Test2: Wk6: 2 Glomerular Hemodynamics - Puri

Question 1

renal nerves are

Answer 1

sympathetic

Question 2

renal nerves do (4)

Answer 2

vasoconstriction
⬆ Renin Secretion
⬆ Na reabsorption
pain fibers

Question 3

Mesangial Cells function

Answer 3

Maintain structural
architecture of
glomerulus

Question 4

Mesangial Cells Dz

Answer 4

IgA nephropathy

Diabetic nephropathy

Question 5

Glomerular endothelial cells function

Answer 5

Fenestrations and glycocalyx

facilitate selective permeability and filtration

Question 6

Glomerular endothelial cells Diseases (4)

Answer 6

ANCA-associated GN
Lupus nephritis
Hemolytic uremic syndrome
Diabetic nephropathy

Question 7

GBM (glomerular Basement Membrane) Function

Answer 7

Regulates filtration

Question 8

GBM Disease

Answer 8

Goodpasture Syndrome

Question 9

Podocytes Function

Answer 9

Foot processes wrap around capillaries; slit diaphragm regulates filtration

Question 10

Podocytes Disease (3)

Answer 10

Minimal change disease
FSGS
Membranous Nephropathy

Question 11

Parietal epithelial

cells Function

Answer 11

Line Bowman’s capsule

Question 12

Parietal epithelial

cells Dz

Answer 12

Crescentic GN

Question 13

The renal system has two arterials in — and two vascular beds in —

Answer 13

series; series

Question 14

Total renal resistance is the sum of

Answer 14

afferent and efferent arteriolar resistances

Question 15

Step 1 and Step 2

Answer 15

Step 1: filtration

Step 2: Reabsorbtion

Question 16

Plasma filtration at the glomerulus; essential for

Answer 16

essential for filtration of toxic metabolites

Question 17

Reabsorption of essential solutes into in the —

Answer 17

peritubular capillaries

Question 18

Normal GFR

Answer 18

125mL/min to 180L/day

Question 19

how many times per day is the entire ECF filtered

Answer 19

> 10x

Question 20

Peritubular reabsorption

Answer 20

As the tubules resorb solutes, including Na+, glucose and amino
acids, they accumulate in the peritubular interstitial space. From this interstitial space the solutes have to re-enter the peritubular capillaries for return to the
circulation.

Question 21

steps in Na reabsorption from urine to the blood

Answer 21

3

Question 22

Step 1 in Na+ reabsorption from the urine to blood

Answer 22

Na+ crosses the lipid bilayer at the brush border by cotransport or antiport

Question 23

Step 2 in Na+ reabsorption from the urine to blood

Answer 23

Na+ exits the cell at the basolateral border via the Na+,K+ ATPase

Question 24

Step 3 in Na+ reabsorption from the urine to blood

Answer 24

Once Na (and water) is in the interstitial space it can be absorbed from interstitium into blood with fluid following the balance of Starling forces or can back-leak (4)

Question 25

Glomerular filtration depends on balance of

Answer 25

hydrostatic and oncotic pressures

Question 26

The hydrostatic (capillary pressure) is dependent on --- and the --- around the capillaries.

