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99 Cards in this Set
- Front
- Back
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At what concentration is the transport mechanism for glucose saturated?
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300 mg/dL
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Define effective renal plasma flow.
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ERPF = U (PAH) x V/P (PAH) = C (PAH)
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Define filtration fraction.
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FF = GFR/ RPF
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Define free water clearance.
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C(H2O) = V- C(osm)
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Define GFR.
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GFR = U(inulin) x V/P (inulin) = C (inulin) GFR also equals the difference in (osmotic pressure of the glomerular capillary minus Bowman's space) and (hydrostatic pressure of the glomerular capsule minus Bowman's space).
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Define renal blood flow.
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RBF = RPF/1 - Hct
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Define renal clearance.
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Cx = UxV/Px The volume of plasma from which the substance is cleared completely per unit time.
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Define urine flow rate.
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V = urine flow rate C (osm) = U(osm)V/P(osm)
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How are amino acids cleared in the kidney?
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Reabsorption occurs by at least 3 distinct carrier systems, with competitive inhibition within each group.
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How do NSAIDs cause renal failure?
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By inhibiting the production of prostaglandins which normally keep the afferent arterioles vasodilated to maintain GFR
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How high can the osmolarity of the medulla reach?
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1200-1400 mOsm
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How is ICF measured?
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ICF = TBW - ECF
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How is interstitial volume measured?
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Interstitial volume = ECF - PV
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How is PAH secreted?
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Via secondary active transport
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How is PAH transport mediated?
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Mediated by a carrier system for organic acids
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How much of the ECF is interstitial fluid?
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Three-fourths
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How much of the ECF is plasma?
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One-fourth
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How much of the total body water is part of intracellular fluid?
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Two-thirds
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How much of the total body water is part of the extracellular fluid?
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One-third
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If clearance of substance X is equal to GFR, what occurs?
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There is no net secretion or reabsorption
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If clearance of substance X is greater than GFR, what occurs?
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Net tubular secretion of X
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If clearance of substance X is less than GFR, what occurs?
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Net tubular reabsorption of X
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T/F. Secondary active transport of amino acids is saturable.
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TRUE
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What 3 layers form the glomerular filtration barrier?
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1. Fenestrated capillary endothelium 2. Fused basement membrane with heparan sulfate 3. Epithelial layer consisting of podocyte foot processes
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What actions does ADH have on the kidney?
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-Increase water permeability of principle cells in collecting ducts -Increase urea absorption in CD -Increase Na/K/2Cl transporter in the thick ascending limb
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What actions does AII have on the kidney?
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-Contraction of efferent arteriole increasing GFR -Increased Na and HCO3 reabsorption in proximal tubule
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What actions does aldo have on the kidneys?
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-Increased Na reabsorption in distal tubule -Increased K secretion in DT -Increased H ion secretion in DT
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What actions does ANP have on the kidney?
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-Decreased Na reabsorption -Increased GFR
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What actions does PTH have on the kideny?
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-Increased Ca reabsorption -Decreased phosphate reabsorption -Increase 1,25-(OH)2 Vit D production
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What activates 1 alpha-hydroxylase?
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PTH
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What are the 4 actions of angiotensin II?
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1. Vasoconstriction 2. Release of aldo from adrenal cortex 3. Release of ADH from posterior pituitary 4. Stimulates hypothalamus to increase thirst
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What are the 4 endocrine functions of the kidney?
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1. EPO release 2. Vitamin D conversion 3. Renin release 4. Prostaglandins release
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What are the consequences of a loss in the charge barrier?
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-Albuminuria -Hypoproteinemia -Generalized edema -Hyperlipidemia
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What competitively inhibits the carrier system for PAH?
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Probenecid
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What constricts the efferent arteriole?
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Angiotensin II
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What dilates the renal afferent arteriole?
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Prostaglandins
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What do the collecting ducts reabsorb in exchange for K or H?
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Na ions
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What does renin do?
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Cleave angiotensinogen into angiotensin I
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What does the anterior pituitary secrete?
