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Phys Facts > Renal System > Flashcards

Renal System Flashcards

1
Q

The kidneys represent approximately ____ of the total body ATP consumption.

A

1/6

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2
Q

The kidneys filter about _____ liters of plasma per day.

A

180 liters

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3
Q

The filtration rate of the kidneys is approximately __________ at a blood pressure of 70 mmHg.

A

125 ml/min

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4
Q

The ______________ of the male urethra is under voluntary control and has extensive cholinergic innervation.

A

primary sphincter

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5
Q

The male urethra is approximately ___ cm long.

A

20 cm

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6
Q

The female urethra is approximately ___ cm long.

A

4 cm

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7
Q

The ____________ center in the brain controls the process of urination.

A

pontine micturition

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8
Q

Pelvic floor muscles are arranged in ______ around the urethra, rectum, and vagina.

A

slings

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9
Q

The functional unit of the kidney is the _______.

A

nephron

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10
Q

The nephron is responsible for ________ and _________ processes in the kidney.

A

filtration, transport

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11
Q

The __________ is the site of filtration in the nephron

A

glomerulus

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12
Q

The _______ is responsible for transport processes in the nephron.

A

tubule

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13
Q

The ___________ osmotic concentration gradient ranges from 300 to 1400 mOsm/L.

A

medullary

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14
Q

The ____________ (RPF) is approximately 605 ml/min.

A

renal plasma flow

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15
Q

The filtration fraction is calculated by dividing the _____ by the _____.

A

GFR, RPF

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16
Q

To measure GFR, a substance must be __________(five things).

A

freely filtered, not reabsorbed, not secreted, not synthesized by the tubule, not broken down by the tubule

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17
Q

The mass of a solute equals the product of the solute concentration and the solvent ________.

A

volume

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18
Q

______ is a substance that can be used to measure GFR because it meets all five criteria for a substance used to measure GFR.

A

Inulin

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19
Q

__________ can be used to estimate GFR.

A

Creatinine

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20
Q

Creatinine overestimates GFR by approximately ____% because it is secreted by the tubules.

A

10%

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21
Q

The renal clearance of a substance is the _____________ from which that substance is completely cleared by the kidneys per unit time.

A

volume of plasma

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22
Q

The normal renal clearance of glucose is _____ ml/min.

A

0 ml/min, because glucose is completely reabsorbed in the tubules.

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23
Q

The organic anion _______________ is secreted by the proximal tubule cells and can be used to measure effective renal plasma flow (ERPF).

A

para-aminohippurate (PAH)

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24
Q

Effective renal blood flow (ERBF) can be determined by dividing ______ by (____________).

A

ERPF, 1-hematocrit

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25
Q

___________ is the volume of blood plasma that is cleared of solute-free water per unit time.

A

Free water clearance

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26
Q

Free water clearance can be used as an indicator of how the body is regulating _______.

A

water

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27
Q

The glomerulus has three filtration barriers: _______, _______, and ________.

A

fenestrated endothelial cells, basal lamina, slit membranes

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28
Q

Fenestrated endothelial cells in the glomerulus are _______, allowing for a high filtration rate.

A

leaky

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29
Q

The basal lamina in the glomerulus acts as an initial sieve and is _________ charged.

A

negatively

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30
Q

Slit membranes in the glomerulus are located between ________ foot processes and act as sieves to restrict the passage of molecules larger than ___ nm in diameter.

A

podocyte, 5 nm

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31
Q

The _______________ is a specialized structure in the nephron that is involved in the regulation of GFR.

A

juxtaglomerular apparatus

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32
Q

The juxtaglomerular apparatus consists of __________ epithelial cells and ___________ cells.

A

macula densa, juxtaglomerular

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33
Q

________ is a mechanism that helps regulate GFR by sensing changes in fluid flow through the proximal tubule and loop of Henle.

A

Tubular glomerular feedback (TGF)

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34
Q

Factors that decrease TGF sensitivity include _________, ________, _________, and ________.

A

atrial natriuretic peptide, nitric oxide, cAMP, PGI2.

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35
Q

Factors that increase TGF sensitivity include ________, ________, ________, ________, and ________.

A

adenosine, thromboxane, 5-HETE, angiotensin II, prostaglandin E2

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36
Q

Renal autoregulation helps maintain a stable GFR despite changes in ___________.

A

blood pressure

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37
Q

Intrinsic control mechanisms of GFR include __________ response and ____________ feedback.

A

myogenic response, tubuloglomerular feedback

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38
Q

Extrinsic control mechanisms of GFR include __________, __________, and _________.

