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55 Cards in this Set

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Equation to measure body fluid volumes
V= Q/C
V= body fluid volume
Q= indicator administered
C=concentration of indicator
TBW indicators
D20, H20, antipyrine
ECF indicators
Na, inulin, mannitol
PV indicators
Albumin, Evans blue, Cr red blood cells
100 mM glucose =
100 osm
100 nM NACL
200 mOsm/L
Filtered Load =
GFR * Solute (plasma)
Excretion:
Volume Urine Flow * Urine concentration
Clearance Concept
Related the excretion of a substance to its concentration in plasma
Clearance Calculation
C= U*V/Ps
Cs: Clearance of substance
U: urine concetration of substance
V: Urine flow
P: Plasma concentration
Applying Clearance to GFR
Inulin Clearance used to measure GFR
Best clinical measure of GFR
Creatinine
Clearance to Renal Plasma Flow and RBF
PAH clearance = RBF
PAH measures PLASMA FLOW ONLY
RBF using REnal plasma flow =
RBF=RPF (1- hematocrit)
*Hct: 0.40
Specialized portion of capillaries that perfuse medilla
vasa recta
Filtration fraction
GFR/RBF
Filtration
GFR= KF (Pgc-Pbc) -
(TT gc-TTbc)
Myogenic autoregulation
Increase in arterial pressure, stretches vessel wall leading to an icnrease in calcium movement and contraction
Tubuloglomerular feedback
decrease in arterial pressure causes decrease in GFR, decreasing NACL to macula densa, Therefore efferent arteriolar resistnace Increases in response to HIGH angiotensin II.
Regulation of filtration of AFFERENT Arteriole; CONSTRICTION (Dilation is opposite)
Pcap: D
GFR: D
RBF: D
Regulation of filtration of EFFERENT Arteriole:
CONSTRICTION
(Dilation is opposite)
Pcap: U
GFR: U
RBF: D
T Max or GLucose is
300 mg/min reabsorption
REABSORPTION AND SECRETION
REABSORPTION AND SECRETION
Proximal Tubule
NAHCO3 reabsoprtion
NACL
Water
Glucose
How are ions absorbed
Na/H antiport
Cl/Anion antiport
Na/K Atpase
*Water follows non Cl reabsorption and icnreases tubular fluid of Cl.
H= in proximal tubule is
Secreted
Descending Thin Limb
Reabsorbs 15% GFR.
Tbublular fluid volume DECREASES
Tubular fluid osmolarity INCREASES
Thick Ascending Loop of Henle
break
Reabsorption of Na
Symport with Cl/ K
Antiport with H
Reabsorption of K
Symport with Na and Cl-
Reabsorption of Ca
Ca Atpase, Na/Ca exchange
2G/Ca Atpase antiport
PTH stimulates
Reabsorption of MG
active and electrical force
SECRETION of H
Na/H exchange/ NH4+
Early Distal tubulue
REabsorbs NACL via Na-Cl symoporter
REabsorbs Ca via PTH
What inhibits NA/CL symporter and PTH
Thiazide diuretics
LAte Tubule
H20 reabsorbed by ADH
NACL REab by Aldosterone
HCO# reab vy aldosterone
SECRETION Of K= Aldosterone
Secretion of K determines
total excretion
Collecting Duct
Reabsorbs H20 by ADH
Reab. UREA via ADH
PTH acts on ? for Ca reabsorption
DCT
ADH receptor complex activates
adenylate cyclase. CAMP activates a kinase and phosphorylates proteins
In Normal system, Urine flow and osmolarity are
inversely related
In the presence of ADH
Water is reabsorbed
Urine volume is Small
Urine concentration is same in MEdulla = HYPEROSMOTIC
In the absence of ADH
No Water reabsorbed
Urine flow is high/dilute
Medullary osmoloarty if low.
REgulation of Plama osmoloarity by ADH
see page 300
ADH secretion is increased my
elevated plasma sodium or osmolarity
ADH secretion is decresed by
High blood volume or pressure
Glucose in a DM patietn causes
opsmotic diuresis
ANP will
Increase GFR
Decrease REnin, angio II, aldosterone, NACL and H2o reapbsortopn, ADH secretion
ADH will
Increase H20 reabsorption, decrease urine flow and Increase urine osmolarity
Henderson Hasselbach equation
ph=6.1 log (HCO3) / 0.03 PCO2
Increase in ventilation will
decrease PCO@ (Alkalosis)
Decrease in Ventilation
Increases PCO2 (acidosis)
Cahnge in renal acid excretion and HCO3 production is
Metabolic response
Standard Values of
HCO3 = 24 mEq/L
PCO2= 40 mm HG
Just know
Acidosis due to loss of HCO3 or DIARRHEA
Hyperchloremic Acidosis (because kdineys reabosrb CL since no HCO3)