Pbd Final

Front 1

The waste product found in the blood that results from the metabolism of nitrogen-containing compounds is?

Back 1

Urea

Front 2

The visceral layer of Bowman's Capsule is made up of ___________ cells

Back 2

Podocytes

Front 3

The hormone released from the kidney that stimulates the bone marrow to produce red blood cells is __________________.

Back 3

Erythropoietin

Front 4

Which of the following is a function of renal mesangial cells:
a. secrete the enzyme renin
b. serve in a sensory capacity to monitor flow in the renal tubules
c. are phagocytic cells
d. form the glomerular filtration slits
e. all of the above

Back 4

C. Are phagocytic cells

Front 5

Concerning renal handling of penicillin, which of the following is NOT true:
a. it is transported by the same protein that moves endogenous organic anions
b. this is an example of a maximal tubular transport capacity (TM) system
c. the transporters involved can be blocked by giving PAH
d. the system results in the amount of penicillin filtered exceeding the amount excreted
e. all of the above are true

Back 5

d. The system results in the amount of penicillin filtered exceeding the amount secreted

Front 6

Inulin is infused into a patient to obtain a constant plasma concentration of 4 mg/l. Urine is collected for 1 hour and has a volume of 100 ml. The urine inulin concentration is 360 mg/l. The clearance of inulin (put down your calculators) gives what valuable information about renal function: _____________________.

Back 6

GFR

Front 7

The minimum amount of water required to remove the waste products produced each day is referred to as _________________________.

Back 7

Obligatory water loss

Front 8

The major extracellular buffer system is the _______________.

Back 8

CO2- HCO3 system
Carbon dioxide- bicarbonate system

Front 9

T/F:
An elevated level of uric acid in the plasma is referred to as azotemia.

Back 9

False, gout
Azotemia is the increase of nitrogenous waste or BUN, aka uremia

Front 10

T/F:
Secretion by the renal tubules represents a second pathway for substances carried in the plasma to enter the tubules

Back 10

True

Front 11

functional unit of the kidney is the ___________.

Back 11

Nephron

Front 12

T/F:
In the first part of the proximal tubule, sodium crosses the lumenal membrane by countertransport with H+.

Back 12

True

Front 13

T/F:
Due to the characteristics of inulin, it is used to measure renal plasma flow.

Back 13

False, measures GFR aka clearance

Front 14

The units used to express clearance are?

Back 14

Volume of plasma per time

Front 15

If renal plasma flow is 519 ml/min, GFR is 115 ml/min, and the clearance of drug X is 95 ml/min, then drug X is:
a. not filtered
b. undergoing net reabsorption
c. undergoing net secretion
d. can not tell

Back 15

b. Undergoing net reabsorption

Front 16

Concerning the Loop of Henle, which of the following is NOT true:
a. the ascending limb pumps sodium out of the lumen
b. the descending limb is permeable to water
c. this system is called the countercurrent multiplication system
d. all of the above are true

Back 16

d. All of the above are true

Front 17

T/F:
The renal system is the fastest system for maintaining correct plasma pH

Back 17

False, the respiratory system is fastest in response

Front 18

T/F:
Loss of colonic contents is equivalent to adding alkaline material to the body.

Back 18

False, equivalent to adding acidic material to body

Front 19

T/F:
In the first part of the proximal tubule, sodium crosses the lumenal membrane by cotransport with H+.

Back 19

False, counter transport

Front 20

T/F:
Due to the characteristics of para-aminohippuric acid (PAH), it is used to measure GFR.

Back 20

False, PAH measures renal blood flow

Front 21

T/F:
The definition of clearance of a substance is: the volume of plasma from which the substance is completely cleared by the kidneys per unit time.

Back 21

True

Front 22

If renal blood flow is 483 ml/min, GFR is 128 ml/min, and the clearance of drug X is 175 ml/min, then drug X is:
a. not filtered
b. undergoing net reabsorption
c. undergoing net secretion
d. can not tell

Back 22

c. undergoing net secretion

Front 23

What are the major components of the intracellular buffer system?

Back 23

Proteins and phosphate

Front 24

_______________ is released by the kidneys in response to low plasma sodium, reduced renal blood pressure, or increased outflow from renal sympathetic nerves.

Back 24

Renin

Front 25

In the glomerular capillaries of an healthy individual, the Starling force that should be zero or close to zero is ________.

