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Clinical Pathology > UNIT 2 - Lecture 1: Kidney Review > Flashcards

UNIT 2 - Lecture 1: Kidney Review Flashcards

1
Q

What are the 6 main functions of the kidney?

A
  1. Endocrine functions
  2. Elimination of waste
  3. Electrolyte balance
  4. Acid-base balance
  5. Conservation of nutrients
  6. Water balance
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2
Q

What 5 hormones are produced by the kidney?

A
  1. EPO
  2. Active Vit D (calcitriol)
  3. Prostaglandins
  4. Renin
  5. Aldosterone
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3
Q

EPO production increases with _____ leading to stimulation of _____.

A

hypoxia, erythropoiesis

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4
Q

How does the kidney make active Vit D (calcitriol)?

A

It is converted from inactive Vit D (calcidiol)

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5
Q

What spp lacks the enzyme required for conversion from inactive to active Vit D? What does this result in?

A

horses; results in Ca absorption being dependent on the amt of dietary Ca and not on Vit D

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6
Q

What effect does PTH have on production of calcitriol?

A

It increases it

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7
Q

Calcitriol _____ intestinal and renal absorption of Ca2+ and phosphate and promotes Ca2+ and phosphate release from _____.

A

increases, the bone

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8
Q

What are prostaglandins?

A

Vasodilators important in maintaining renal medullary blood flow

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9
Q

Admin of _____ inhibit renal prostaglandin production –> can result in medullary _____ and kidney damage.

A

NSAIDs, hypoxia

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10
Q

What is the main stimulus for renin secretion?

A

Hypoperfusion of the kidney and decreased Cl-

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11
Q

Renin converts _____ –> _____

A

angiotensin I, angiotensin II

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12
Q

What are 2 main actions of angiotensin II?

A
  1. Vasoconstriction –> increased BP
  2. Increased Na+ and H2O retention to expand plasma volume
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13
Q

What inhibits renin?

A

Atrial natriuretic peptide (ANP)

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14
Q

What does aldosterone do?

A

Promotes Na+ retention and K+ excretion to enhance water retention

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15
Q

T/F: Aldosterone promotes acid excretion

A

True

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16
Q

What stimulates aldosterone?

A

Angiotensin II, hyperkalemia, ACTH

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17
Q

What inhibits aldosterone?

A

Dopamine and ANP

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18
Q

ADH is a hormone that _____ on the kidney and is not _____ by it.

A

acts, produced

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19
Q

What is another name for ADH?

A

vasopressin

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20
Q

What stimulates ADH release?

A

Dehydration (increases plasma osmolality)

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21
Q

ADH acts on _____ tubular epithelial cells –> _____ water –> _____ urine

A

collecting, resorb, concentrate

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22
Q

What are 2 endogenous wastes the kidney produces?

A

Nitrogenous and Creatinine

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23
Q

What exogenous wastes does the kidney produce?

A

Drugs and metabolites

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24
Q

Nitrogenous wastes are formed from _____.

A

protein catabolism

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25
Q

Where is creatinine produced and from what?

A

In muscle from creatine

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26
Q

Where is creatinine filtered and how easily?

A

Freely by the glomerulus (is not resorbed)

27
Q

What electrolytes does the kidney balance?

A

Na, Cl, K, Ca, P, Mg

28
Q

What plasma analytes are conserved by the kidney?

A

Water, glucose, AAs and proteins, Na, Cl, bicarbonate, Ca, Mg

29
Q

What plasma analytes are excreted by the kidney?

A

Urea, creatinine, ammonia, phosphates, K, H+, lactate, ketones, bilirubin, hemoglobin, myoglobin

30
Q

How is urine concentration or dilution assessed?

A

with a urine specific gravity (USG)

31
Q

What is urine concentration?

A

Formation of urine hyperosmotic compared to plasma

32
Q

What is urine dilution?

A

Formation of urine hypoosmotic compared to plasma

33
Q

What 2 things does urine concentration and dilution require (in functional tubules)?

