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15 Cards in this Set

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Renal

AD renal disease associated with subarachnoid hemorrhages and mitral valve prolapse?
Adult polycystic kidney disease
-cysts are not present at birth (AD diseases all have delayed manifestation)
-causes HTN --> berry aneuryism leading to subarachnoid hemorrhage/intracerebral bleed
-mitral valve prolaspse ("click murmur")
-diverticulosis ("PT with HTN with renal abnormality who has hematochezia (mcc of hemato = diverticulosis) Dx: adult polycystic kidney dz)
Renal

Describe the renal filtration barrier:
The glomerular filtration barrier is responsible for filtration of plasma according to the size and net charge.

Composed of:
1. fenestrated capillary endothelium (size barrier)
2. fused basement membrane with haparin sulfate (negative charge barrier)
3. epithelial layer consisting of podocyte foot processes
Renal

When is the charge of the glomerular filtration barrier lost and what does this cause?
Lost in nephrotic syndrome:
albuminuria, hypoproteinemia, generalized edema, and hyperlipidemia
Renal

Plasma volume is measured by what two compounds?
albumin
evans blue
Renal

What is extracellular volume measured by?
Mannitol and inulin
Renal

What are all the formulas for GFR?
GFR = UV/P if substance is not secreted or absorbed (like inulin)

FF = GFR/RPF

Filtered load = GFR x plasma conc.
Renal

What does afferent arteriole contriction do to RPF, GFR, and FF? Efferent? Increase in plasma conc? Decrease in plasma conc? Constriction of ureter?
RPF: decrease
GFR: decrease
FF: NC

Efferent:
RPF: decrease
GFR: increase
FF: increase

Increase plasma conc:
RPF: NC
GFR: decrease
FF: decreased

Decreased plasma conc
RPF: NC
GFR: increased
FF: increased

Constriction of ureter
RPF: NC
GFR: decreased
FF: decreased
Renal

What is the formula for free water clearance?
C of H20 = V - Cosm

V=urine flow rate
Cosm = UosmolalityV/Posm
Renal

At what glucose conc is the glucose uptake receptors in the proximal tubule saturated?
350 mg/dl
Renal

Describe amino acid clearance in the kidney:
There is reabsorption of AA by at least 3 different carrier systems and they each display competitive inhibition.

Also, secondary active transport occurs in the proximal tubule and is saturable
Renal

A pt was in a car accident. You are given his urine creatine and urea conc., and plasma creatine and urea conc.

Find his GFR:
Filtered equals excreted
Renal

What cells secrete renin and in response to what?
JG cells of the smooth muscle in the afferent arteriole
Renal

What hormone in the adrenal cortex is activated by angiotensin II?
18-hydroxylase
Renal

What cells induce renal sympathetic discharge?
Beta 1: causes an increase in cAMP which causes and increase in renin.

Beta2: can also cause

(B2 can also be activatated with increase cAMP = vasodilation)
Renal
HY HY HY p.68Gs

How do you calculate positive free water clearance?
Ch2o = V - COsm

Ch2o is free water clearance
V = volume of urine in mL/min
COsm = obligated water = UOsm x V / Posm

A positive CH2O indicates dilution (free water lost in urine): it could also indicate acute tubular necrosis and abscence of normal renal dilution/concentration

Loop diuretics inhibit generation of free water. And patients with unretricted water intake can't generate free water and develop hyponatremia.