Back 25

Tissue oncotic pressure

Front 26

T/F:
If the fraction excreted is less than one, then net secretion is taking place

Back 26

False, net reabsorption

Front 27

T/F:
Antidiuretic hormone increases the permeability of the collecting ducts for the kidneys.

Back 27

True

Front 28

If a patient has arterial blood values of:
pH= 7.48
[HCO3]= 32 mEq/L
Pco2= 46 mmHg
They are in a state of?

Back 28

Metabolic alkalosis with respiratory compensation

Front 29

The diuretic that blocks sodium reabsorption in the thick ascending limb of the Loop of Henle is in the class of diuretics known as ______________________.

Back 29

Loop diuretics

Front 30

The renal tubule casts that are formed in the collecting ducts, contain dead cells, and are sometimes called "renal failure cast" are properly referred to as __________________________.

Back 30

Broad, granular cast

Front 31

T/F:
Hematuria is always indicative of disfunction of the glomerular filtration apparatus (barrier).

Back 31

False, Proteinuria

Front 32

T/F:
The radiologic exam used to evaluate the abdominal cavity is the retrograde pyelogram.

Back 32

False, intravenous pyelogram

Front 33

T/F:
The class of diuretic that has the greatest potential of disturbing plasma pH is the thiazide class.

Back 33

False, Carbonic Anhydrase Inhibitors

Front 34

T/F:
The macula densa consists of specialized vascular cells in the afferent and efferent arterioles that produce and store renin

Back 34

False, Juxtaglomeruler cells

Front 35

T/F:
Constriction of the afferent arterioles would increase flux (GFR) out of the glomerular capillaries.

Back 35

False, decrease flux

Front 36

T/F:
If the clearance of a drug is less than that of inulin, then there is net reabsorption of that drug.

Back 36

True

Front 37

T/F:
Angiotensin II and aldosterone stimulate the release of antidiuretic hormone (ADH / vasopressin).

Back 37

True

Front 38

T/F:
Creatinine is secreted by the renal tubules but in only very small amounts. Therefore, the clearance of creatinine tends to underestimate GFR.

Back 38

False, overestimates GFR

Front 39

T/F:
Low levels of plasma protein would increase GFR.

Back 39

True

Front 40

Plasma levels of urea are measured as ____________

Back 40

Blood urea nitrogen, BUN

Front 41

T/F:
Angiotensin converting enzyme (ACE) cleaves angiotensin I (AI) to form angiotensin II (AII).

Back 41

True

Front 42

T/F:
Filtered glucose crosses the luminal (apical) membrane of the tubular epithelial cells of the early segment of the proximal tubule by countertransort with sodium.

Back 42

False, cotransport

Front 43

T/F:
The ascending limb of the Loop of Henle is highly permeable to water.

Back 43

False, the descending limb

Front 44

T/F:
Severe diarrhea can produce acidosis.

Back 44

True

Front 45

T/F:
The reabsorption of filtered bicarb (HCO3-) depends on the tubular secretion of hydrogen ions.

Back 45

True

Front 46

Reabsorption of water from the proximal renal tubules via the intercellular spaces between the tubular epithelial cells is referred to as movement through the ______________ pathway.

Back 46

Paracellular

Front 47

To determine if a substance is undergoing net secretion or reabsorption by the renal tubules, the clearance of that substance is compared to the clearance of inulin or creatinine and this ratio is referred to as __________________ .

Back 47

Fraction excreted

Front 48

T/F:
Dietary sodium restriction can result in an upregulation of the inducible Cox 2 expression and the inhibition of renin release

Back 48

False, only restricts COX2 upregulation, and results in renin release

Front 49

T/F:
Eccentric hypertrophy of the heart is usually associated with a pressure overload condition.

Back 49

False, concentric

Front 50

T/F:
In addition to ACE another enzyme that can convert Angtiotensin I to Angiotensin II in man is the chymase enzyme.

Back 50

True

Front 51

T/F:
Angiotensin II is important in the clotting system. It can inhibit the production of plasmin via its activation of a plasminogen activator inhibitor.

Back 51

True

Front 52

T/F:
When systolic pressures exceed160 mmHg, the risk of stroke is increased 2 fold.

Back 52

False, 4 folds

Front 53

The kidney is important in volume and blood pressure control. It has a powerful negative feedback on pressure and the process by which the kidney performs this feat is called______________________.

