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98 Cards in this Set
- Front
- Back
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which kidney taken for transplants? Why?
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left, b/c long renal vein
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what is relation b/t ureters and uterine artery + ductus deferens?
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ureters are under both
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what % of body weight is total body water?
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60%
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what % of TBW is extra cellular? Intracellular?
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Extra cellular is 1/3, intracellular is 2/3
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does ECF have high/low Na? K?
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high NaCl, low K
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does ICF have high/low Na? K?
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high K, low NaCl
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what % of ECF is plasma volume? ISF?
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ECF is 1/4, ISF is 3/4
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what is plasma volume measured by?
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radiolabled albumin
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what is ECF volume measured by?
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inulin
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what are the layers of glomerular filtration barrier?
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fenestrated capillary endothelium (size), fused BM w/ heparan sulfate, epithelial layer w/ podocytes
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what syndrome when charge barrier of glomerular filtration barrier lost?
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nephrotic syndome
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formula for renal clearance
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C = UV/P
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units of clearance
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ml/min
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Ux
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urine concentration of X
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Px
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plasma concentration of X
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V
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urine flow rate
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if clearance < GFR what happened?
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net reabsorption
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what substance used to calculate GFR?
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inulin
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normal GFR?
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100 ml/min
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the clearance of what substance is approx of GFR? Does it over or underestimate?
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Creatinine; overestimates b/c slight secretion
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Effective renal plasma flow estimated w/ clearance of what?
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PAH (filtered + actively secreted @ PT)
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formula for ERPF
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ERPF = Upah x V / Ppah = Cpah
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how much does ERPR understimate true RPF?
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10%
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formula for RBF
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RBF = RPF / (1-Hct)
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formula filtration fraction
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FF = GRF/RPF
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normal FF?
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20%
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formula filtered load
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GFR x plasma conc
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prostaglandins dilate which renal vessels?
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afferent arteriole
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AT2 constricts which renal vessels?
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efferent arteriole
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formula excretion rate
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excretion rate = V x U
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Formula reabsorption
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reabsorption = filtered - excreted
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formula secretion
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secretion = excreted - filtered
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glucose is reabsorbed where? How?
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at proximal tubule, by Na+/glucose cotransport
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what is treshold of glucose transport?
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160-200 mg/dL
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what is Tm of glucose transport?
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350 mg/dL
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how are amino acids reabsorbed? Where?
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Na+ dependent transporters @ PT
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Hartnup's disease
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deficiency of neutral amino acid (tryptophan) transporter --> pellegra
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what is absorbed at PT?
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all of glucose, amino acids; most of bicarb, Na+, Cl-, H2O; isotonic
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what is generated at PT?
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ammonia (buffer for secreted H+)
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how does PTH act at PT?
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inbibit Na/P co transport --> phosphate excretion
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how does AT2 act at PT?
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stimulates Na/H exchange --> increase Na, H2O reabsorption
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what is absorbed at TALH?
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actively reabsorbs Na, K, Cl; indirectly induces paracellular absorption of Mg, Ca
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what section is impermeable to H2O?
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TALH
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what is absorbed at thin descending loop of Henle?
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passive reabsorbs H2O via medullary hypertonicity
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what section is impermeable to Na?
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thin descending loop of Henle
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where is the concentrating segment?
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thin descending loop of Henle
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where is the diluting segment?
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TALH, DCT
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what is reabsorbed at DCT?
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activel reabsorbs Na, Cl
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how does PTH act at DCT?
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increase Ca/Na exchange --> Ca2+ reabsorption
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what is reabsorbed at CCT?
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reabsorb Na+ in exchange for secreting K+, H+
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how does aldosterone act at CCT?
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insert Na+ channels on luminal side
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how does ADH act at CCT?
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at V2 receptors --> insert aquaporin channels on luminal side
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when is TF/P < 1?
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when solute is resabsorbed more quickly than water
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when is TF/P > 1?
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when solute is reabsorbed less quickly than water
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what 3 things trigger Renin release?
