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Physiology > Renal, Topnotch + CDB > Flashcards

Renal, Topnotch + CDB Flashcards

1
Q

Length of the ureter

A

25-35 cm

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2
Q

Origin of the nephron

A

Metanephric blastema

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3
Q

Origin of the collecting duct system

A

Ureteric bud

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4
Q

pH compatible with life

A

6.8-8.0

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5
Q

Stimulus for EPO production by interstitial cells of kidney

A

Hypoxia

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6
Q

Form of vitamin D produced in kidneys

A

1,25-hydroxycholecalciferol

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7
Q

Enzyme in the kidney that converts vitamin D to its active form

A

1a-hydroxylase

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8
Q

Function of kidney during starvation

A

Gluconeogenesis

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9
Q

Vertebral level of kidneys

A

T12-L3

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10
Q

Weight of 1 kidney

A

150g

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11
Q

Part of kidney that is pain sensitive

A

Capsule

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12
Q

Organism implicated in staghorn calculi/mg ammonium po4/struvite

A

Proteus mirabilis

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13
Q

Renal circulation

A

Renal artery > segmental artery > interlobar artery > arcuate artery > interlobular artery (cortical/radial) > afferent arteriole > glomerular capillaries > efferent arteriole > peritubular capillaries/vasa recta > interlobular vein > arcuate vein > interlobar vein > segmental vein > renal vein

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14
Q

Cxs of glomerular capillaries (2)

A

1) Highly fenestrated hence responsible for GFR

2) Only capillaries that leas to arterioles and not venules

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15
Q

Hairpin loop-shaped peritubular capillaries of the juxtamedullary nephrons

A

Vasa recta

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16
Q

Creates corticopapillary osmotic gradient

A

Countercurrent multipliers

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17
Q

Structure known as the countercurrent multiplier

A

Loop of Henle

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18
Q

Maintains the corticopapillary osmotic gradient

A

Countercurrent exchangers

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19
Q

Structure known as the countercurrent exchanger

A

Vasa recta

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20
Q

Substances moved in circles by the countercurrent exchanger (2)

A

1) Na

2) Urea

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21
Q

Urge to urinate

A

150 mL

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22
Q

Reflex contraction

A

300mL

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23
Q

Sense of fullness

A

400mL

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24
Q

of nephrons per kidney

A

1M

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25
Q

The kidneys undergo compensatory regeneration upon __% damage to nephrons

A

75%

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26
Q

Cortical vs Juxtamedullary nephrons: Percentage

A

75%, 25%

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27
Q

Cortical vs Juxtamedullary nephrons: Loops of Henle

A

Short-long

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28
Q

Cortical vs Juxtamedullary nephrons: Capillary network

A

Peritubular capillaries-vasa recta

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29
Q

Diameter of pores of capillary endothelium

A

8nm or 80A

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30
Q

Vasoactive substances secreted by capillary endothelium

A

1) NO

2) ET-1

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31
Q

Form the visceral epithelium in the glomerulus

A

Podocytes

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32
Q

Where filtrations slits are located in kidneys

A

Podocytes

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33
Q

Function of mesangial cells

A

1) Contractile elements
2) Mediate filtration
3) Take up immune complexes

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34
Q

Components of JG apparatus

A

1) JG cells
2) Macula densa
3) Lacis cells

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35
Q

Glomerular cells of the afferent arterioles

A

JG cells

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36
Q

What JG cells secrete

A

Renin

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37
Q

Where macula densa is located

A

Wall of DCT

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38
Q

Function of the macula densa

A

Monitor Na concentration in the DCT

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39
Q

Site of kidneys most susceptible to ischemia

A

PCT

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40
Q

% sodium, K, and H2O reabsorbed in the PCT

A

66%

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41
Q

% glucose and aa reabsorbed in PCT

A

100%

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42
Q

Part of loop of Henle permeable to water but not to solutes

A

Descending limb

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43
Q

Part of loop of Henle permeable to solute but not to water

A

Ascending limb

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44
Q

Substances that kidneys filter only (2)