Back 53

Pressure diuresis

Front 54

In the two kidney, one-clip model of hypertension renin levels are initially elevated. Do they stay elevated or come back down to normal?

Back 54

Stay elevated

Front 55

Nitric oxide can stimulate a vasodilatory action at the vascular smooth muscle. What is the second messenger for this action? _______________.

Back 55

cGMP

Front 56

T/F:
Insulin, aldosterone, and epinephrine decrease the rate of uptake of potassium into the cells of the body

Back 56

False, increase the rate of uptake

Front 57

T/F:
A patient with a plasma potassium level of 3.0 mEq/L would be considered hypokalemic.

Back 57

True

Front 58

T/F:
The principle cells of the distal tubule reabsorb potassium into the tubule.

Back 58

False, intercalated cells

Front 59

T/F:
Thiazide diuretics, such as chlorothiazide, have as a site of action the ascending limb of the Loop of Henle.

Back 59

False, site of action is early distal tubule

Front 60

T/F:
Plasma pH tends to decrease during sleep

Back 60

True

Front 61

T/F:
Poststreptococcal diffuse proliferative glomerulonephritis is a common cause of the nephritic syndrome in children.

Back 61

True

Front 62

T/F:
Long-term, high-dose use of analgesics can cause chronic glomerulonephritis

Back 62

False, chronic pyelonephritis

Front 63

Which of the following is NOT a characteristic of the Nephrotic Syndrome:
a. generalized edema
b. hyperalbuminemia
c. massive proteinuria
d. hyperlipiduria

Back 63

b. hyperalbuminemia

(its hypoalbuminemia)

Front 64

A patient's arterial blood values are:
pH = 7.48
[HCO3-] = 32 mEq/L
PCO2 = 46 mmHg
This person has?

Back 64

Metabolic alkalosis with respiratory compensation

Front 65

T/F:
The radiologic exam used to evaluate the renal pelvis is the retrograde pyelogram

Back 65

True

Front 66

T/F:
The syndrome characterized by acute onset, hematuria, RBC casts, hemoglobin casts, some oliguria, and azotemia that often follows a streptococcal infection in children is the nephrotic syndrome.

Back 66

False, nephritic syndrome

Watch the spelling!!
I not O

Front 67

T/F:
The leading cause of renal-failure death is acute pyelonephritis.

Back 67

False, chronic glomerulonephritis

Front 68

T/F:
The chymase enzyme is part of an alternative pathway for the conversion of angiotensinogen to angiotensin I.

Back 68

False, AngI--> AngII

Front 69

T/F:
Systemically, renin is the rate limiting enzyme in the renin-angiotensin system.

Back 69

True

Front 70

T/F:
Angiotensin II may exert a positive feedback regulation on angiotensinogen via its action on the AT1 receptor .

Back 70

True

Front 71

T/F:
The primary source of angiotensinogen for the systemic RAS is the kidney.

Back 71

False, hepatocytes in liver

Front 72

T/F:
There are both short and long loop feedbacks to inhibit renin release. The long loop is an increase in BP while the short loop would be an increase in Ang II levels.

Back 72

True

Front 73

T/F:
AT2 receptors are widely distributed in fetal tissue and usually act to increase the actions of AT1 receptor activation.

Back 73

False, decrease by acting in opposition of AngII on AT1 receptors

Front 74

What is considered the major reason that less than 35% of the patients with hypertension have their blood pressure controlled to 140/90 mmHg ______________.

Back 74

Compliance

Front 75

T/F:
The inflammatory renal disorder that frequently occurs in children following a streptococcal infection is poststreptococcal diffuse proliferative glomerulonephritis.

Back 75

True

Front 76

T/F:
Angiotensin II can facilitate the release of catecholamines, aldosterone and ADH.

Back 76

True

Front 77

T/F:
The primary source of aldosterone for the systemic RAS is the adrenal cortex.

Back 77

True

Front 78

T/F:
The AT1 and the AT2 receptors both are of similar molecular weight, have 7 transmembrane regions and are bound by Ang II; however, once stimulated, their actions usually oppose each other.

Back 78

True

Front 79

T/F:
Chronic ACE inhibition will block the breakdown of Ang 1-7.

Back 79

True

Front 80

T/F:
. Filtration fraction is defined as the ratio of glomerular filtration rate over (divided by) renal plasma flow.