A
  1. Countercurrent mechanism
  2. Concentration gradient and ADH
34
Q

What are the 3 requirements for the kidney to make concentrated urine?

A
  1. ADH
  2. Epithelial cells of the distal nephron must be responsive to ADH
  3. Must have a concentration gradient
35
Q

For the kidney to make concentrated urine, osmolality of interstitial fluid of renal medulla must be _____ osmolality of fluid in the tubules.

A

greater than

36
Q

What 2 things does the kidney require to make diluted urine?

A
  1. Na+ and Cl- must be delivered to the loop of Henle
  2. Very little to no water removed from tubular fluid by distal nephron
37
Q

What is osmolality?

A

Measure of dissolved particles in a fluid

38
Q

What is isosthenuria and what are the USG parameters?

A

Urine osmolality ~= plasma osmolality

USG 1.007-1.013

39
Q

What is hyposthenuria and what are the USG parameters?

A

Urine osmolality < plasma osmolality (urine is diluted)

USG = < 1.007

40
Q

What is hypersthenuria and what are the USG parameters?

A

Urine osmolality > isosthenuric values (urine is concentrated)

USG = >1.013

41
Q

What are the 3 main processes controlling renal excretion of H2O and solutes?

A
  1. Glomerular filtration (passive)
  2. Tubular resorption (active and passive)
  3. Tubular secretion (active and passive)
42
Q

What are the 3 components of the glomerular filtration barrier?

A
  1. Capillary endothelium
  2. Basement membrane
  3. Glomerular epithelial cells (podocytes)
43
Q

Glomerular filtration is the major route for _____ and _____ excretion.

A

solute, water

44
Q

Passage thru healthy glomerular filtration barrier depends on _____ and _____.

A

molecular size, electrical charge

45
Q

What is GFR?

A

Rate that fluid moves from plasma to glomerular filtrate

46
Q

Why is albumin not seen in urine in large amounts?

A

It is too big too pass and is negatively charged

47
Q

What spp can have small amounts of albumin in the urine in health?

A

dogs

48
Q

What is the flow of urine?

A

Glomerulus –> proximal tubule –> loop of Henle –> distal tubule –> collecting tubule –> collecting duct –> urine

49
Q

Glomerular filtration is _____-selective while tubular reabsorption is _____-selective.

A

non, highly

50
Q

What is the path of molecules that are reabsorbed in the kidney?

A

Substance transported thru tubular epithelial membrane –> renal interstitial fluid –> peritubular capillary membrane –> blood

51
Q

___% of water is passively resorbed in the proximal tubule.

A

~75%

52
Q

What molecules are resorbed in the proximal tubules?

A

Small hydrophilic molecules (electrolytes and minerals)

53
Q

Most _____ is conserved in the proximal tubule.

A

bicarbonate

54
Q

The proximal tubule is the site of action for _____.

A

angiotensin II

55
Q

The loop of Henle is the site of action for _____.

A

furosemide

56
Q

In the descending loop of Henle, ___, ___, and ___ are secreted into ultrafiltrate while ___ is passively absorbed.

A

Na, Cl, urea, water

57
Q

In the ascending loop of Henle, ___, ___, ___, ___, and ___ are resorbed while ___ is not.

A

Cl, Na, K, Ca, Mg, water

58
Q

The ascending loop of Henle is impermeable to _____.

A

water

59
Q

What is the juxtaglomerular complex and where is it found?

A

Feedback control of GFR and blood flow; in the distal tubule

60
Q

The JGC absorbs most ions including ___, ___, and ___ while it is virtually impermeable to ___ and ___.

A

Na, K, Cl, water, urea

61
Q

The distal tubule is the site of action for _____.

A

thiazide diuretics

62
Q

The collecting tubule resorbs ___% water and Na.

A

<10%

63
Q

What controls water resorption in the collecting tubule?

A

ADH

Clinical Pathology (22 decks)

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