A

1) Inulin

2) Creatinine

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45
Q

Substances that kidneys filter and secrete (2)

A

1) PAH

2) Organic acids and bases

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46
Q

GFR is __% lower in females

A

20-25%

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47
Q

Fraction of renal plasma flow that is filtered

A

Filtration fraction

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48
Q

Normal filtration fraction

A

20%

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49
Q

Formulas for filtration fraction

A

GFR/RPF

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50
Q

Substance used to determine RPF (gold std)

A

PAH

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51
Q

Size of substance freely filtered in kidneys

A

20A or less

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52
Q

Size of substance not filtered at all in kidneys

A

> 42

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53
Q

Filterability of 1.0

A

Freely filtered as water

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54
Q

Filterability of 0.75

A

Filtered only 75% as rapidly as water

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55
Q

Filterability according to charge

A

Positive > neutral > negative

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56
Q

Portion of renal corpuscle affected by NSAID and mechanism

A

Afferent arteriole; inhibition of PG (dilates afferent arteriole)

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57
Q

Portion of renal corpuscle affected by ACEI and mechanism

A

Efferent arteriole; inhibition of ATII (constricts efferent arteriole)

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58
Q

Glomerular hydrostatic pressure

A

60 mmHg

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59
Q

Net filtration pressure (GFR)

A

10 mmHg

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60
Q

Effect on GFR when efferent arteriole is moderately constricted

A

Increase

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61
Q

Effect on GFR when efferent arteriole is severely constricted

A

Decrease

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62
Q

Effect on GFR when ultrafiltration coefficient (Kf) is increased

A

Increase

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63
Q

Causes of decreased Kf

A

1) DM
2) Htn
3) Renal diseases

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64
Q

Cause of increased hydrostatic pressure in the bowman’s space

A

Urinary tract obstruction

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65
Q

Glomerular filtration forms

A

Primitive urine

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66
Q

% CO received by kidneys

A

25%

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67
Q

Organs that are sensitive to ischemia

A

1) Brain
2) Liver
3) Kidney

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68
Q

Type of infarct in the kidney

A

Wedge-shaped white or anemic infarct

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69
Q

Renal cortex vs medulla: greater renal blood flow

A

Renal cortex

70
Q

BP at which renal autoregulation is optimal

A

80-170 mmHg

71
Q

Massive sympathetic stimulation that results in massive vasoconstriction of kidneys

A

CNS ischemic response

72
Q

Substances secreted as autoregulatory mechanisms to maintain GFR

A

1) Adenosine
2) NO
3) ATII

73
Q

Effect of adenosine on kidneys

A

Afferent arteriole vasoconstriction

74
Q

Effect of nitric oxide on kidneys

A

Afferent arteriole vasodilation

75
Q

Percentage of solute reabsorbed is held constant

A

Glomerulotubular balance

76
Q

Concentration at which substance starts to appear in the urine

A

Renal threshold

77
Q

Concentration at which all excess substance appear in the urine or the limit to the rate at which solute can be transported (reabsorbed)

A

Renal transport maximum

78
Q

Renal Tmax of glucose

A

375 mg/dL

79
Q

Renal threshold of glucose

A

200 mg/dL

80
Q

Filtered load at renal threshold of glucose

A

250 mg/min

81
Q

Normal filtered load of glucose

A

125 mg/min

82
Q

Kidney transport mechanism that does not exhibit Tmax and threshold

A

Gradient-time transport

83
Q

Factors that affect transport of substances that use the gradient-time mechanism (3)

A

1) Electrochemical gradient
2) Membrane permeability
3) Time

84
Q

Relationship between flow rate and rate of transport in gradient-time transport

A

Inverse

85
Q

Epithelium of PCT

A

Low columnar with extensive brush border

86
Q

Osmolarity of PCT

A

Isosmotic

87
Q

Epithelium of thin segments of loop of Henle

A

Simple squamous

88
Q

Epithelium of thick segments of loop of Henle

A

Simple cuboidal

89
Q

% of filtered water reabsorbed in loop of Henle

A

20%

90
Q

% of filtered Na,K,Cl reabsorbed in loop of Henle

A

25%

91
Q

Ion channel inhibited by loop diuretics (Furosemide, Bumetanide, Ethacrynic acid)