Back 80

True

Front 81

T/F:
For para-aminohippuric acid (PAH), the amount excreted by the kidneys equals the amount filtered plus the amount secreted.

Back 81

True

Front 82

T/F:
Frequent urination during the night is referred to as oliguria.

Back 82

False, nocturia

Front 83

Plasma potassium levels greater than 5.5 mEq/L would be considered?

Back 83

Hyperkalemia

Front 84

T/F:
arterial blood sample reveals the following values: pH of 7.37, PCO2 = 50 mmHg, and HCO3- = 28 mEq/L. This patient has respiratory acidosis with renal compensation.

Back 84

True

Front 85

T/F:
Potassium is secreted into the tubular fluid by the intercalated cells.

Back 85

False, principle cells

Front 86

T/F:
Casts observed during a microscopic exam of a urine sample that appear as clear (transparent) cylinders are referred to as fatty cast.

Back 86

False, hyaline cast

Front 87

T/F:
Diffuse proliferative glomerulonephritis (Diffuse PGN) is the most frequent of all glomerular lesions.

Back 87

True

Front 88

T/F:
Plasma pH usually goes down in a patient with a fever.

Back 88

True

Front 89

The most potent class of diuretics that work by disrupting the countercurrent multiplier are the ________________ diuretics.

Back 89

Loop

Front 90

Hypoalbuminemia, massive proteinuria, and generalized edema would be associated with the ________________ syndrome.

Back 90

Nephrotic syndrome

Front 91

T/F:
The kidneys play an important role in the degradation of the active form of Vitamin D to the inactive form.

Back 91

False, degradation of inactive form to active form

Front 92

T/F:
If other variables remain constant, constriction of the efferent arterioles would increase glomerular capillary pressure.

Back 92

True

Front 93

Specialized epithelial cells of the ascending limb of the renal tubule, referred to collectively as the _____________.

Back 93

Macula densa

Front 94

T/F:
Autoregulation, via the myogenic mechanism, can regulate renal blood flow and, therefore, glomerular filtration rate (GFR), even under extreme conditions such as hemorrhage resulting in serious hypotension

Back 94

False, GFR cannot be regulated under large outflow

Front 95

The hormone produced by the kidneys that stimulates bone marrow production of erythrocytes is ___________.

Back 95

Erythropoietin

Front 96

. ______________ cells, found in association with the glomerulus, are phagocytic, have myofilaments, and lay down an extracellular matrix that supports the glomerular capillaries.

Back 96

Mesangial cells

Front 97

T/F:
Atrial natriuretic hormone (ANH) and the natriuretic factor (quabain-like factor) both increase the sodium excretion by the same mechanism.

Back 97

False, ANH is through increase in cGMP, Natriuretic factor inhibits Na/K ATPase pump

Front 98

T/F:
Renin is the rate-limiting enzyme in the systemic renin-angiotensin system

Back 98

True

Front 99

T/F:
Individuals with the II (insertion) polymorphism for the non-coding region of the ACE enzyme have higher circulating levels of ACE and are more prone to cardiovascular diseases that do individuals with the DD (deletion) ACE polymorphism.

Back 99

False, have lower circulating levels

Front 100

T/F:
Hepatocyte angiotensinogen mRNA can be upregulated by estrogen

Back 100

True

Front 101

T/F:
Kinins, prostaglandins and endothelins have natriuretic and diuretic actions on the kidney.

Back 101

False, Endothelins are anti- natriuretic

Front 102

Blood pressure in a borderline hypertensive patient is about ___________.

Back 102

140/90 mmHG

Front 103

T/F:
The hereditary kidney disease that produces enormous kidneys containing large, fluid-filled cysts is hepatorenal syndrome.

Back 103

False, polycystic kidney disease

Front 104

T/F:
Kinins can increase the production of plasmin, whereas Angiotensin II will reduce levels of plasmin by stimulation of PAI-1.

Back 104

True

Front 105

The activation of pro-renin to renin is mediated by the enzyme ________.

Back 105

Cathepsin B

Front 106

T/F:
. If plasma glucose levels are above the maximal tubular transport capacity (TM), the amount of glucose excreted is equal to the amount filtered minus the amount reabsorbed.

Back 106

True

Front 107

T/F:
The reabsorption of penicillin out of the renal tubules is enhanced by iv infusion of PAH, an organic anion that is transported by the same membrane transport system that moves penicillin

Back 107

False, slows down reabsorption, not enhance it

Front 108

T/F:
An increase in plasma osmolarity results in the release of antidiuretic hormone and results in the production of a more concentrated urine.