A

intrarenal baroreceptors, hormones, the sympathetic nervous system

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39
Q

___________ act as vasodilators in the kidney, increasing GFR.

A

Prostaglandins

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40
Q

__________ acts as a vasoconstrictor in the kidney, decreasing GFR.

A

Angiotensin II

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41
Q

__________ increases blood pressure and acts as a vasoconstrictor in the kidney, decreasing GFR.

A

Norepinephrine

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42
Q

____ acts as a vasodilator on the afferent arteriole and a vasoconstrictor on the efferent arteriole, increasing GFR.

A

ANP (atrial natriuretic peptide)

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43
Q

________(medication) cause afferent vasoconstriction, decreasing GFR.

A

NSAIDs

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44
Q

__________(medication) decrease efferent vasoconstriction, increasing GFR.

A

ACE inhibitors

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45
Q

The glomerular filtration rate (GFR) can be calculated using the formula: _________.

A

GFR = CI = (UI * V) / PI; where CI is the clearance of inulin, UI is the urine concentration of inulin, V is the urine flow rate, and PI is the plasma concentration of inulin.

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46
Q

The ______________ is the difference between the hydrostatic and oncotic pressures across the glomerular capillary wall, which drives filtration.

A

net filtration pressure (NFP)

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47
Q

The rate of filtration is determined by the product of the _________, ___________, and __________.

A

hydraulic permeability, surface area, net filtration pressure

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48
Q

The filtration coefficient (Kf) represents the mean filtration coefficient in _______________.

A

glomerular capillaries

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49
Q

The _________ capillaries reabsorb fluid and solutes from the renal tubules.

A

peritubular

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50
Q

The ____________ is responsible for the recovery of the filtered load and is the major site of solute secretion.

A

proximal tubule

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51
Q

The _____________ is responsible for ion reabsorption and some water reabsorption.

A

loop of Henle

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52
Q

Beyond the loop of Henle, the _________ segments are responsible for fine-tuning the final amounts of substances excreted.

A

nephron

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53
Q

True or False: The thick ascending limb of the loop of Henle is not water permeable.

A

True

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54
Q

The countercurrent multiplier system is responsible for producing and maintaining the medullary __________ concentration gradient.

A

osmotic

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55
Q

Organic nutrients that are reabsorbed in the _____________ include glucose, amino acids, acetate, Krebs cycle intermediates, water-soluble vitamins, lactate, acetoacetate, and b-hydroxybutyrate.

A

proximal tubule

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56
Q

Organic nutrient reabsorption in the proximal tubule occurs via ___________, usually coupled with sodium.

A

active transport

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57
Q

Organic nutrient transporters exhibit ___________, meaning that there is a maximum rate at which they can transport substances.

A

saturation

58
Q

True or False: Organic nutrient transporters are specific, meaning that they only transport certain substances.

A

True

59
Q

True or False: Organic nutrient reabsorption can be inhibited by drugs or disease states.

A

True

60
Q

Approximately _____ g/day of protein is filtered, while normally only ______ mg/day is excreted.

A

1.8 g/day, 100 mg/day

61
Q

Protein reabsorption occurs via _________ and is easily saturated.

A

endocytosis

62
Q

Reabsorbed proteins are ___________ within the proximal tubule cells.

A

metabolized

63
Q

Small proteins are reabsorbed via ___________.

A

endocytosis

64
Q

Oligopeptides are reabsorbed via _______ or ________ coupled uptake.

A

sodium, proton

65
Q

Glucose reabsorption in the proximal tubule occurs via _____________.

A

sodium-glucose cotransporters (SGLTs)

66
Q

SGLT2 is located in the early proximal tubule and has a low ________ for glucose but a high capacity.

A

affinity

67
Q

________ is located in the late proximal tubule and has a high affinity for glucose but a low capacity.

A

SGLT1

68
Q

True or False: Glucose reabsorption is a passive process.

A

False

69
Q

The transport maximum (Tm) for glucose is the _________ rate at which glucose can be reabsorbed.

A

maximum

70
Q

______ refers to the appearance of glucose in the urine before the Tm is reached, due to variations in the affinity and capacity of SGLTs.

A

Splay

71
Q

When plasma glucose concentration exceeds the Tm, glucose appears in the _____.

A

urine

72
Q

Organic anions and cations are secreted into the ____________.

A

proximal tubule

73
Q

Organic anion secretion is mediated by __________________.

A

organic anion transporters (OATs)

74
Q

Organic cation secretion is mediated by ________________.

A

organic cation transporters (OCTs)

75
Q

Organic anion and cation secretion is important for the ___________ of drugs, toxins, and metabolites.