A

Na-K-2Cl

92
Q

Epithelial lining of distal tubule

A

Simple cuboidal

93
Q

Aka Goormatigh or Polkissen cells or agranular cells

A

Lacis cells

94
Q

Cells found in second part of distal tubule

A

1) Principal cells

2) Intercalated cells

95
Q

Function of principal cells (3)

A

1) Reabsorb Na
2) Secrete K
3) Reabsorb H2O

96
Q

Function of intercalated cells (2)

A

1) Reabsorb K
2) Secrete Na
3) HCO3 regulation

97
Q

Transport systems by which intercalated cells secrete H+ (2)

A

1) Na-H countertransport

2) H-ATPase

98
Q

Part of kidney responsive to aldosterone

A

DT

99
Q

Part of kidney responsive to vasopressin

A

DT and CD

100
Q

% filtered water reabsorbed in DT

A

5

101
Q

Part of renal tubules impermeable to urea

A

DT

102
Q

Part of renal tubules permeable to urea

A

CD

103
Q

Site for regulation of final urine volume and concentration

A

CD

104
Q

Effect of aldosterone on kidneys (3)

A

1) Na reabsorption
2) Water reabsorption
3) K secretion

105
Q

Effect of ATII on kidneys (2)

A

1) Na reabsorption

2) Water reabsorption

106
Q

Effect of ANP and BNP on kidneys

A

Decrease Na reabsorption

107
Q

Effect of PTH on kidneys

A

1) Increase Ca reabsorption
2) Decrease PO4 reabsorption
3) Increase 1a-hydroxylase

108
Q

Triggers for ADH secretion and respective sensors

A

1) Increased osmolarity (Hypothalamus)
2) Decreased BP (atrial stretch receptors)
3) Decreased blood volume (carotid sinus and aortic arch)

109
Q

Effect of alcohol on body fluid regulation of kidneys

A

Decreases ADH secretion

110
Q

Hormone secreted by DT and CD that acts similar to ANP

A

Urodilatin

111
Q

Change in osm that triggers ADH secretion

A

1%

112
Q

Change in blood volume that triggers ADH secretion

A

10%

113
Q

Stimulus for renin secretion by JG cells

A

Decrease in BP

114
Q

Effect of renin

A

Angiotensinogen > angiotensin I in liver

115
Q

Where and angiotensin I is converted to angiotensin II and enzyme responsible

A

Lungs and kidneys via ACE

116
Q

CKD with normal size

A

1) SLE
2) HIV
3) PTB
4) Amyloidosis
5) Sarcoidosis

117
Q

All tubular capillaries are derived from

A

Efferent arterioles

118
Q

Onion-skinning or fibrinoid necrosis is seen in what renal disease

A

Malignant nephrosclerosis

119
Q

Most common site of abdominal aneurysm

A

Infrarenal/before bifurcation of abdominal aorta

120
Q

Symptom of abdominal aneurysm

A

Abdominal bruit

121
Q

Most common type of htn

A

Essential/idiopathic

122
Q

Most common cause of secondary htn

A

Renovascular dse

123
Q

Most common renovascular disease

A

Renal artery stenosis

124
Q

Filtration rate - reabsorption rate + secretion rate

A

Excretion rate

125
Q

How many times is plasma volume filtered in a day

A

60x

126
Q

% water reabsorbed from filtered volume

A

99%

127
Q

% phenol reabsorbed from filtered volume

A

0%

128
Q

Regulation of urine concentration (2)