Back 108

True

Front 109

T/F:
During drug development, fraction excreted of the drug is calculated to determine if the drug is undergoing net secretion or net reabsorption.

Back 109

True

Front 110

The secretion of hydrogen ions in the proximal tubule to capture filtered bicarb ions is referred to as ____________.

Back 110

Ion trapping

Front 111

T/F:
75% of the hypertensive patients in the US do have their blood pressure controlled with appropriate drug intervention.

Back 111

False, 75% does not

Front 112

T/F:
The actions of kinins on endothelial cells can result in an increase in the production of plasmin, whereas angiotensin II acts on the endothelial cells can result in the generation of PAI-1 which will decrease the production of plasmin.

Back 112

True

Front 113

T/F:
Pro-renin levels are normally higher in the plasma than renin levels and these substances may contribute to hypertrophy and fibrosis independent of AngII.

Back 113

True

Front 114

T/F:
AngII can facilitate the release of ADH, aldosterone, and catecholamines.

Back 114

True

Front 115

T/F:
In the skin, the local renin angiotensin system may be involved in wound healing since levels of AngII are elevated after injury.

Back 115

True

Front 116

T/F:
Chronic ACE inhibition can elevate levels of Ang-(1-7) by resulting in an increase in the synthesis and a decrease in the degradation of the peptide.

Back 116

True

Front 117

T/F:
AT2 receptors are widely distrubuted in fetal tissue, are re-expressed in times of injury and usually act in opposition to actions mediated by AT1 receptor activation.

Back 117

True

Front 118

T/F:
75% of the hypertensive patients in the US do have their blood pressure controlled with appropriate drug intervention.

Back 118

False, 75% does not

Front 119

T/F:
The actions of kinins on endothelial cells can result in an increase in the production of plasmin, whereas angiotensin II acts on the endothelial cells can result in the generation of PAI-1 which will decrease the production of plasmin.

Back 119

True

Front 120

T/F:
Pro-renin levels are normally higher in the plasma than renin levels and these substances may contribute to hypertrophy and fibrosis independent of AngII.

Back 120

True

Front 121

T/F:
AngII can facilitate the release of ADH, aldosterone, and catecholamines.

Back 121

True

Front 122

T/F:
In the skin, the local renin angiotensin system may be involved in wound healing since levels of AngII are elevated after injury.

Back 122

True

Front 123

T/F:
Chronic ACE inhibition can elevate levels of Ang-(1-7) by resulting in an increase in the synthesis and a decrease in the degradation of the peptide.

Back 123

True

Front 124

T/F:
AT2 receptors are widely distrubuted in fetal tissue, are re-expressed in times of injury and usually act in opposition to actions mediated by AT1 receptor activation.

Back 124

True

Front 125

What is the BUN range?

Back 125

8-26 mg/dl

Front 126

What is the product of the breakdown of creatine and what is the normal range?

Back 126

Creatinine, 0.6-1.2 mg/dl

Front 127

What is the by product of insulin?

Back 127

Hormones

Front 128

Bilirubin is formed from the metabolism of?

Back 128

Heme groups

Front 129

What is the pH range compatible with life (arterial)?

Back 129

6.9 - 7.8

Front 130

Prostacyclin (PGI2) and kinins are vaso__________.

Back 130

Dilators

Front 131

Prostaglandins (PGF2), thromboxane (Txa), and AngII are vaso__________.

Back 131

Constrictors

Front 132

If there is a decrease in O2 in blood flow, the release of erythropoietin ___________.

Back 132

Increase

Front 133

Absorption of what ion depends on the active form of Vitamin D?

Back 133

Ca++

Front 134

T/F:
The parachyma of the kidney has no pain/ nerves.

Back 134

True

Front 135

What is the name of the indentation on the medial border through which the renal vessels, nerves, and ureter exit?

Back 135

Hilum

Front 136

The _______ is the outer layer and has a stippled appearance.

Back 136

Cortex

Front 137

The _________ is the inner layer that includes many renal pyramids and is straited in appearance.

Back 137

Medulla

Front 138

How many nephrons are there total between the two kidneys?

Back 138

2 million

Front 139

Up to what percentage of nephron function can you lose without symptoms?

Back 139

90%

Front 140

What are the two types of nephrons?

