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USMLE

Renal Physiology 1

QuestionAnswer
clearance of any substance = ? urinary excretion/plasma concentration
what does the clearance of PAH equal? effective renal plasma flow (unless the secreting mechanism is saturated)
what kind of diuretics are contraindicated in renal failure? Why? potassium sparing exacerbates elevated serum potassium & hyperkalemia can lead to arrhythmia
tubular fluid with lowest osmolarity is found where? macula densa
how is interstitial fluid volume related to inulin space? inulin space approximates ECF volume, so interstitial fluid volume = inulin space - plasma volume
what percent of total body weight is total body water? 60%
what proportion of total body water is ECF and ICF? 1/3 ECF 2/3 ICF
what percent of ECF is plasma volume? interstitial volume? 1/4 plasma volume 3/4 interstitial volume
how is plasma volume measured? radiolabeled albumin
how is extracellular volume measured? inulin
formula for clearance? C=UV/P (urine concentration x urine flow rate / plasma concentration)
what forms the size barrier of the glomerulus? fenestrated capillary endothelium
what formes the negative charge barrier of the glomerulus? fused basement membrane with heparan sulfate
what is lost in nephrotic syndrome? charge barrier results in albuminuria, hypoproteinemia, generalized edema, and hyperlipidemia
what substance is used to calculate GFR? inulin
creatinine clearance is an approximate measure of what? GFR
what does renal blood flow equal? renal plasma flow/1-Hct
effective renal plasma flow underestimates true renal plasma flow by how much? about 10%
filtration fraction = ? GFR/RPF
what arteriole does AT II act on? preferentially constricts efferent arteriole decreases RPF, increases GFR, so FF increases
what dilates the afferent arteriole? what effect does this have? prostaglandins increases RPF, GFR so FF remains constant
afferent arteriole constriction has what effect? decreases RPF & GFR, so FF remains constant
efferent arteriole constriction has what effect? decreases RPF, increases GFR, so FF increases
increased plasma protein concentration has what effect on GFR? decreases GFR, (RPF stays same so FF decreases)
decreased plasma protein concentration has what effect on GFR? increases GFR (RPF stays same, so FF increases)
constriction of ureter has what effect on GFR? decreases it (also decreases FF)
free water clearance = ? urine flow rate - clearance(osm)
at what plasma glucose level does glucosuria begin? at what level does the transport mechanism become saturated? glucosuria: 200 transtport sat: 350
the osmolarity of the medulla can reach what level? 1200 mOsm
on what type of cells does aldosterone act? principal cells of collecting ducts - activates Na+/K+ pump; intercalated cells - stimulates H+ secretion
portion of the nephron that reabsorbs all of the glucose & AAs, and most of the bicarbonate, sodium, and water; secretes ammonia, which acts as a buffer for H+ early proximal convoluted tubule
portion of the nephron that passively reabsorbs water via medullary hypertonicity thin descending limb
portion of the nephron that contains the NKCC and indirectly induces the absorption of Mg2+ and Ca2+; impermeable to water thick ascending limb
location of the nephron in which calcium reabsorption is under the control of PTH? early distal convoluted tubule
actions of the early distal convoluted tubule? actively reabsorbs Na+, Cl-; reabsorbs calcium under PTH control
portion of the nephron that reabsorbs sodium in exchange for secreting potassium or H+? what regulates this? collecting tubules aldosterone
reabsorption of water in this portion of the nephron is under control of ADH (vasopressin) collecting tubules
Created by: Asclepius