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Pharmacology > Renal System > Flashcards

Renal System Flashcards

1
Q

What are the functions of the kidney?

A

Homeostatic regulation of H2O + ion content in blood
Excretion of metabolic waste products
Production of hormones

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2
Q

What is the overall structure of the kidney?

A 
Cortex (outer)
Medulla (inner)
Nephrons 
Cortical nephrons = cortex 
Juxtamedullary nephrons = medulla
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3
Q

Describe nephron structure

A 
Bowman's capsule 
Proximal tubule 
Loop of Henle
Distal tubule 
Collecting duct
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4
Q

What is the bowman’s capsule surrounded by?

A

Glomerulus

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5
Q

What happens at the bowman’s capsule?

A

Ultrafiltration

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6
Q

Describe blood flow around bowman’s capsule

A

Blood flows from afferent arteriole into glomerulus + leaves through efferent arteriole

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7
Q

What surrounds the arterioles?

A

Peritubular capillaries

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8
Q

What are the role of the renal capillaries?

A

Form venules = conduct blood out of the kidney

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9
Q

What is the function of renal portal system?

A

Filter blood + into lumen of nephron

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10
Q

Where are fluid reabsorbed?

A

From tubule back into blood at peritubular capillaries

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11
Q

What processes happen at the nephron?

A

Filtration
Excretion
Reabsorption
Secretion

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12
Q

What is filtration?

A

Movement of fluid from blood into lumen

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13
Q

What is excretion?

A

Anything filtered from renal capsule

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14
Q

What is reabsorption?

A

Movement of filtrate from lumen of tubule back into blood through peritubular capillaries

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15
Q

What is secretion?

A

Removes selected molecules from blood + adds them to filtrate in tubule lumen

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16
Q

How do you calculate the amount of urine?

A

(amount filtered) - (amount reabsorbed) + (amount secreted)

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17
Q

What are the two mechanisms in autoregulation of GFR?

A

Myogenic mechanism of regulation

Tubuloglomerular feedback

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18
Q

Describe myogenic mechanism of regulation

A

Afferent + efferent have smooth muscles
Contraction = blood pressure + = smooth muscle contracts = reduce diameter = oppose flow
Relaxation = bp - = relaxes = + diameter = facilitate flow

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19
Q

Describe tubuloglomerular feedback

A 
GFR +
Flow through tubule +
Paracrine factors released
Afferent constricts 
Resistance +
Hydrostatic pressure in glomerulus -
GFR -
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20
Q

What is clearance?

A

Vol of plasma from which a substance has been removed + excreted into urine per unit time

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21
Q

What is the equation for clearance?

A 
         Plasma Conc
22
Q

What is clearance used as an index for?

A

Kidney function

23
Q

Describe the structure of glomerulus

A

Capillary endothelium has pores
Basal lamina
Podocytes with long cytoplasmic extensions

24
Q

What is the significance of capillary endothelium in glomerulus?

A

Pore surface negatively charged = negatively charged proteins = repulse negatively charged proteins

25
Q

What is the significance of basal lamina in glomerulus?

A

Layer of extracellular matric that separates capillary + endothelium of Bowman’s capsule
Negatively charged = exclude plasma proteins from filtration

26
Q

What is the significance of podocytes in glomerulus?

A

Form narrow filtration slits

27
Q

Describe what happens in glomerulus

A

Proteins excluded from filtration based on charge + molecular weight
H2O, Na+, K+, Ca2+, glucose + urate = YES
Blood plasma = NO

28
Q

What happens in proximal tubule?

A

Glucose + amino acid reabsorption

= co-transport

29
Q

What is the descending limb?

A

H2O permeable

30
Q

What is the ascending limb?

A

H2O impermeable

31
Q

What happens in the descending limb?

A

Impermeable to NaCl = no active transport

= osmolarity + = reach max at loop

32
Q

What happens in ascending limb?

A

Reabsorbed NaCl passively
= active transport by NaK
= osmolarity - = min at top

33
Q

Describe what happens overall in Loop of Henle

A

Isosmotic fluid leave proximal tubule
= more concentrated as descends limb
Removal of solute in ascending limb
= hypoosmotic fluid
Permeability of H2O + solutes in DT + CD regulated by hormones
Final urine osmolarity depends on reabsorption in CD

34
Q

Describe the transport of solutes out of Loop of Henle

A

Transport out of ascending limb dilutes filtrate + helps concentrate interstitial fluid in medulla
BUT H2O leaving descending limb DOESNT do this

35
Q

Describe the transport of solutes into Loop of Henle

A

Solute reabsorbed by ascending limb moves into descending limb of vasa recta
= + blood osmolarity
H2O reabsorbed by descending limb moves into ascending limb of vasa recta
= - blood osmolarity

36
Q

Describe what happens in the initial segment of DT

A

NaCl reabsorbed by Na+/Cl- co-transporter
H2O impermeable
Osmolarity falls further

37
Q

Describe what happens in last segment of DT + CD

A

Principle cells recover more than Na+ + H2O via channels
α- intercalated cells reabsorb K+ + secrete H+
Through K+/H+ transporter
Reabsorbs HCO3-
= regulate pH
β- intercalated cells = secrete HCO3- + reabsorb Cl-
Through Cl-/HCO3-

38
Q

What is the last segment of DT + CD composed of?

A

Principle cells + intercalated cells

39
Q

What are the processes that form urine?

A

Filtration
Reabsorption
Secretion

40
Q

What does Na+ balance + blood pressure do?

A

Increase osmolarity

41
Q

What is vasopressin?

A

Anti-diuretic hormone (ADH)

42
Q

What does vasopressin do?

A

Stimulate H2O recovery via aquaporin at CD

= concentrates urine

43
Q

What does aldosterone do?

A

Control Na+ balance

44
Q

How does aldosterone control Na+ balance?

Physiological modulation

A

Physiological modulation = + extracellular K+ + - BP = stimulates aldosterone secretion by adrenal cortex

45
Q

How does aldosterone control Na+ balance?

Pathological modulation

A

+ in ECF osmolarity = inhibit aldosterone release from adrenal cortex = abnormal - in Na+ = stimulate aldosterone secretion

46
Q

What happens when there is an increase in Na+?

A

+ BP = Na+ retention increases osmolarity = + thirst

= drinking + ECF, blood vol + = BP +

47
Q

What happens aldosterone acts on principle cells in DT + CD?

A

More Na+ reabsorbed due to insertion of more ENaC on membrane
= urine dilutes

48
Q

Why does a decrease in blood pressure increase H2O retention?

A

ANG II activates release of aldosterone
= BUT high osmolarity = blood aldosterone = - reabsorption of Na+
= BUT high osmolarity = release vasopressin = + reabsorption of H2O
= + BP + H2O retention = - osmolarity

49
Q

What are diuretic drugs used for?

A

High blood pressure

50
Q

What do loop acting diuretics do?

A

Inhibit transport system in ascending limb

51
Q

What do thiazide diuretics do?

A

Inhibit transport system in DT

52
Q

What do K+ sparing diuretics do?

A

Inhibit ENaC in CD

Block effects of aldosterone on channels

Pharmacology (40 decks)

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