Back 140

Cortical and Juxtamedullary

Front 141

What type of nephron is in the outer cortex and has short loops of Henle?

Back 141

Cortical nephrons

Front 142

What type of nephron is next to the medulla and has long Loops of Henle?

Back 142

Juxtamedullary nephrons, give straited appearance to renal pyramids

Front 143

What part of the nephron contains the filtering component (glomerulus)?

Back 143

Renal corpuscle

Front 144

The glomerulus consist of __________ which envelopes a tuft of _____________.

Back 144

Bowman's capsule; Glomerular capillaries

Front 145

The afferent arterioles take blood _____ the glomerular capillaries.

Back 145

To

Front 146

The efferent arterioles take blood _____ the glomerular capillaries.

Back 146

Away from

Front 147

What are the 2 parts of the Bowmans capsule?

Back 147

Parietal and visceral layers

Front 148

Which layer of the BC has a single layer of flattened epithelial cells?

Back 148

Parietal layer

Front 149

Which layer of the the BC has podocytes?

Back 149

Visceral layer

Front 150

When primary and secondary foot processes interdigitate they form slits used for what process?

Back 150

"seiving" or filtering

Front 151

Where is the Bowmans space?

Back 151

Between parietal and visceral layers

Front 152

What are the three layers of the filtration barrier?

Back 152

Fenestrated endothelium
Basement membrane
Podocytes (visceral layer)

Front 153

What is the purpose of the filtration slit membrane?

Back 153

To bride the filtration slits

Front 154

T/F:
In molecular sieving/ straining, negative charged (anions) molecules have a harder time passing though compared to a positive charged (cation) or uncharged (nuetral) molecule.

Back 154

True

Front 155

What cell cleanse the sieve of debris and is phagocytic?

Back 155

Mesangial cells

Front 156

Mesangial cells contain __________ that lay down mesangial _______ for the suport of the _____________.

Back 156

Myofilaments; Matrix; Glomerular tuft

Front 157

What tubule is composed of a single layer of epithelial cells that rest in the basement membrane and breaks down into several segment?

Back 157

Renal tubule

Front 158

What are the two parts of the proximal tubule?

Back 158

Proximal convoluted tubule (closest to glomerulus and renal corpuscle) and pars recta

Front 159

What are the 2 parts of the distal tubule?

Back 159

Distal convoluted tubule and connecting tubule

Front 160

What segment carries the wring from the the connecting segment of the nephron to a calyx of the renal pelvis?

Back 160

Collecting duct

Front 161

The renal pelvis connects to the _______ which carrie the urine to the urinary bladder.

Back 161

Ureter

Front 162

What are the 3 parts of the juxtaglomerular apparatus?

Back 162

Juxtaglomerular cells
Macula densa
Mesangial cells (Lacis or Goormaghtigh cells)

Front 163

_________ are specialized vascular cells (modified SM cells) in the afferent and efferent arterioles where renin is produced and stored in granules.

Back 163

Juxtaglomerular cells

Front 164

__________ are specialized epithelial cells of the thick ascending limb of the renal tubule.

Back 164

Macula Densa

Front 165

What are derived from division of the efferent arterioles and intimately associated with the renal tubule?

Back 165

The Peritubular capillaries (PTC)

Front 166

The __________ are long, straight vessles that run parallel to and give rise to a capillary plexus that is intimately associated with the Loops of Henle.

Back 166

Vasa recta

Front 167

T/F:
If you contract the afferent arteriole, pressure in the glomerulus will increase.

Back 167

False, pressure decreases

Front 168

In the starling hypothesis for the renal system, what does the J stand for?

Back 168

GFR

Front 169

If blood pressure increases, GFR will ___________.

Back 169

Increase

Front 170

What is known as when perfusion pressure increases and the smooth muscle in the arteriolar wall stretches inducing the SM to constrict?

Back 170

Myogenic mechanism

Front 171

The myogenic mechanism is an example of?

Back 171

Autoregulation

Front 172

Small changes in systemic arterial pressure (SAP) produce moderate _________ as a nueral control.

Back 172

Sympathetic discharge, NE release

Front 173

When under extreme conditions when there is larger sympathetic outflow, what happens to the afferent arterioles, Pc, and GFR?

Back 173

Afferent arterioles constrict, Pc and GFR are reduced

Front 174

When there is small changes in SAP, what happens to the GFR?

