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35 Cards in this Set

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Glomerular Proteinuria
appearance of large and negatively charged proteins in the urine. Suggests chaange in function of glomerular barrier.
Albuminuria
Loss of charge selectivity. Passes through the GLOMERULUS. Usually albumin is negatively charged, which reduces its permeability.
IgG in urine
size selectivity is lost, large plasma proteins in urine which escape through the RENAL TUBULES. Albumin also is released
Tubular Proteinuria
Beta-2 microglobulin in urine (and albumin). Endocytotic process impaired due to hypoxic or immunlogical damage.
What is Kf
the hydraulic permeability of the glomerular barrier x surface area availible for filtration.
What happens when there is a change in Kf
Increase in Kf: increase in GFR
Decrease in KF: decrease in GFR
(mostly due to surface area changes)
What happens when capillary oncotic pressure changes
Decrease pressure: increase GFR
Increase pressure: decrease GFR
What happens if there is a change in Bowmans space hydrostatic pressure (PBS)
increase PBS: decrease GFR
What happens when there is a vasoconstriction/vasodilation in the afferent arteriolar resistance
Vasoconstriction: decrease GFR & RBF
Vasodilation (decreased resistance): increase in GFR & RBF
What happens when there is a vasoconstriction/vasodilation in the efferent arteriolar resistance
Vasoconstriction: increase GFR & RBF
Vasodilation (decreased resistance): decrease in GFR & RBF
What happens to GFR and RBF when there is a strong activation of the renal nerve
Decrease in RBF and GFR
What happens to GFR and RBF when sympatheic nerves or EPI causes vasoconstriction
Minimal effects on GFR and RBF
Calculation of Excretion
(Urine conc of X)x urine flow rate
Calculation of Clearance
Cx = (Ux x V) / Px

Cx = clearance
Ux = urine conc
V = urine flow rate
Px = plasma conc
Filtration Fraction Calculation
FF = GFR / RPF (Renal plasma flow)
Describe the micturition reflex and the type of nerves/receptors activated
1. Bladder volume increase, detrusor muscle is stretched
2. Sensory afferents are activated
3. Parasympathetic efferents are activated, detrusor contraction occurs
4. Urine forced through internal sphincter and into urethra, 2nd set of sensory afferents activated.
5. Tonix activity of somatic motor nerve to external sphincter is inhibited, sphincter is relaxed.
6. urine is released
What kind of receptors inhibits bladder voiding
Muscarinic
Define Filtration
removal of dissolved substances and water from the plasma, this occurs in the glomerulus
Define Reabsoption
recapturing filtered solute and water and returning it to the plasma, this occurs in the tubules
Define Secretion
movement of solute from peritubular capillaries INTO the tubules
Filtered Load calculation
GFR x plasma conc Y
What happens when a substance has a clearance greater than GFR
is must be secreted
What happens when a substance has a clearance less than GFR
it must be reabsorbed
what is the relationship between serum creatinine and GFR?
inverse relationship, higher the serum concentration of creatinine the lower the GFR
Proximal tubule Na reabsoption
Na reabsorbed by:
Na/H antiport
Na/solute symport
passive diffuction with Cl
solvent drag with water

67% is reabsorbed this way
Na reabsopbtion in the Loop of Henle: thin descending limb
no reabsoption
Na reabsopbtion in the Loop of Henle: thin asecending limb
no reabsoption
Na reabsopbtion in the Loop of Henle: thick ascending limb
Na/K ATPase
Apical transporter Na-K-2Cl symport
Na/H antiport
Passive paracellular reabsorption
Na reabsorption in distal tubule and collecting duct
use of symporter
Na reabsorption in late distal tubule and collecting duct
principle cells reabsorb Na by Na/K ATPase
Free water clearence
Positive = dilute urine
Negative = concentrated urine
Furosemide
Loop diuretic, inhibiets Na-K-2 Cl Symports in the thick ascending limp
Thizides
block Na/Cl symport in the early distal tubule
K+ sparing diretics (spironolactone, amiloride)
work at the late distal and cortical collecting duct.
spironolactone: block aldosteron receptors
Amiloride: block ENaC
How do certain drugs increase K+ lost in urine
Because the increase in tubular flow and Na delivery increase K secretion