Clin Med- Renal

Front 1

Kidney patients have high or low calcium?

Back 1

low calcium

Front 2

Kidney patients have high or low phosphate?

Back 2

high phosphate

Front 3

What are some functions of the kidneys? (8)

Back 3

1-extracellular volume control
2-electrolyte balance
3-waste product excretion
4-drug and hormone elimination/metabolism
5-Bp regulation
6-hematocrit regulation
7-regulation of Ca/Phosphate blance
8-Vit D3 metabolism

Front 4

The ureters are ____________ to the ovarian/testicular artery.

Back 4

posterior (water under the bridge)

Front 5

What are three screening methods that can be checked for preventative measure in renal disease?

Back 5

-serum creatinine
-GFR
-Urine testing

Front 6

Is BUN used for preventative screening?

Back 6

NO

Front 7

Why does a normal creatinine level not always mean everything is okay?

Back 7

because you need to lose 50-75% of function before there is a change

Front 8

Role of the kidney? (REEM)

Back 8

R-regulates
E-endocrine
E-exocrine
M-metabolic

Front 9

What endocrine funcions does the kidney take care of?

Back 9

erythropoietin/prostaglandin regulation

Front 10

What exocrine functions does the kidney take care of?

Back 10

waste product and drug regulation

Front 11

Filtration of the kidneys work not because of concentraion gradient, but by what?

Back 11

hydrostatic pressure

Front 12

___________ is a bag of highly spedialized capillaries in the kidney?

Back 12

Glomerulus

Front 13

What are 3 unique properties of the glomerular capillary?

Back 13

-increased hydraulic pressure
-increased permeability
-location btw 2 arteriolar bed (afferent and efferent)

Front 14

What are the main 3 functions of the nephron?

Back 14

-filtration
-secretion
-reabsorbtion

Front 15

Renin is a produced where?

Back 15

juxtaglomerular apparatus

Front 16

Renin release is controlled by what 4 things?

Back 16

1-afferent arterioles
2-renal sympahtetic nerve and glomeruli
3-Macula densa
4-Angiotensin II

Front 17

When does the afferent arteriole release renin?

Back 17

when it is constricted

Front 18

Aldosterone causes the retention of what?

Back 18

sodium

Front 19

The adrenal medulla releases what?

Back 19

catecholamines

Front 20

What does aldosterone do to:
-sodium
-potassium
-Bp?

Back 20

-increase sodium
-decrease potassium
-increase Bp

Front 21

Aldosterone functions to maintain an adequate ECV by regulating what?

Back 21

the amount of sodium reabsorbed in the tubule

Front 22

Where is aldosterone produced?

Back 22

the glomerulosa cells of the adrenal cortex

Front 23

How does aldosterone change the shape of the receptor to allow for DNA binding?

Back 23

by binding to the intracellular mineralocortocoid receptor

Front 24

Aldosterone increases the number of what in the apical surface of principal cells?

Back 24

number of open sodium channels

Front 25

Besides increasing the # of open sodium channels, aldosterone also increases what?

Back 25

number of Na-K pumps on the basolateral surface

Front 26

Aldosterone mainly effects what part of the kidney?

Back 26

principal cells fo the collecting ducts

Front 27

Aldosterone release is dependent upon what two primary stimuli?

Back 27

-increasee in angiotensin II concentration

-increase in plasma K (leads to the release of aldosterone into circulation)

Front 28

What is the half-life of aldosterone?

Back 28

20 minutes

Front 29

Hypoaldosteronism will result in __________ sodium uptake in the collecting ducts, causing a decrease in ______, which leads to an increase in what?

Back 29

-decreased
-ECV
-sympathetic tone, renin, angiontensin II, and ADH

Front 30

Aldosteron affects the what tubules more?

Back 30

distal tubules

Front 31

What are some causes of Hypokalemia?

Back 31

-catacholamines used to treat asthma
-Alcolosis
-Diuretics/Drugs
-Aldosteronism
-vomiting
-too much insulin

Front 32

What are the two main actions of ADH?

Back 32

-water absorbtion
-vasoconstriction

Front 33

Dehydration leads to an ___________ in serum osmolarity?

Back 33

increase

Front 34

High osmolarity does what to ADH release?

Back 34

increases

Front 35

What disease is characterized by the pituitary gland not being able to secrete ADH?

Back 35

Central Diabetes insipidus

Front 36

What disease is seen when the collecting ducts are unable to respond to ADH due to a mutation in the V2 receptor?

Back 36

Nephrogenic Diabetes Insipidus

Front 37

What disease is seen when drugs or tumors result in continued secretion of ADH or increased action of ADH on the collecting ducts?