Back 174

It is maintained by the constricting or dilating of the afferent arteriole

Front 175

If your blood pressure is below 90, you are?

Back 175

hypotensive

Front 176

The tubuloglomerular feedback is a flow ___________ mechanism.

Back 176

Dependent

Front 177

T/F:
The macula densa is a sensory organ.

Back 177

True

Front 178

Explain the tubuloglomerular feedback.

Back 178

If there is too much flow in the tubules (leaking too much fluid) there is a constriction of the afferent arteriole to decrease GFR and shut down Pc

Front 179

The liver produces the plasma protein ______________

Back 179

Angiotensinogen

Front 180

T/F:
AngI is cleaved by ACE (angiotensin converting enzyme) to AngII.

Back 180

True

Front 181

What 3 factors affect the release of renin?

Back 181

Low plasma sodium levels
Reduced renal bloof pressure
Increased outflow from the renal sympathetic nerves

Front 182

T/F:
The kidney are innervated by the parasympathetic system.

Back 182

False, just the sympathetic

Front 183

AII is a potent vaso ________.

Back 183

Constrictor

Front 184

AII and AIII stimulate the release of what?

Back 184

Aldosterone

Front 185

AII does what 3 things affecting the renin- angiotensin system?

Back 185

Releases ADH/vasopressin
Enhances nuerotransmitter relase from sympathetic nerve endings
Stimulates drinking

Front 186

What is the 4 main functions of the nephron?

Back 186

Filtering
Reabsorption
Secretion
Excretion

Front 187

When a particle is filtered out of the vascular department then transported back into it, it is ___________.

Back 187

Reabsorbed

Front 188

This technique is used to measure pressures, withdram samples, and infuse fluids of known composition.

Back 188

Micropuncture

Front 189

In micropuncture, what two things are being observed?

Back 189

What happened to the filtarte as it traveled down the tubule
The modification of fluid by the epithelial cells

Front 190

What technique uses the clamping of the ureter to allow tubular cells to work on stationary fluid that is then tested?

Back 190

Stop- flow

Front 191

In the technique stop- flow, what does each sample represent?

Back 191

Different fuild from different segments of the tubule and the effects of the tubules on the stationary fluid

Front 192

T/F:
Many substances that pass through the glomerular filtration barrier into the renal tubule are found in small quantities or are totally absent in the urine.

Back 192

True
Absent because substances are reabsorbed

Front 193

Name 5 ways that substances move across membranes in tubular reabsorption.

Back 193

simple diffusion- electrochemical gradient
facilitated diffusion- membrane proteins
cotransport- secondary active transport requiring gradient
countertransport- same as co
primary active transport- requires ATP

Front 194

T/F:
The amount excreted - the amount filtered = amount reabsorbed

Back 194

False, its amount filtered - excreted = reabsorbed

Front 195

Sodium crosses the luminal (apical) membrane by ___________ with glucose, amino acids, PO4 and lactate.

Back 195

Cotransport/symporters

Front 196

Sodium crosses into the early segment of the proximal tubule during secretion by _________ with H+.

Back 196

Countertransport/antitransport

Front 197

Sodium crosses the basolateral membrane by ___________.

Back 197

Active transport/ Na-K-ATPase pump

Front 198

In the second half to the proximal tubule Na is _______ with Cl.

Back 198

Reabsorbed

Front 199

Glucose croses the luminal (apical) surface by _______ establishing a high glucose concentration inside the cell

Back 199

Cotransport

Front 200

Glucose crosses the basolateral membrane by ___________

Back 200

Simple facilitated diffusion

Front 201

The point at where the maximum amount of glucose is being absorbed is known as?

Back 201

The threshold (160-180 mg/dl)
or Maximal tubular transport capacity (Tm)

Front 202

Since glucose is ________ it has no hinderance in crossing the filtation barrier leading the amount of glucose in the plasma to be __________ than the amount of glucose in the filtrate.

Back 202

Freely filtered, equal to

Front 203

A secondary pathway into the tubule is?

Back 203

Secretion

Front 204

What is the primary pathway into the tubule?

Back 204

Filtration

Front 205

T/F:
Substances that are secrted (enter tubular fluid) cross the basolateral and luminal membrance of the tubular epithelial cells by different processes.

Back 205

True

Front 206

If a substance crosses one membrane by diffusion it will cross the other by ________ transport

Back 206

Primary/ Secondary active transport

Front 207

T/F:
The secretory systems that move organic cations also move penicillin.