Answer 26

plasma flow and the resistance of arterioles

Question 27

``` glomerular capillary hydrostatic pressure (PGC) is ```

Answer 27

60mmHg

Question 28

peritubular capillaries pressure

Answer 28

15 mmHg

Question 29

increase blood flow --- is not reached

Answer 29

filtration equilibrium

Question 30

constrict blood flow to AA what happens to blood flow in EA

Answer 30

decrease

Question 31

constrict blood flow to EA what happens to blood flow in AA

Answer 31

decrease

Question 32

reduced renal plasma flow will reduce --- more than increased plasma flow will increase it

Answer 32

GFR

Question 33

change filtration by (2 ways) both are changed by

Answer 33

1 capillary pressure 2 blood flow through the capillary both changed by AA and EA

Question 34

AA and EA control both

Answer 34

glomerular plasma flow and glomerular filtration rate

Question 35

total renal resistance =

Answer 35

AA + EA

Question 36

EA constriction GFR

Answer 36

will increase except when EA is constricted so much that that GFR falls - ex shock

Question 37

AA Constriction

Answer 37

⬇ PGC ⬇ GFR ⬇ RBF

Question 38

EA Constriction

Answer 38

⬆ PGC ⬆ GFR ⬇ RBF

Question 39

EA Dilation

Answer 39

⬇ PGC ⬇ GFR ⬆ RBF

Question 40

AA Dilation

Answer 40

⬆ PGC ⬆ GFR ⬆ RBF

Question 41

always solve for --- first

Answer 41

RPF

Question 42

Filtration Fraction Equation FF =

Answer 42

FF = GFR / RPF

Question 43

Filtration Fraction is

Answer 43

the percent of plasma water flowing through the glomerular capillary that is filtered

Question 44

peritubular capillaries have --- hydrostatic pressure

Answer 44

decreased

Question 45

peritubular capillaries have --- oncotic pressure

Answer 45

increased

Question 46

increased oncotic pressure favors

Answer 46

reabsorption

Question 47

High filtration fraction means

Answer 47

more plasma filtered at glomerulus and protein is more concentrated in peritubular capillaries

Question 48

High filtration fraction = --- = ---

Answer 48

higher oncotic pressure = higher Na reabsorption

Question 49

low filtration fraction = --- = ---

Answer 49

lower oncotic pressure = less Na reabsorption

Question 50

FF for high Na diet

Answer 50

low

Question 51

FF for low Na diet

Answer 51

high

Question 52

--- FF is desired during reduced MAP/ CO and reduced Na and vice a versa

Answer 52

high

Question 53

4 Systems that regulate GFR/RPF and FF

Answer 53

1. RAAS 2. SNS 3. Arginine Vasopressin AVP 4. Atrial Natriuretic Peptide ANP

Question 54

RAAS, SNS, and AVP --- FF by and --- Na

Answer 54

increase FF by constricting EA conserve Na

Question 55

ANP dilates --- and constricts --- resulting in

Answer 55

AA, EA ⬆⬆ GFR ⬆ RPF ⬆FF

Question 56

ANP is supposed to get rid of Na but increases FF

Answer 56

doesn't change Na reabsorption at this step but effects the late nephron

Question 57

Angiotensin II --- both AA and EA but is preferential for --- of ---

Answer 57

constriction, constriction, EA

Question 58

Angiotensin II is a strong

Answer 58

vosoconstrictor

Question 59

Angiotensin II effect on GFR

Answer 59

GFR falls slightly or doesn't change | maintain GFR

Question 60

when is Angiotensin II activated

Answer 60

when volume depleted ➡ CO falls ➡ GFR decreases

Question 61

SNS --- GFR and RPF by --- AA and EA resulting in --- FF

Answer 61

decrease; constrict; increased

Question 62

if SNS is maximally activated what happens

Answer 62

shut down kidney, massive constriction GFR is almost 0

Question 63

what protects the kidney during state of SNS shock

Answer 63

prostaglandin system

Question 64

--- and --- oppose vasoconstriction of AA induced by SNS and ANGII

Answer 64

PGI2 and PGE2 - dilate AA

Question 65

NSAIDS during shock

Answer 65

block prostaglandins

Question 66

NSIADS in kidney Dz

Answer 66

no

Question 67

Tubuloglomerular feedback Mechanism

Answer 67

the myogenic response regulates GFR by negative feedback

Question 68

Macula Densa produces (2)

Answer 68

Renin and ANGII

Question 69

master regulator of Renal System

Answer 69

Macula Densa

Question 70

Macula Densa is part of the --- and touches the ---

Answer 70

thick ascending limb, AA

Question 71

Macula Densa exchanges information between

Answer 71

blood and urine

Question 72

clearance estimates the volume of

Answer 72

plasma that contained that much of a substance at plasma concentration

Question 73

clearance =

Answer 73

Clearance = Ux x V / Px

Question 74

Filtered Load =

Answer 74

GFR x Plasma Conc.

Question 75

Excreted load =

Answer 75

V x urine conc.

Question 76

Fx > Ex

Answer 76

net tubular absorption

Question 77

Fx < Ex

Answer 77

net tubular secretion

Question 78

Ex = Ex

Answer 78

used to calculate GFR - inulin

Question 79

increase plasma inulin concentration; what happens to inulin clearance

Answer 79

unchanged - inulin clearance is independent of plasma concentration

Question 80

Creatinine is --- related to GFR

Answer 80

inversely

Question 81

Creatinine can be used to estimate

Answer 81

GFR

Question 82

Creatinine --- GFR by ---

Answer 82

overestimate by 10%

Question 83

if GFR falls plasma creatinine will

Answer 83

rise

Question 84

Fractional excretion Na <1%

Answer 84

renal hypo-perfusion

Question 85

fractional excretion Na >2%

Answer 85

acute tubular necrosis