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decrease BP (JG cells), dec Na+ delivery (MD cells), inc S tone
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where is EPO released from?
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endothelial cells of peritubular capillaries
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ANP secreted in response to?
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increased atrial pressure
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ANP causes?
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inc GFR + Na+ filtration w/ NO compensatory Na+ reabsorption distally
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net effect of ANP
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Na+ + volume loss
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PTH secreted in response to?
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dec Ca+, vit D; inc P
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PTH causes?
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inc Ca+ reabsorption (DCT), vitD3 production, dec P reabsorption (PCT)
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net effect of PTH?
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inc Ca+ and P absorption from gut
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AT2 synthesized in response to?
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dec BP
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AT2 causes?
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efferent arteriole constriction --> inc GFR, FF WITH compensatory Na+ reabsorption
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net effect of AT2?
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preservation of renal function in a low volume state w/ simultaneous Na+ reabsoprtion to decrease additional volume loss
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ADH secreted in response to?
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inc plasma osmolarity + dec blood volume
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mechanism of ADH?
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binds principle cells --> increase # water channels
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aldosterone secreted in response to?
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dec blood volume + inc K+
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effect of aldosterone?
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inc Na+ reabsorption, K secretion, H secretion
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insulin causes hyper/hypo K?
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insulin causes hypoK (into cell) via Na/K ATPase
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β agonists cause hyper/hypo K?
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hypoK+ via Na/K ATPase
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acidosis causes hyper/hypo K?
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acidosis causes hyperK (out of cells) via K/H exchanger
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hyperosmolarity causes hyper/hypo K?
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hyperosmolairty cause hyperK
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digitalis causes hyper/hypo K?
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digitalis causes hyperK via blocking Na/K ATPase
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cell lysis causes hyper/hypo K?
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cell lysis causes hyper K
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electrolyte disturbance: disorientation, stupor, coma
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low Na+
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electrolyte disturbance: neurolgoic irritability, delirium, coma
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high Na+
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electrolyte disturbance: seconadyr to metabolic alkalosis, hypoK+, hypovolemia, inc aldosterone
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low Cl-
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electrolyt disturbance: secondary to non anion gap metabolic acidosis
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high Cl-
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electroyte disturbance: U waves, flattened T waves, arrhythmias, paralysis
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low K+
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electrolyte disturbance: peaked T waves, wide QRS, arrhythmias
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high K+
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electrolyte disturbance: tetany, NM irritability
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low Ca2+
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electrolyte disturbance: delirium, renal stones, abd pain
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high Ca2+
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electrolyte disturbance: NM irritability, arrhythmias
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low Mg2+
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electrolyte disturbance: delirium, dec DTRs, cardiopulmonary arrest
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high Mg2+
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electrolyte disturbance: low mineral ion product causes bone loss, osteomalacia
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low PO4-3
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electrolyte disturbance: high mineral ion product cuases renal stones; metastatic calcifications
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high PO4-3
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Henderson Hasselbalch equation
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pH = pKa + log [HCO3-] / .03 pCO3
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Winters formula
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pCO2 = 1.5 (HCO3-) + 8
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Anion gap formula
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Na - Cl - HCO3
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normal anion gap
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8-12 mEq/L
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MUDPILES: causes of increased anion gap
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methanol, uremia, DKA, paraldehye or pheniformin, iron tablets or INH, lactic acidosis, ethylene glycol, salicylates
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early asprin toxcitiy causes what acid/base disturbance?
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respiratory alkalosis
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late asprin toxicity causes which acid/base disturbance?
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metabolic acidosis
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RTA type 1
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defect in CCT ability to excrete H+; assoc w/ hypoK+, risk for Ca+ stones
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RTA type 2
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defect in PT HCO3- reabsorption; assoc w/ hypoK+, hypoP rickets
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RTA type 4
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hypoaldosteronism or no response to aldosterone; assoc w/ hyperK+, inhibition of ammonium excretion in PT
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RTA type 4 leads to what change in urine pH?
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decrease urine pH d/t decreased buffering capacity
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