A

elimination

76
Q

The ____ of the tubular fluid can affect the excretion of weak acids and bases.

A

pH

77
Q

___________ can reduce the clearance of memantine, leading to drug accumulation and potential adverse effects.

A

Alkaline urine

78
Q

For a weak acid, the _______ form is more lipid-soluble and therefore more readily reabsorbed.

A

acidic

79
Q

For a weak base, the _______ form is more lipid-soluble and therefore more readily reabsorbed.

A

basic

80
Q

Water reabsorption is primarily driven by _______, following the movement of solutes.

A

osmosis

81
Q

True or False: The water permeability of different nephron segments varies.

A

True

82
Q

The proximal tubule is _______ water permeable.

A

highly

83
Q

True or False: The thick ascending limb of the loop of Henle is water permeable.

A

False, it is not water permeable

84
Q

The _____________ has variable water permeability, regulated by antidiuretic hormone (ADH).

A

collecting duct

85
Q

The loop of ________ plays a crucial role in establishing the medullary osmotic concentration gradient.

A

Henle

86
Q

The ____________ actively transports sodium, potassium, and chloride ions out of the tubular fluid, creating a hyperosmotic medullary interstitium.

A

thick ascending limb (TAL)

87
Q

The _______ is impermeable to water, preventing water from following the reabsorbed solutes.

A

TAL

88
Q

The ___________ limb is permeable to water, allowing water to move out of the tubular fluid into the hyperosmotic medullary interstitium.

A

descending

89
Q

The ___________, a specialized capillary network surrounding the loop of Henle, acts as a countercurrent exchanger, maintaining the medullary osmotic gradient.

A

vasa recta

90
Q

______ recycling also contributes to the medullary osmotic gradient.

A

Urea

91
Q

True or False: Sodium reabsorption is a major function of the nephron.

A

True

92
Q

In the proximal tubule, sodium is reabsorbed primarily via _______________, such as SGLTs and Na+/H+ exchangers.

A

sodium-coupled transporters

93
Q

In the TAL, sodium is reabsorbed via the ________ transporter.

A

NKCC2

94
Q

In the distal convoluted tubule and collecting duct, sodium reabsorption is regulated by ____________.

A

aldosterone

95
Q

Sodium reabsorption occurs throughout the nephron, with approximately ____% reabsorbed in the proximal tubule, _____% in the loop of Henle, ____% in the distal tubule, and ____% in the collecting duct.

A

67%, 25%, 5%, 3%

96
Q

The primary monitored variable for tubular regulation of sodium is ____________.

A

blood pressure

97
Q

__________ is a hormone that plays a key role in regulating sodium reabsorption in the distal tubule and collecting duct.

A

Aldosterone

98
Q

__________ is a hormone that stimulates aldosterone secretion and also has direct effects on sodium reabsorption.

A

Angiotensin II

99
Q

___________ is a hormone that opposes the actions of aldosterone and angiotensin II, promoting sodium excretion.

A

Atrial natriuretic peptide (ANP)

100
Q

The ___________________ is a hormonal cascade that is activated in response to decreased blood pressure or decreased sodium delivery to the distal tubule.

A

renin-angiotensin-aldosterone system (RAAS)

101
Q

_______ is an enzyme that is released from the juxtaglomerular cells of the kidney in response to various stimuli, including decreased blood pressure, decreased sodium delivery to the distal tubule, and sympathetic nervous system activation.

A

Renin

102
Q

Renin converts _________ to _________.

A

angiotensinogen, angiotensin I

103
Q

Angiotensin I is then converted to angiotensin II by __________________, which is primarily found in the lungs.

A

angiotensin-converting enzyme (ACE)

104
Q

The ______________ transporter is located in the thick ascending limb of the loop of Henle and is responsible for reabsorbing approximately 25% of the filtered sodium load.

A

sodium-potassium-chloride cotransporter (NKCC2)

105
Q

_________, such as furosemide, inhibit NKCC2, leading to increased sodium excretion.

A

Loop diuretics

106
Q

The ___________ channel is located in the distal tubule and collecting duct and is responsible for reabsorbing approximately 3% of the filtered sodium load.

A

epithelial sodium channel (ENaC)

107
Q

_________ is a potassium-sparing diuretic that inhibits ENaC.

A

Amiloride

108
Q

The _______________ (NCC) is located in the distal convoluted tubule and is responsible for reabsorbing approximately 5% of the filtered sodium load.

A

sodium-chloride cotransporter

109
Q

The ___________ located in the carotid sinuses, aortic arch, and cardiac atria sense changes in blood pressure.