A

1) Medullary countercurrent system

2) Vasopressin

129
Q

High permeability of thin descending limb to water is via

A

Aquaporin-1

130
Q

Nodular sclerosis of glomerular membrane is seen in what disease

A

DM

131
Q

Microscopic finding in kidneys with DM

A

Kimmelsteil-Wilson Lesions

132
Q

Microscopic finding in kidneys with minimal change disease

A

Effacement of podocytes

133
Q

Combined blood flow through both kidneys in an average adult

A

1100mL/min

134
Q

Renal vessels with greatest resistance (4)

A

1) Interlobar artery
2) Interlobular artery
3) Afferent arteriole
4) Efferent arteriole

135
Q

Formula for renal blood flow

A

(R artery pressure-R vein pressure)/Total renal vascular resistance

136
Q

Drug that causes diabetes insipidus by interfering with ADH receptors on DT

A

Lithium

137
Q

Major ion secreted into tubules coupled with sodium entry

A

Hydrogen

138
Q

Forces that propel the urine along the ureter

A

1) Gravity

2) Peristaltic contractions

139
Q

Treatment for post-operative bladder atony

A

Bethanechol

140
Q

Where EPO is produced

A

Interstitial peritubular cells

141
Q

Usual daily urine output

A

700-1400mL

142
Q

Why ACEI exacerbates cough

A

ACE inhibits bradykinin

143
Q

Normal venous pH

A

7.35

144
Q

Normal interstitial fluid pH

A

7.35

145
Q

Body fluid buffer systems (3)

A

1) Bicarbonate
2) Phosphate
3) Intracellular proteins

146
Q

The respiratory buffer responds to

A

H+ levels

147
Q

Respiratory regulation of acid-base balance is __% effective in returning pH back to normal

A

50-75%

148
Q

Respiratory regulation returns pH back to normal within ___ minutes

A

3-12

149
Q

Mechanisms of renal regulation of acid-base balance (3)

A

1) Excess H+ secretion
2) HCO3 reabsorption
3) Production of new HCO3 using ammonia and phosphate buffers

150
Q

Normal HCO3

A

22-26 mmol/L

151
Q

Normal pCO2

A

35-45 mmHg

152
Q

Acid-base imbalance due to conditions resulting in decreased ventilation

A

Respiratory acidosis

153
Q

Acid-base imbalance due to conditions resulting in increased ventilation

A

Respiratory alkalosis

154
Q

Respi acid vs alka: Airway obstruction

A

Respi acid

155
Q

Respi acid vs alka: Pneumonia

A

Respi alka

156
Q

Respi acid vs alka: ARDS

A

Respi acid

157
Q

Respi acid vs alka: Pulmonary embolus

A

Respi alka

158
Q

Respi acid vs alka: COPD

A

Respi acid

159
Q

Respi acid vs alka: High altitude

A

Respi alka

160
Q

Respi acid vs alka: Psychogenic

A

Respi alka

161
Q

Respi acid vs alka: Salicylate intoxication

A

Respi alka

162
Q

Formula for plasma anion gap

A

Na - (HCO3 + Cl-)

163
Q

Met acidosis where there is excess organic anions to maintain electroneutrality

A

HAGMA

164
Q

Met acidosis where there is increased chloride to maintain electroneutrality

A

NAGMA

165
Q

HAGMA (11)

A

MUDPILES
Methanol, uremia, DKA, paraldehyde, propylene glycol, iron, isoniazid, idiopathic acidosis, lactic acidosis, ethylene glycol, ethanol, salicylic acid

166
Q

NAGMA (6)

A

HARD UP

Hyperalimentation, acetazolamide, RTA, diarrhea, ureteroenteric fistula, pancreaticoduodenal fistula

167
Q

Conditions resulting in metabolic alkalosis (5)

A

1) Loop diuretics
2) Thiazide diuretics
3) Vomiting
4) Hyperaldosteronism
5) Ingestion of alkaline drugs

168
Q

Osmolarity of medullary interstitium

A

1200-1400

169
Q

Segment of tubules that is virtually impermeable to water

A

TALH

170
Q

Most important cause of high medullary osmolarity

A

TALH

Physiology (15 decks)

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