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(Physio) Health Sciences > The Kidney > Flashcards

The Kidney Flashcards

1
Q

If GFR is too low then….. A) ….filtrate moves too quickly and is not reabsorbed B) ….filtrate backs up to the kidneys C) ….filtrate moves too slowly and too much is reabsorbed D) ….Blood pressure is too low

A

C) ….filtrate moves too slowly and too much is reabsorbed

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2
Q

what substance has a plasma clearance rate of 0

A

glucose because it is all reabsorbed

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3
Q

where does most of acid base balance take place

A

proximal convuluted tubule

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4
Q

describe the blood supply of the kidney

A

renal artery carries blood to the kidney renal vein carries blood away these are separated by the glomerular and peritubular capillary beds

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5
Q

What is the order (from outside in) of kidney layers A) cortex, medulla, pelvis B) pelvis, cortex, medulla C) Cortex, pelvis, medulla oblongata D) cortex, medulla oblongata, pelvis

A

A) cortex, medulla, pelvis

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6
Q

what else can be used to determine GFR

A

creatinine , the end product of muscle metabolism

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7
Q

describe the basement membrane

A

acellular network of collagen and glycoproteins, glycoproteins are negatively charged to repel negative proteins including albumin (smallest plasma protein)

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8
Q

what is the nephron and where is it situated

A

the smallest functional unit of the kidney, situated in the renal cortex and the medulla

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9
Q

what is plasma clearance

A

the volume of plasma cleared of substance per minute

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10
Q

what are the 3 layers that separate the glomerulus and bowman’s capsule are why are they needed

A

glomerular capillary wall basement membrane inner layer of bowman’s capsule ensures only very small particles can pass through to the bowman’s space

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11
Q

Which of these is not a function of the PCT? A) Reabsorption of glucose, amino acids and ions B) Secretion of some toxins & urea C) Reabsorption of H+ D) Recovery of bicarbonate ions

A

C) Reabsorption of H+

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12
Q

when is plasma clearance lower than GFR

A

when a substance is filtered and reabsorbed and not reabsorbed

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13
Q

what substance has a plasma clearance rate of 0

A

glucose because it is all reabsorbed

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14
Q

how does HCO3- get into the capillary from the proximal tubule

A

Na+/HCO3- symporter in the basolateral membrane HCO3- moves down cg, this powers Na+ to move against cg

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15
Q

what is plasma clearance

A

the volume of plasma cleared of substance per minute

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16
Q

how does HCo3- get reabsorbed into distal tubule

A

Cl-/HCO3- antiporter HCO3- exchanged for Cl-

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17
Q
  1. A fit and healthy 21 year old male Medical Science student with normal kidneys decreases his intake of dietary sodium by half over a period of two months. Which of the following would be expected to be increased in response to this restriction of dietary sodium? A. Arterial pressure B. Extracellular fluid volume C. Release of Atrial Natriuretic Peptide (ANP) D. Release of renin E. Sodium excretion
A

Answer: D Learning Point: Fluid Homeostasis

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18
Q

What is the role of a macula densa cell? A) Monitor Na+ and control GFR B) Monitor osmolality in the collecting duct C) Control the vasodilation/constriction of the nephron D) Increase ADH secretion

A

A) Monitor Na+ and control GFR

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19
Q

what else can be used to determine GFR

A

creatinine , the end product of muscle metabolism

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20
Q

What is the order of the structures of the nephron? A) Bowmans Capsule, DCT, Loop of Henle, PCT, Collecting Duct B) Loop of henle, PCT, DCT, collecting duct C) Bowmans capsule, PCT, loop of henle, DCT, collecting duct

A

C) Bowmans capsule, PCT, loop of henle, DCT, collecting duct

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21
Q

8 parts of the nephron

A
  1. glomerulus 2. bowman’s capsule 3. proximal convoluted tubule 4. descending loop of Henle 5. ascending loop of Henle 6. Distal convoluted tubule 7. connecting and cortical collecting tubules 8. collecting duct
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22
Q

Where would ACE inhibitors intervene? A) HMG-CoA –> Mevalonate B) Ang 1 –> Ang 2 C) Angiotensinogen –> Ang 1 D) Renin

A

B) Ang 1 –> Ang 2

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23
Q

What effect does vasopressin have? A) Increases calcium reabsorption B) Stimulates production of aquaporins C) Natriuresis D) Increases GFR

A

B) Stimulates production of aquaporins

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24
Q
  1. The kidney secretes a protein that triggers a cascade which regulates blood sodium concentration and blood pressure. What is the name of this protein?

