Extra

Question 1

Angiotensin II.

What does it do

to PGC, GFR, RBF and FF, Pertitubular oncotic pressure

Answer 1

Causes vasoconstriction of the efferent arteriole

–> Increase PGC–> increase GFR, but decrease RBF

Filtration fraction will thus, increase because the amount of protein in the plasma increases–> increasing your peritubular oncotic pressure

Question 2

L –> dL

Answer 2

1L= 10dL

Question 3

L to mL

Answer 3

1L= 1000 mL

Question 4

Rate of rate of urine (K+) excretion

Answer 4

U_x * V (flow)

Question 5

TGF goal:

1. Maintain a constant GFR
2. Maintain constant NaCl delivery to DCT

How does this work>

Answer 5

Question 6

Adenosine acts on what part of the GC?

Answer 6

Vasoconstriction of the afferent arteriole

Question 7

How do MESENGIAL CELLS ALTER GFR?

Answer 7

Alter SA of K+

Question 8

How does constriction of the afferent arteriole alter of FF?

Answer 8

No change

Question 9

How does constriction of the efferent arteriole alter of FF?

Answer 9

increase

Question 10

Why do our kidneys use 2x rate of O2 than the brain?

Answer 10

Increase reabsorption of Na+ occurs linearly

Question 11

What happens when we sweat?

Answer 11

Think of sweat as losing water:

Hyperosmotic volume contraction

When we sweat

• 1. Decrease in ECF volume*
• 2. Increase in ECF osmolarity*
• —creates a concentration gradient: water wants to move from ICF–> ECF—-*
• 3. Decrease in ICF volume*
• 4. Increase in ICF osmolarity*

Question 12

A child is diagnosed with SIADH. What happens to ECF, ICF and osmolarity.

Answer 12

Same thing as excessive water intake: hypoosmotic volume expansion

— Increase ECF volume—-

Decrease osmolarity of ECF and ICF

—– Increase in ICF volume—–

• Plasma protein levels decrease bc increase in ECF volume.

Hematocri- stays same bc water goes into RBC, increasing volume and offesting dilution

Question 13

What happens when we have diarreah?

Answer 13

isoosmotic volume contraction

1. ECF volume will decrease; no change in osmolarity, so ICF volume does not change.
2. Plasma protein levels increase and hemotocrit increase because decrease ECF increases them. RBC do not shrink or swell
3. BP will decrease d/t decrease in ECF volume

Question 14

What happens when lost in a desert?

Answer 14

Sweat

(hyperosmostic volume contraction)

1. Decrease in ECF volume: Increase in ECF osmolarity--> water moves from [ICF–> ECF–> decrease in ICF volume–> incrrease in ICF osmolarity
2. Plasma protein levels increase
3. Hemotocrit: stays the same bc water is moving out

Question 15

What happens when during adrenal insufficiency

Answer 15

Adrenal insufficiency–> loss of NaCl

• Hypo-osmotic volume contraction
  1. Decrease ECF osmolarity because aldosterone insufficiency, leading to decreased reabsorption and the kidneys excrete more NaCl> water.
• ECF volume decrease:
• ICF volume increases
• ICF osmolarity decreases

2. Plasma protein concentration increases
3. Hematocrit will increase d/t decreased ECF volume and the RBC swell
4. BP decreases

Question 16

What happens during infusion of isotonic NaCl

• Plasma protein concentration
• hematocrit
• BP

Answer 16

isoosmotic volume expansion

1. ECF volume decreases; but there is not change in osmarity.
   * BECAUSE THERE IS NO CHANGE IN OSMOLARITY, water cannot move bc the NaCl distributed evenly in both.
2. Plasma protein concentration decreases and hematocrit decreases bc it dilutres. RBCs do not shrink or swell bc no change in osmolarity.
3. BP increases

Question 17

What happens when during excessive NaCl intake

Answer 17

• hyperosmotic volume expansion
• Increase in ECF osmolarity
• Cause water to move from the ICF–> ECF: ECF increases and ICF decreases
• Increase in ICF osmolarity
• plasma protein concentration decreases
• hemotocrit decreases

Question 18

A 40 y/o Caucasian female presents with a 3 week cc of “weird urine problems” She says the urine is extremely clear and doesn’t seem to be as yellow as she thinks it should be. You decide to perform a test that assesses the bodies ability to concentrate the urine. What is the name of this test?
.