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-FSH and LH -ACTH -GH -TSH -MSH -Prolactin
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What does the beta subunit do?
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The beta subunit determines hormone specificity
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What does the early distal convoluted tubule actively reabsorb?
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-Na ions -Cl ions
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What does the posterior pituitary secrete?
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ADH and oxytocin
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What does the secretion of prostaglandins from the kidney do?
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Vasodilates the afferent arterioles to increase GFR
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What does the thick ascending loop of Henle actively reabsorb?
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-Na ions -K ions -Cl ions
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What does the thick descending loop of Henle indirectly reabsorb?
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-Mg ion -Ca ions
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What effect does constriction of the efferent arteriole have?
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-Decreased RPF -Increased GFR -FF increases
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What effect does dilation of the afferent arteriole have?
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-Increased RPF -Increased GFR - FF remains constant
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What enzyme converts 25-OH Vit D to 1,25-(OH)2 Vit D?
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1alpha-hydroxylase
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What happens to glucose in the kidneys when glucose is at a normal level?
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Glucose is completely reabsorbed in the proximal tubule.
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What hormones act on the kidney?
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1. ADH 2. Aldosterone 3. Angiotensin II 4. Atrial natriurtic Peptide 5. PTH
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What inhibits constriction of the efferent arteriole by AII?
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ACE inhibitors
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What inhibits dilation of the afferent arteriole by prostaglandins?
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NSAIDS
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What is an important clinical clue to diabetes?
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Glucosuria
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What is angiotensin II's overall function?
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To increase intravascular volume and increase blood pressure
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What is passively reabsorbed in the thin descending loop of Henle?
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Water via medullary hypertonicity (impermeable to sodium)
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What is reabsorbed in the early distal tubule under the control of PTH?
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Ca ions
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What is the function of the early proximal convoluted tubule?
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Reabsorbs all of the glucose and amino acids and most of the bicarbonate, sodium, and water
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What is the oncotic pressure of Bowman's space?
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Zero
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What is the thick ascending loop of Henle impermeable to?
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Water
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What is the threshold for glucose reabsorption in the proximal tubule?
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200 mg/dL
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What may act as a 'check' on the renin-angiotensin system in heart failure?
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ANP
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What part of the nephron secretes ammonia?
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Early proximal convoluted tubule
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What part of the pituitary is derived from neuroectoderm?
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Posterior pituitary
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What percentage of the body is water?
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0.6
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What regulates the reabsorption of water in the collecting ducts?
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ADH
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What secretes renin?
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JG cells
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What stimulates ADH secretion?
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-Increased plasma osmolarity -Greatly decreased blood volume
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What stimulates aldosterone secretion?
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-Decreased blood volume (via AII) -Increased plasma K concentration
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What stimulates angiotensin secretion?
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Decreased blood volume (via renin)
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What stimulates ANP secretion?
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Increased atrial pressure
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What stimulates EPO release?
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Hypoxia
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What stimulates PTH secretion?
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Decreased plasma ca concentration
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What stimulates renin release?
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1. Decreased renal arterial pressure 2. Increased renal nerve discharge (Beta 1 effect)
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What subunit do TSH, LH, FSH and hCG have in common?
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Alpha subunit
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What symptom is present once threshold is reached?
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Glucosuria
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What type of tissue is the anterior pituitary derived from?
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Oral ectoderm
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What value is used clinically to represent GFR?
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Creatinine clearance
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What variables are needed to calculate free water clearance?
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-Urine flow rate -Urine osmolarity -Plasma Osmolarity
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Where
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does
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Primarily
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the
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Where
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does
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In
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the
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Where
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is
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Endothelial
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cells
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Where
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is
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Proximal
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tubule
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Which
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barrier
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Charge
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barrier
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Which
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layer
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Fused
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basement
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Which
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layer
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Fenestrated
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capillary
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Where does ACE convert AI to AII
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Where does secondary active transport of amino acids occur
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Where is EPO secreted
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Where is paraaminohippuric acid secreted
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Which barrier is lost in nephrotic syndrome
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Which layer filters by negative charge
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Which layer filters by size
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