF decreases, no change in ICF or osmolality

Hyperosmotic dehydration caused by decreased fluid intake, diabetes insipidus, diabetes mellitus, fever — ECF decreases, ICF decreases, osmolality increases

Hyposmotic dehydration caused by adrenal insufficiency (e.g., Addison’s disease) — ECF decreases, ICF increases, ECF osmolarity decreases

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9
Q

ICF, ECF, and ECF osmolarity changes with diabetes insipidus

A

ECF volume: decreases

ICF volume: decreases

ECF osmolarity: increases

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10
Q

ICF, ECF, and ECF osmolarity changes with hypoaldosteronism

A

ECF volume: decreases

ICF volume: increases

ECF osmolarity: decreases

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11
Q

ICF, ECF, and osmolality changes with diabetes mellitus

A

ECF volume decreases

ICF volume decreases

ECF osmolarity increases

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12
Q

ICF, ECF, and ECF osmolarity changes with SIADH

A

ECF volume: increases

ICF volume: increases

ECF osmolarity: decreases

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13
Q

What happens to RBCs placed in isotonic, hypotonic, and hypertonic solutions?

A

RBC in isotonic = no change

RBC in hypotonic = cell swells

RBC in hypertonic = cell shrinks

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14
Q

Acute and chronic changes in renal blood flow and GFR caused by increased angiotensin II synthesis

A

RBF decreases

GFR increases

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15
Q

Acute and chronic changes in renal blood flow and GFR caused by increased release of ANP

A

RBF: increases
GFR: increases

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16
Q

Acute and chronic changes in renal blood flow and GFR caused by decreased prostaglandin formation

A

RBF: decreases
GFR: no change/decreases?

17
Q

Effect of sympathetic stimulation on RBF, GFR, renin secretion, and proximal tubular Na+ reabsorption

A

RBF: decreases
GFR: decreases

Renin secretion: increases

Proximal tubular Na+ reabsorption: increases [less is excreted]

18
Q

List factors that regulate secretion of aldosterone

A 
Renin
Angiotensin II (increases aldosterone secretion)
19
Q

Physiological effects of RAAS [actions of aldosterone]

A

Increases Na+ reabsorption
Increases K+ secretion
Increases H+ secretion

20
Q

Effects of sympathetic nerves on regulation of Na+ reabsorption along the nephron

A

Sympathetics nerve stimulation —> increased NaCl reabsorption at PT, TAL, and DT/CD [PT most important site of action]

21
Q

Alterations in Na+ reabsorption with hypovolemia

A

Integrated response to decreased ECV:

GFR decreases —> increased Na+ reabsorption by proximal tubule, loop of henle, distal tubule, and collecting duct

Water reabsorption is enhanced

22
Q

Alterations in Na+ reabsorption with hypervolemia

A

Integrated response involves:

Increase in GFR —> decreased reabsorption of Na in proximal tubule, loop of henle, distal tubule, and collecting duct

Water excretion follows

23
Q

Effect of angiotensin II on regulation of Na+ reabsorption along the nephron

A

Angiotensin II —> increased NaCl reabsorption at PT, TAL, DT/CD

24
Q

Effect of aldosterone on regulation of Na+ reabsorption along the nephron

A

Aldosterone —> increased NaCl reabsorption at TAL, DT/CD

25
Q

Effect of ANP on regulation of Na+ reabsorption along the nephron

A

ANP —> decreased NaCl reabsorption at CD

26
Q

What change in fluid balance would you expect if you ate a high NaCl diet for 2 weeks?

A

ECF/Interstitial fluid volume increases

[same effect as hyperaldosteronism aka Conn’s dz]

27
Q

A decrease in the GFR, RBF, and peritubular capillary hydrostatic pressure indicates constriction of the afferent arteriole. If there was also a rise in oncotic pressure in the peritubular capillary, it is an indication that the filtration fraction has increased. What does this mean for constriction vs. dilation of the efferent arteriole?

A

The efferent arteriole is constricted [plasma flow dropped more than the GFR indicating the efferent arteriole also vasoconstricted]

28
Q

With diabetes insipidus, there is ______ free water clearance and excretion of _____ is elevated

A

Positive [dilute urine]; potassium [d/t elevated aldosterone]

29
Q

Changes in sympathetic tone, plasma angiotensin II levels, ANP levels, and plasma oncotic pressure as a result of dehydration d/t severe diarrhea

A

Sympathetic tone increases

Plasma angiotensin II levels increases

ANP levels decreases

Plasma oncotic pressure increases

30
Q

Changes in aldosterone, ANP/BNP, angiotensin II, and ADH levels with CHF

A

Aldosterone levels increase

ANP-BNP levels increase

Angiotensin II levels increase

ADH levels increase

31
Q

What changes in TBW, ECF osmolarity, ECF volume, ICF osmolarity, and ICF volume would take place if a dehydrated individual replaced all their fluids with pure electrolyte-free water?

A 
TBW: no change
ECF osmolarity decreases
ECF volume decrease
ICF osmolarity decrease
ICF volume increase

Renal II Cumulative Final (20 decks)

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