A

baroreceptors

110
Q

AVP stands for ____________; it’s another name for anti-diuretic hormone (ADH).

A

arginine vasopressin

111
Q

When blood pressure decreases, the baroreceptors signal the ______________ to increase heart rate and constrict blood vessels, which helps to increase blood pressure.

A

sympathetic nervous system

112
Q

The sympathetic nervous system also stimulates _______ release from the juxtaglomerular cells of the kidney.

A

renin

113
Q

Angiotensin II constricts __________ arterioles more than __________ arterioles, which helps to maintain glomerular filtration rate (GFR) despite a decrease in renal blood flow.

A

efferent, afferent

114
Q

Angiotensin II also stimulates _______, which leads to increased water intake and helps to restore fluid volume.

A

thirst

115
Q

_________ increases sodium reabsorption in the distal tubule and collecting duct by stimulating the expression and activity of ENaC and sodium-potassium ATPase.

A

Aldosterone

116
Q

Aldosterone also promotes _________ excretion.

A

potassium

117
Q

_____ is released from the atria of the heart in response to increased blood volume or atrial stretch.

A

ANP

118
Q

ANP inhibits _______ reabsorption in the proximal tubule, loop of Henle, and collecting duct, leading to increased ________ excretion.

A

sodium, sodium

119
Q

ANP also inhibits ______ and aldosterone secretion, further promoting sodium excretion.

A

renin

120
Q

ANP increases GFR by ___________(dilating/constricting) afferent arterioles and ___________(dilating/constricting) efferent arterioles.

A

dilating, constricting

121
Q

ANP decreases ___________ nervous system activity.

A

sympathetic

122
Q

__________ are a class of drugs that increase urine output and are commonly used to treat hypertension.

A

Diuretics

123
Q

__________ block the conversion of angiotensin I to angiotensin II, reducing the effects of angiotensin II on blood pressure and sodium reabsorption.

A

ACE inhibitors

124
Q

_______________ block the binding of angiotensin II to its receptors, preventing its effects.

A

Angiotensin receptor blockers (ARBs)

125
Q

_____________ block the effects of aldosterone on sodium reabsorption.

A

Aldosterone antagonists

126
Q

__________ is a condition characterized by adrenal insufficiency, leading to a deficiency in aldosterone and cortisol.

A

Addison’s disease

127
Q

Patients with ____________ may experience hypotension, hyponatremia, and hyperkalemia.

A

Addison’s disease

128
Q

__________, also known as primary aldosteronism, is a condition characterized by excessive aldosterone secretion, leading to hypertension, hypokalemia, and metabolic alkalosis.

A

Conn’s syndrome

129
Q

The kidneys are the major source of ____________, a hormone that stimulates red blood cell production in the bone marrow.

A

erythropoietin

130
Q

Erythropoietin secretion is stimulated by __________ in the kidneys.

A

hypoxia

131
Q

_________ can be caused by chronic kidney disease due to impaired erythropoietin production.

A

Anemia

132
Q

Erythropoietin is a ________ hormone.

A

peptide

133
Q

Renal interstitial cells are the major source of erythropoietin, with small amounts produced by the _______.

A

liver

134
Q

The _____________________ is the pressure exerted by the fluid in the renal interstitium.

A

renal interstitial hydraulic pressure (RIHP)

135
Q

An _________(increase/decrease) in RIHP opposes fluid reabsorption from the tubules.

A

increase

136
Q

The ________________ pressure is the osmotic pressure exerted by the proteins in the peritubular capillaries.

A

peritubular capillary oncotic pressure

137
Q

An increase in peritubular capillary oncotic pressure promotes ________ reabsorption into the capillaries.

A

fluid

138
Q

The ________________ is the portion of the extracellular fluid volume that is effectively perfusing the tissues.

A

effective arterial blood volume (EABV)

139
Q

A decrease in EABV activates the _______, leading to sodium and water retention to restore fluid volume.

A

RAAS

140
Q

__________________ is an enzyme that converts cortisol to inactive cortisone in the kidney, preventing cortisol from binding to mineralocorticoid receptors and causing excessive sodium retention.

A

11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2

141
Q

__________ contains glycyrrhetinic acid, which inhibits 11β-HSD2, potentially leading to sodium retention and hypertension.

A

Liquorice

142
Q

___________ is a rare genetic disorder caused by a deficiency in 11β-HSD2, leading to sodium retention, hypertension, and hypokalemia.

A

Apparent mineralocorticoid excess (AME)

Phys Facts (7 decks)

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