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SF3- EXAM 3 (Camelita) > Renal Structure and Function > Flashcards

Renal Structure and Function Flashcards

1
Q

Which metabolic waste products are excreted by the kidneys?

A
  • Urea
  • Uric acid
  • Creatinine
  • Bilirubin
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2
Q

How is urea produced?

A

Proteins -> Amino acids-> NH2 removed-> forms ammonia-> liver convert ammonia to urea

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3
Q

Uric acid is produced from _________ catabolism.

A

Nucleic acid

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4
Q

Creatinine is produced from _______ catabolism.

A

Creatine phosphate

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5
Q

Azotemia

A

Nitrogenous wastes in blood

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6
Q

Uremia

A

Toxic effects as wastes accumulate

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7
Q

There are two types of bilirubin. What are they and where are they located?

A
  • Unconjugated (indirect) bilirubin
    • ​Created from rbc breakdown
    • Travels in the blood to the liver
  • ​Conjugated (direct) bilirubin
    • ​Bilirubin once it reaches the liver
    • Undergoes a chemical change
    • Moves to the intestines before being removed through your stool
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8
Q

Normal total bilirubin

A
  • Under 18: 1 mg/dl
  • Over 18: 1.2 mg/dl
  • In urine: <1 mg/dl

NOTE: Normal results for conjugated bilirubin should be less thab 0.3 mg/dl

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9
Q

Normal serum creatinine concentrate

A

0.6 to 1.2 mg/dL

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10
Q

Normal BUN concentration

A

8 to 25 mg/dL

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11
Q

BUN to creatinine ratio is elevated in ____________.

A

Preranal acute kidney injury

NOTE: An elevated level would be a ratio greater than 20:1

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12
Q

Pre-Renal vs. Post-renal acute kidney injury

A
  • Pre-Renal
    • ​Inadequate Perfusion
      • ​Not enough blood at sufficient pressure to allow filtering
  • Renal
    • ​Cellular Damage/Intristic
      • ​Damage to the cells that make filtering mechanism possible
  • Post- Renal​
    • ​Obstruction
      • ​Urine unable to drain adequately-system “backed up”
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13
Q

Which chemicals are excreted from the kidneys?

A
  • Pesticides
  • Food additives
  • Toxins
  • Drugs
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14
Q

What hormones are produced in the kidney?

A
  • Renal erythropoetic factor
  • 1,25 dihydroxycholecalciferol (Vitamin D)
  • Renin
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15
Q

What hormones are metabolized and excreted by the kidney?

A
  • Most peptide hormones

Examples: Insulin, angiotensin II, etc.

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16
Q

How do the kidneys regulate erythrocyte production?

A
  1. Decreased O2 delivery to kidney
  2. Increased erythropoetin
  3. Increased erythrocyte production in kindeys
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17
Q

The kidneys produce the ___ (active/inactive) form of vitamin D.

A

Active

*1,25 dihydroxy vittamin D3

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18
Q

Vitam D3 is important in ___ and _____ metabolism.

A

Phospahate; calcium

19
Q

How do kidneys regulate acid- base balance?

A
  • Excrete acids
  • Regulate body fluid buffers

NOTE: KIdneys are the only means of excreting non-volatile acids

20
Q

Kidneys role in gluconeogenesis

A

Kidneys synthesize glucose from precursors during prolonged fasting

21
Q

How do kidneys regulate arterial pressure?

A

Endocrine organ

  • ​Renin-angiotensin system
  • Prostoglandins
  • Kallikrein-kinin system

Control of extracellular fluid volume

22
Q

Nephron Tubular Segments

23
Q

Function of proximal convoluted tubule

A

Reabsorption of water, ions, and all organic nutrients

24
Q

Function of distal convoluted tubule

A

Secretion of ions, acids, drugs, toxins

NOTE: Distal convoluted tubules also have reabsorption ability of water, sodium ions, and calcium ions, under hormonal control

25
Q

Function of collecting duct

A

Variable reabsorption of water and reabsorption or secretion of sodium, potassium, hydrogen, and bicarbonate ions

26
Q

Function of renal corpuscle

A

Production of filtrate

27
Q

Function of Loop of Henle

A
  • Further reabsorption of water (descending limb) and both sodium and chloride (ascending limb)
28
Q

Function of papillary duct

A

Delivery of urine to minor calyx

29
Q

What are the basic mechanisms of urine formation?

A
  1. Filtration
  2. Reabsorption
  3. Secretion
  4. Excretion
30
Q

Distinguish between the variability and selectivity of filtration, reabsorption, and secretion.

A

Filtration

  • Somewhat variable
  • Not selective

Reabsorption

  • Highly variable
  • Selective

Secretion

  • Highly variable
31
Q

Renal Handling of Different Substances

32
Q

Renal Handling of Water and Solutes

A

NOTE: Glomerular filtration rate decreases with age, which can lead to varies stages of kidney disease

33
Q

What affect can NSAIDs have on glomerular filtration rate?

A

Decrease

  • NSAIDs block the protective prostaglandin effect. GFR is not maintained. Acute kidney injury can ensue

NOTE: In the absence of NSAIDs, in the setting of decreased effective circulating volume, the afferent arterioles vasodilate via prostaglandin whileefferent arterioles vasoconstrict. GFR is maintained

34
Q

__________ are the primary regulators of the extracellular fluid volume.

35
Q

How do the kidneys control blood pressure?

A

By increasing the ECF

NOTE: Kidneys maintain blood plessure by keeping fluid balance and metabolite balance

36
Q

Createnine is used to measure__________.

A

Glomerular filtration rate

37
Q

What factors to can lead to a decrease in perfusion?

A
  • Decrease in blood pressure
  • Increase in resistance for efferent arteriole
38
Q

What are the major stimuli for the renin-angiotensin system?

A
  • Low blood pressure
  • Decrease in salt
  • Hyperkalemia
39
Q

Mechanism by which low salt leads to an increased production of aldosterone

A
  1. Low salt stimulates renin
  2. Renin produces angiotensin I
  3. That is converted to angiotensin II
  4. Angiotensin II stimulates the adrenal cortex to release aldosterone
  5. Aldosterone acts of Na-K- ATPase that is on the basal lateral membrane to promote sodium reabsorption and potassium secretion
40
Q

The cortex contains ______ of the blood supply in the kidney.

41
Q

Outside of the colelcting duct is the _______, which serves as a reservoir for the filtration to travel into the pelvis and then into the ureters.

A

Minor calyx

42
Q

What the two capillary beds of the kidneys and what takes place in each?

A
  • Glomeruli capillary
    • ​Where filtration takes place
  • Peritubular capillary
    • ​Where reabsorption and secretion occurs

NOTE: The afferent arteriole brings blood into glomeruli capillary where it is filtered. The remaining blood from the glomerular capillary and goes back to efferent arteriole and back to circulation

43
Q

Tubular glomerular feedback mechanism

A

States that the filtrate that travels in the proximal tubule, and loop of henle goes across the macula densa cells. These cells sense sodium concentration and flow rate.

44
Q

Is the proximal tubule considered hypo-osmotic, hyper-osmotic, or iso-osmotic?

A

Iso-osmotic

*This means that reabsorbing water and electrolytes in similar concentration and the reabsorption of filtrate has the same osmolarity as the plasma

SF3- EXAM 3 (Camelita) (23 decks)

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