A. Angiotensin II

B. Angiotensinogen

C. Erythropoietin

D. Renin

E. Vasopressin

A

Answer: D Learning point: function of the kidney

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25
Q

what increases GFR

A

increased blood pressure and hydrostatic pressure in the glomerulus caused by vasodilation of afferent arteriole / vasoconstriction of efferent arteriole

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26
Q

when is plasma clearance = GFR, example of such substance

A

when a substance is filtered but not reabsorbed e.g. inulin

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27
Q

describe hydrostatic pressure

A

the pressure exerted by fluid on the capillary walls of the glomerulus or walls of the bowman’s capsule

28
Q

where is carbonic anhydrase and what does it do

A

in the renal tubule, converts carbonic acid into H2O and CO2

29
Q

Which of these corresponds to a GFR control system which effects the glomerular capillary vasoconstriction/dilation A)Tubuloglomerular Feedback B)Sympathetic innervation C)Myogenic autoregulation

A

B)Sympathetic innervation

30
Q

Roughly, on average, how much urine do kidneys form each minute? A) 115 ml/min B) 2 l/min C) 50 ml/min D) 500 ml/min

A

A) 115 ml/min

31
Q

What organelle is particularly present in the PCT cells? A) Chloroplasts B) Rough ER C) Golgi Apparatus D) Mitochondria

A

D) Mitochondria

32
Q

Where is aldosterone released from? A) the hypothalamus B) the anterior pituitary C) the kidney D) the adrenal cortex

A

D) the adrenal cortex

33
Q

when is plasma clearance = GFR, example of such substance

A

when a substance is filtered but not reabsorbed e.g. inulin

34
Q

Which of these is not a part of the renal corpuscle? A) Basal Lamina B) Glomerulus C) Afferent Arteriole D) Bowmans Capsule

A

C) Afferent Arteriole

35
Q

Describe the effect of ANP….

A

Decreases blood Na- Decreasing blood pressure and volume –> by counteracting ang 2

36
Q

describe the glomerular capillary wall

A

a single layer of flattened epithelial cells perforated with fenestrations

37
Q

what is the renal corpuscle

A

glomerulus and bowman’s capsule

38
Q

Which of these corresponds to a GFR control system which uses macula densa cells A)Tubuloglomerular Feedback B)Sympathetic innervation C)Myogenic autoregulation

A

A)Tubuloglomerular Feedback

39
Q

Which structures are the principle detectors for RAAS A) Macula Densa cells B) Renal corpuscle C) Juxta-glomerular D) Granular cells

A

C) Juxta-glomerular

40
Q

what causes metabolic acidosis

A

dietary input of H+ exceeds H+ excretion e.g. Atkins diet ketoacidiosis, type 1 diabetes

41
Q

how is H+ secretion similar and different in the distal convoluted tubule to the proximal

A

both tubules use ATPase pumps to pump H+ into tubule distal tubule uses a K+/H+ antiporter whereas Na+/H+ anti porter used in proximal tubule

42
Q

what is colloid osmotic pressure

A

the pressure exerted by albumin colloids on the glomerulus the proteins generate oncotic pressure that tries to hold water back in the glomerulus

43
Q

what is the function of the renal tubules

A

they convert glomerular filtrate into urine

44
Q

Which of these corresponds to a GFR control system which causes vasoconstriction/dilation of the afferent arteriole in response to BP A)Tubuloglomerular Feedback B)Sympathetic innervation C)Myogenic autoregulation

A

C)Myogenic autoregulation

45
Q

Diabetes is an example of a condition which typically has: A) too high GFR B) too low GFR C) No GFR

A

A) too high GFR

46
Q

blood supply to glomerulus

A

receives arteriole branches from the renal artery afferent arteriole brings blood in efferent arteriole takes blood out

47
Q

what is plasma clearance a measure of

A

GFR

48
Q

what causes respiratory alkalosis

A

hyperventilation, excess artificial ventilation

49
Q

when is plasma clearance higher than GFR

A

when a substance is filtered and secreted but not reabsorbed

50
Q

what are the two types of loops (of henle)

A

Juxtamedullary and Cortical

51
Q

what is plasma clearance a measure of

A

GFR

52
Q

what causes respiratory acidosis

A

hypoventilation and respiratory depression CO2 retention, elevated H+

53
Q

what causes metabolic alkalosis

A

excessive vomiting of acidic stomach contents, too many bicarbonate antacids

54
Q

what is the renal hilium

A

region of the kidney where renal artery, vein and ureter pass

55
Q

If a lady has proteins present in their urine, which could this not indicate out of the following? A) she’s pregnant B) she’s got a fever C) she’s got high blood pressure D) she’s got high GFR

A

B) she’s got a fever

56
Q

What is the epithelium lining the PCT?

A

Cuboidal (with brush border)

57
Q

when is plasma clearance higher than GFR

A

when a substance is filtered and secreted but not reabsorbed

58
Q

what happens to H2o and co2 produced in renal tubule

A

diffuses into epithelial cell and combine to make H2CO3 which is broken down by carbonic anhydrase into H+ and HCO3-

59
Q

when is plasma clearance lower than GFR

A

when a substance is filtered and reabsorbed and not reabsorbed

60
Q

describe the inner layer of the Bowman’s capsule

A

made up of Podocytes which are a special kind of epithelial cell with foot like projections that wrap around capillaries of glomerulus filtration slits between Podocytes which filter blood

61
Q

how is acidosis prevented

A

secretion of H+/reabsorption of HCO3-

62
Q

what is the glomerulus

A

a capillary network that is the main site of filtration

63
Q

how does H+ get back into the proximal tubule

A

ATPase pump or Na+/H+ antiporter on the APICAL membrane

64
Q

what 3 things does GFR depend upon

A
  1. net filtration pressure (difference between hydrostatic and colloid osmotic pressure ) 2. glomerular surface area 3. permeability of glomerular membrane
65
Q

what are the forces involved in glomerular filtration

A

hydrostatic pressure and colloid osmotic pressure

(Physio) Health Sciences (10 decks)

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