Back 37

Syndrome of inappropriate ADH secretion (SIADH)

Front 38

Constriction of the afferent arteriole will lead to a decreased pressure in the _________ ________, which inturn leads to a decreased what?

Back 38

-glomerular capillary
-decreased GFR

Front 39

Relaxation of the afferent arteriole leads to what?

Back 39

Increase in:
-GFR
-hydrostatic pressure

Front 40

Dilation of the efferent arteriole leads to what?

Back 40

decrease in GFR and hydrostatic pressure

Front 41

An increase in sympathetic output will _______ everything?

Back 41

contract

Front 42

Increased sympathetic output does what to GFR? It is seen in what?

Back 42

decrease
-seen in hemorrhage

Front 43

Prostaglandins dilate what?

Back 43

afferent and efferent arterioles

Front 44

Angiotensin II does what to arterioles?

Back 44

constricts

Front 45

What is reabsorbed in the Loop of Henle?

Back 45

-NaCl (25%)
-K (disending limb only)
-Water (disending limb only)
-Mg
-Ca

Front 46

What is secreted in the Loop of Henle?

Back 46

NOTHING

Front 47

In the DCT there is the reabsorption of what?

Back 47

-NaCl
-Water
-Ca
-Ammonia

Front 48

In the DCT, how much NaCl is absorbed in the proximal part?....Distal Part?

Back 48

-proximal 10%
-distal 2-5 %

Front 49

In the DCT, water is collected in what part of the tubule, and it is under the effect of what sex steroid?

Back 49

-distal part
-aldosterone

Front 50

In the DCT, calcium is collected in what part of the tubule, and is under the effect of what?

Back 50

-proximal
-parathyroid hormone

Front 51

In the DCT, ammonia is reabsorbed in what part of the tubule?

Back 51

distal

Front 52

What is secreted in the distal part of the DCT?

Back 52

K and H

Front 53

In the medullary part of the collecting ducts and tubules, what is reabsorbed?

What is it under the effect of?

Back 53

-water
-ADH

Front 54

What are some off label uses of Aldactone?

Back 54

-PCOS
-Facial hair in women

Front 55

ADH is released from where?

Back 55

the posterior pituitary where it is stored (it is NOT made there)

Front 56

Angiotensis II does what to BP?

Back 56

Increases BP

Front 57

NSAIDS do what to renin and water?

Back 57

-increase renin release
-increase water retention

Front 58

Antiotensin II does what to ADH?

Back 58

increases ADH

Front 59

Antiotensin II does what to aldosterone?

Back 59

increases aldosterone

Front 60

Angiotensin II does what to arterioles?

Back 60

vasoconstricts arterioles

Front 61

What are some regulatory mechanisms that help to maintain pH?

Back 61

-buffer systems of the blood
-concentration of carbonic acid controlled by the lungs
-concentration of bicarb controlled by the kidneys

Front 62

What is the best intracellular buffer?

Back 62

hemoglobin

Front 63

What is the best intravascular buffer?

Back 63

Bicarbonate

Front 64

Filtration works by what?

Back 64

hydrostatic pressure

Front 65

Is albumin easily filtered?

Back 65

NO

Front 66

What disease is characterized by HTN, swelling, and cola-colored pee?

Back 66

Post Strep-GN

Front 67

An increased BUN can mean what?

Back 67

hypovolemia and decreased GFR

Front 68

In low flow rates, about how much of filtered urea is reabsorbed?

Back 68

60%

Front 69

What are some causes of increased BUN?

Back 69

-increased protein catabolism
-increased protein digestion
-decreased GFR

Front 70

What are some causes of a decrease in BUN?

Back 70

-decreased protein intake
-decreased protein production that is seen in liver disease

Front 71

Creatinine is ______ filtered and ________ secreted?

Back 71

-freely filtered
-slightly secreted

Front 72

Creatinine clearance = what?

Back 72

GFR

Front 73

For every doubling of your blood creatinine, the filtration rate of your kidneys is what?

Back 73

cut in half

Front 74

What is normal BUN?

Back 74

10-20 mg/dl

Front 75

After filtration, what percent of BUN is reabsorbed by the tubules?

Back 75

50%

Front 76

BUN levels are related to what main 3 things?

Back 76

1-renal function
2-protein intake
3-liver function

Front 77

How is ceatinine formed?

Back 77

at a constant rate by dehydration of muscle creatine

Front 78

What is the normal serum level for creatinine?

Back 78

1-2 mg/dl

Front 79

What patients have low serum and urine creatinine?

Back 79

-children
-females
-elderly
-spinal cord injuries

Front 80

A BUN/Creatinine ratio of what means dehydration and renal failure?

Back 80

>20