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