Back 207

False, anions

Front 208

If plasma level increases then the amount secreted ________

Back 208

inceases

Front 209

T/F:
PAH competes with the same receptor when being excreted that penicillin does.

Back 209

True

Front 210

T/F:
High doses of penicillin have to be used and frequently in the presence of PAH in order to maintain therapuetic blood levels.

Back 210

False, low dose and less frequent

Front 211

Penicillin and organic anions have a _____ affinity for PAH

Back 211

high

Front 212

Filtrated + secretion =

Back 212

excretion

Front 213

T/F:
Sodium, potassium, chloride, bicarb, and glucose are all reabsorbed in the distal tubule, yet the fluid remains isotonic.

Back 213

False, proximal tubule

Front 214

What does the standing gradient theory state?

Back 214

The movement of water is coupled to sodium transport

Front 215

The standing gradient is ________ on the anatomy of the epithelial cell and localization of transport mechanism (Na pump on lateral membrane).

Back 215

Dependent

Front 216

As Na is pumped into the intercellular spaces the __________ pulls water from the tubular lumen, _________ the hydrostatic pressure within the spaces causing the water to flow thru the ______ into the ____________.

Back 216

Osmotic gradient,
increasing,
interstitium,
peritubular capillaries

Front 217

What is the best indicator for renal function and how its handling a drug?

Back 217

GFR aka clearance

Front 218

When measuring a free filtered drug, the amount per unit time ___________ the amount filtered per time.

Back 218

Equal to

Front 219

The amount of solute in a solution =

Back 219

[solute] x Volume of solvent

Front 220

Amount excreted per unit time=

Back 220

[urine] x Volume of the urine

Front 221

The amount filtered=

Back 221

[Plasma] x V of GFR (volume of filtrate)

Front 222

What is the equation to solve for GFR using [Uine] Volume of urine and [Plasma]?

Back 222

GFR= ([urine] x volume of urine)/([plasma])

Front 223

What characteristics must a compound have to be a true measure of GFR? (5)

Back 223

Freely filtrable
Not reabsorbed
Not secreted
Not synthesized by the tubules
Not metabolized by the tubules

Front 224

What substance meets all the requirements to measure the true GFR?

Back 224

Inulin, used in research
fructose polysaccharide

Front 225

What substance is used in clinical studies to measure GFR but doesnt meet the 5 requirements?

Back 225

Creatinine

Front 226

Which of the 5 factors in measuring true GFR does creatinine not meet?

Back 226

Its secreted by the tubules, in small amounts

Front 227

Creatinine __________ the GFR measurement?

Back 227

Overestimates

Front 228

If [urine]= 200 ml
[inulin] in the urine= 360 mg/L
[inulin] in the plasma= 4 mg/L
What would the GFR equal?

Back 228

GFR= ([urine] x volume of urine)/ [plasma]
= [(360mg/L)(0.2L/2hr)]/(4mg/L)
= 9 L/hr

Front 229

What is the volume of plasma from which the substance is completely cleared by the kidney per unit time?

Back 229

Clearance

Front 230

What are the units for clearance?

Back 230

Volume of plasma/ time

Front 231

If creatinine levels are at 100%, what happens to the GFR?

Back 231

It halves (50%)

Front 232

If GFR > Cr of inulin, than there is net __________

Back 232

Secretion

Front 233

If Cr of inulin > GFR than there is net __________

Back 233

Reabsorption

Front 234

Cdrug/ Cinulin equals?
(Ux/Px)/(Uin/Pin)

Back 234

Fraction excreted

Front 235

The fraction of plasma enetering the kidney in the renal artery that is filtered at the glomerulus is known as?

Back 235

The filtration fraction

Front 236

Filtration factor = (equation)

Back 236

FF= GFR/RPF
RPF= renal plasma flow

Front 237

If:
RBF (renal blood flow)= 1.1 L/min
Hct (hematocrit)= 0.45
(0.55 plasma, 0.45 RBC)
What would the RPF equal?

Back 237

RPF= RBF x Hct (plasma)
= (1.1 L/min)(0.55)
= 605 ml/min

Front 238

If RPF= 605 ml/min
GFR= 135 ml/min
What would be the filtration fraction?

Back 238

GFR/RPF= FF
= (135 ml/min)/(605 ml/min)
= 0.2