Answer 18

Specific gravity- used to assess the concentrating ability of rthe kidney.

Question 19

Constriction of the afferent arteriole occurs via _____ and does what

Answer 19

sympathetic

• decrease GFR
• decrease RBF
• no change on filtration fraction

Question 20

Constriction of efferent artioles occurs via _____ and does what?

Answer 20

Angiotensin II

Increase GFR

Decrease RBF

Incerase filtration fraction

Question 21

Increase plasam protein does to GFR, RBF, filtration fraction

Answer 21

Decrease GFR

no change in RBF

-decrease FF

Question 22

Uretal stone does what to GFR, RBF, FF

Answer 22

Decrease GFR d/t increase hydrostatic pressure in BC

• no change in RBF
• decrease FF

-

Question 23

What is invluded in the renal sinus

Answer 23

Renal pelvis

renal calyces

BV

nerves

fat

Question 24

Cells in PCT

Answer 24

Simple cuboidal–> simple columnar with alot of microvillus, creating a brush boarder

-has TONs of Na/K ATpases

Question 25

LoH cells

Answer 25

Thin limb- permeable simple squamous cells Thick ascending- simple cuboidal epithelium with microvillus, but no BB

Question 26

Why is the LoH so important?

Answer 26

SUPER important for concentrating the filtrate passing through, creating a HYPEROSMOTIC gradient.

Question 27

How do we maintain a water concentration gradient in medulla?

Answer 27

Vasa recta take the water away

Question 28

DCT cells and big player

Answer 28

Cells: simple cuboidal with few microvillus, having a smoother surface than the thick ascending limb Angiotensin II influences Na+ reabsorption

Question 29

CD Cells:

Answer 29

Simple cuboidal--\> simple columnar at the end Job: concentrate urine by reabsorping water **ADH** works here via type 2 aquaporin channels **Aldosterone**

Question 30

Types of collecting tubule cells

Answer 30

1. Light cells (intercalated)--\> H+ and bicarb transport 2. Dark cells (principle cells)- aldosterone hits and increases Na+ reabsorption via Enac and K secretion

Question 31

Remember, the concentration of Na+ in the tubular lumen will be the same as extracellular fluid (145meq). Intracellular Na+ is about 15 meq. This creates a concentration gradient.

Question 32

The regulation of K/Na in the distal tubule is controlled by _\_\_\_\_\_\_\_\__

Answer 32

aldosterone

Question 33

How does aldosterone back on principle cells in the DCT?

Answer 33

Hold onto Na+, get rid if K. Increase Na+ reabsorption, Increase K+ secretion

Question 34

As we go from CTX--\> medulla: osmolarity increases. What does this allow?

Answer 34

concentrate urine.

Question 35

Water is freely filtered. Regulated where?

Answer 35

Distal tubule and collecting ducts

Question 36

Ascending thick limb reabsorbs Na, 2Cl and K. How does this affect the osmolarity?

Answer 36

Decreases; thus the thick ascending limb will always be hyposmotic and hypotonic.

Question 37

What does ANP doe

Answer 37

Vasodilate afferent arterioles- and to a lesser extend; vasoconstrict efferent ANP, overall i**ncreases RBF**

Question 38

Vasoconstriction of arteriols

Answer 38

Vasconstriction--\> decrease in RBF Occurs by activating [sympathetic NS and angiotensin II] * Angiotensin II constricts efferent artioles and increases GFR.

Question 39

What do ACE-inhibtors do?

Answer 39

dilate efferent arterioles and decrease GFR; reduce hyperfiltartion

Question 40

What does vasodilation do?

Answer 40

Increases RBF; producted by PGE2, PGI2, NO, DA, bradykinin, ANP

Question 41

Summary of tubulogomerular feedback

Answer 41

increased renal arterial pressure--\> increased fluid delivery to macula densa MD senses and constricts afferent arterioles, increasing resistance to maintain constant BF.

Question 42

GFR decreases with age, although serum [creatinine] remains _____ because of decreased muscle mass.

Answer 42

constant