Anatomy & Physiology: Renal
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| show | Granular (JG) cells of the macula densa
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| Where is the juxtaglomerular apparatus located in the nephron? | show 🗑
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| show | 1. stimulation of B receptors by sympathetic nerves
2. reduction in kidney perfusion
3. reduction in Na+ delivery in macula densa
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| show | distal tubule
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| What are the autoregulator methods of renal blood flow? | show 🗑
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| show | increased RBF is sensed by vascular smooth muscle and causes them to constrict
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| What is the tubuloglomerular feedback response? | show 🗑
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| What is the main effect of administering an isotonic saline solution? | show 🗑
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| show | 1. ↑ glomerular capilary pressure; hypertension
2. ↑ interstitial oncotic pressure; trauma, burns or infection
3. ↓ capillary oncotic pressure; liver failure, nephrotic syndrome
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| show | to return interstitial fluid and proteins to the vascular compartment
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| show | 1. negatively charges barrier repels large negatively charged solutes
2. neg. charged glycoproteins
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| How do starling forces change along the glomerular capillaries? | show 🗑
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| What substance is used to clinically measure GFR? | show 🗑
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| show | ADH causes increased BUN reabsorption
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| If the GFR quickly decreases by 1/2, how does the nephron maintain the same excretion rate of a solute? | show 🗑
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| What happens to GFR immediately upon dehydration and why? | show 🗑
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| show | 1. autoregulatory mechanisms -- mainly constriciton of afferent arteriole
2. Myogenic response and tubuloglomerular feedback
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| 1. What receptors do vascular smooth muscle cells have that lead to vasoconstriction? 2. What do binding of these receptors cause in coronary vasculature? | show 🗑
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| How does GFR affect reabsorption? | show 🗑
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| show | 1. constricts efferent at low levels
2. constricts both afferent and efferent at high levels
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| show | 1. proximal tubule
2. descending limb of Henle's loop
3. collecting duct
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| Where does AVP act on in the nephron and how does it affect water reabsorption? | show 🗑
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| When is ADH (AVP) released? | show 🗑
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| show | 1. decreased plasma volume as in hemorrhage
2. Yes
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| show | 1. decreased GFR causes NaCl and water retention leading to expansion of the vascular volume
2. protein blocks NaCl from filtering at glomerulus
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| show | glomerular capillaries
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| How do the kidney's respond to increased mean arterial pressure? | show 🗑
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| show | 1. renin and AVP release
2. sympathetic response
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| 1. What fraction of water is reabsorbed in the proximal tubule? 2. for solutes in the filtrate that are freely filtered into the tubule, what is their concentration after water reabsorption? | show 🗑
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| What is the filtration fraction? | show 🗑
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| show | 1. thick ascending limb and distal tubule
2. Na is reabsorbed but not water
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| show | both are ~300 mOsm
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| show | ratio of the osmolality of tubular fluid to plasma
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| show | 1. 1
2. increases b/c water is reabsorbed with solute
3. decreases back to 1 b/c solute reabsorbed without water
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| show | Deep medullary collecting duct
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| show | 1. ascending limb
2. entire nephron
3. proximal tubule and ascending limb
4. proximal tubule
5. principal cells of collectig duct
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| show | deep medullary collecting duct depending on the levels of ADH
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| show | acts on Na+/H+ transporters in the proximal tubule and thick ascending limp of Henle's loop
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| show | 1. H+ ATPase in alpha intercalated cells of the collecting duct
2. increases synthesis of Na/K pump in principal cells of collecting duct and late distal tubule
3. increased Na reabsorption and K secretion
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| show | principal cells
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| 90% of HCO3 is reabsorbed where? | show 🗑
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| show | plasma potassium concentration
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| show | atrial natriuretic peptide
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| The substance which makes the greatest contribution to the osmolarity of the deep medullary interstitium is? | show 🗑
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| Changes in the rate of K excretion depend predominantly on changes in the activity of.... | show 🗑
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| To measure the rate at which the kidney synthesizes new bicarbonate to replace that used in the buffering process, you need to determine... | show 🗑
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| show | 1. isotonic
2. hypertonic
3. hypotonic
4. variable depending on ADH secretion
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| 1. Transport of glucose against its concentration gradient in kidney cells occurs by which mechanism? 2. Which solute does it travel with? | show 🗑
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| show | 1. inner medullary collecting duct
2. thin ascending limb
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| show | 1. 15
2. still 15 but both values are high
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| 1. BUN/creatinine ratio during dehydration? 2. How does this differ from renal failure + dehydration? | show 🗑
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| Prerenal failure originates because of... | show 🗑
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| show | = Filtered Load - Excretion Rate
= (GFR x Px) - (Ux x V)
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| 1. If net transport rate is positive, what can be said about the solute excreted? 2. If net transport rate is negative, what can be said about the solute excreted? | show 🗑
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| show | 1. 42L
2. 17L
3. 25L
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| show | 1. dilation of afferent arterioles
2. inhibition of aldosterone
3. inhibition of renin
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| Identify how each diuretic acts on the nephron: 1. CA inhibitors 2. Osmotic Agents 3. Loop agents 4. Thiazides 5. aldosterone antagonits 6. ADH antagonist | show 🗑
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| show | 1. proximal tubule
2. proximal tubule and descending limp
3. ascending limp
4. distal tubule
5. distal tubule/cortical collecting
6. deep medullary collecting
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| Where is K+ reabsorbed? | show 🗑
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| What effect do AT II and ANP have on peripheral vasculature? | show 🗑
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| If a hyperosmotic NaCl solution was administered, what would happen to urine flow? | show 🗑
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| How does NaCl transport differ in the thin and thick ascending limb? | show 🗑
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| How do Diabetes Insipidus and SIADH both cause hyponatremia? | show 🗑
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| show | 1. Na/H antiporter, Na/solute symporter
2. passive channel
3. Na/K/2Cl symporter, Na/H antiporter
4. Na/Cl symporter
5. passive channel
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| show | increase NH4 excretion by activating the H ATPase on a intercalated cells
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| show | 1. drugs ↓ Na reabsorption in loop or distal tubule
2. ↑ Na to collecting tubules →↑Na/K activity in collecting duct
3. hypokalemia can result
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| Vasopressin binds __ receptor on principal cells and activates __ subunit of the GPCR. | show 🗑
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| What are the causes of increased anion gap metabolic acidosis? | show 🗑
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| Which renal tubule acidosis is proximal and which is distal? Which influences H+ and which influences HCO3-? | show 🗑
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| Which adrenoreceptor causes renin release? | show 🗑
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| What is the method of acid base analysis? (BRW AIM) | show 🗑
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| What percentage of total body weight is water? | show 🗑
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| show | heparan sulfate
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| 1. What is a normal adult GFR? 2. Clearance of which substance can be used to calculate GFR? | show 🗑
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| show | 1. creatinine
2. PAH
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| How is PAH handled in the kidney? | show 🗑
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| 1. What is the calculation for filtration fraction (FF)? 2. What is the normal FF? | show 🗑
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| 1. Which substance controls the blood flow into the afferent arteriole? 2. Which substance controls the blood flow into the efferent arteriole? | show 🗑
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| show | FF = GFR/RPF
1. FF doesn't change because both RPF and GFR ↓
2. FF ↓ because GFR ↑ and RPF ↓
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| show | decreases GFR
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| What is the greatest stimulus for ADH secretion? | show 🗑
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| show | shift K out of cells causing hyperkalemia
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| show | ↑K+/H+ exchanger → ↑ plasma K (hyperkalemia)
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| What effect does alkalosis have on calcium concentration? | show 🗑
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| How are the following handled within the renal tubule: 1. creatinine 2. BUN | show 🗑
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| show | 1. increase in BUN and creatinine
2. hypoperfusion of kidney → ↓ GFR (usually from a ↓ in cardiac output)
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| show | 1. ratio > 15
2. ratio < 15
3. ratio > 15
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| show | extrarenal loss of urea (GI, skin)
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| What controls blood flow in: 1. afferent arteriole 2. efferent arteriole | show 🗑
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