Physiology Flashcards

(48 cards)

1
Q

how can plasma volume be measured

A

radiolabeling albumin

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2
Q

how can extracellular volume be measured

A

by inulin or mannitol

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3
Q

what type of collagen is present in the basement membrane

A

type IV collagen

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4
Q

what barriers exist in the glomerular filtration barrier for preventing molecules to enter the glomerulus

A

charged barrier - GFB contains negatively charged ions which prevent negatively charged ions from crossing through i.e. albumin

size barrier - fenestrated capillary endothelium and podocytes prevent entry of certain sizes of molecules

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5
Q

how can GFR be calculated

A

inulin clearance as it is neither absorbed nor secreted
GFR = (urine inulin X urine flow rate) / plasma inulin

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6
Q

does Creatinine clearance under or overestimate GFR

A

slightly overestimates because a small amount of creatinine is secreted from the proximal renal tubules

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7
Q

how can effective renal plasma flow be estimated

A

using para-amniohippuric acid (PAH) clearance

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8
Q

how to work out filtration fraction

A

FF = GFR/RPF

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9
Q

what effect does prostaglandins have on the arterioles in the kidney

A

prostaglandins Dilate Afferent arterioles
PDA

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10
Q

what effect does ACE II have on the arterioles of the kidney

A

Angiotensin ii Constricts Efferent arterioles
ACE

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11
Q

what effect does afferent arteriole constriction have on GFR and RPF ?

A

GFR decreases
RPF decreases

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12
Q

what effect does efferent arteriole constriction have on GFR and RPF ?

A

GFR increases
PRF decreases

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13
Q

what effect does and increase or decrease of protein concentration have on GFR and RPF ?

A

increased protein - decreases GFR, no change in RPF
decreased protein - increases GFR, no change in RPF

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14
Q

what effect does constriction of ureters have on GFR and RPF ?

A

decrease GFR
no effect on RPF

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15
Q

where is glucose reabsorbed n the kidney and through which transporter

A

proximal convoluted tubules by Na/glucose co-transport (GLUT)

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16
Q

why can pregnancy cause glucosuria at normal plasma glucose levels

A

increased GFR and filtration of all substances inlcuidng glucose. the glucose threshold occurs at lower levels which results in urinary excretion of glucose even at normal blood levels

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17
Q

what part of the kidney does fanconi’s syndrome affect

A

proximal convoluted tubule

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18
Q

renal tubular defect syndromes and location of which they act on

A

Fanconi’s bagles
fanconi- PCT
Bartters syndrome - thick ascending loop of henle
Gitelman syndrome - DCT
little syndrome - collecting tubules
SAME - collecting tubules

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19
Q

features of fanconi syndrome

A

reabsorption defect on the proximal convoluted tubule
increased excretion of glucose, HC03, PO4, and amino acids
results in renal tubular acidosis -> metabolic acidosis, low phosphate and low K

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20
Q

causes of fanconi syndrome

A

Fanconi Has Multiple Interesting Drinks
hereditary i.e. wilsons
ischaemia
multiple myeloma
drugs i.e. cisplatin, lead poisoning

21
Q

features of primary hyperaldosteronism but with low aldosterone levels

A

Liddle syndrome or Syndrome of apparent minealocorticoid excess

22
Q

where is renin produced from?

A

juxtaglomerular cells

23
Q

where is ACE produced from

A

lungs and kidneys

24
Q

where are ANP and BNP produced from

A

ANP - atria
BNP - ventricles

25
where is erythropoetin produced from
interstitial cells in peritubular capillary bed
26
what effect does low and high doses of dopamine have on the kidney
low doses - dilates interlobular arteries, afferent arterioles and efferent arterioles to increase renal blood flow high doses - vasoconstricts
27
defect in renal tubular acidosis type 1
distal RTA = type 1 inability of alpha intercalated cells in DCT to secrete h which results in no new HCO3 being generated = metabolic acidosis
28
defect in renal tubular acidosis type 2
proximal RTA = type II defect in proximal convoluted tubule reabsorption of HCO3 = increased secretion = metabolic acidosis
29
urinary PH of RTA type 1 and 2
type 1 urinary PH > 5.5 type 2 urinary PH < 5.5 but can be > 5.5 when filtered HCO3 exceeds resorptive threshold
30
how does CKD affect calcium and phosphate
unable to excrete phosphate = hyperphosphataemia this in turn causes low calcium which stimulates parathyroid gland = hyperparathyroidism = osteodystrophy
31
effects of IV 5% dextrose
the dextrose is quickly metabolised so is essentially like drinking water. pure water causes serum osmolaliy to reduce which reduces ADH release. Reduced ADH would cause less aquaporin channels to be inserted into the collecting duct = dilute urine as less water is being reabsorbed. It would also reduce urea absorption as ADH causes reabsorption of urea to maintain interstitial conc gradient
32
primary site of absorption of the following electrolytes; Na, K, Cl, glucose, Ca, Mg, PH04
Na, Cl, glucose, K --> proximal convoluted tubule Mg --> thick ascending loop of henle
33
how is magnesium levels maintained
not regulated by hormones unlike other electrolytes. Mainly regulated by absorption in the thick ascening loop of henle. Tight junctions due to caludin 16 and 19 allow for the paracellular movement of Mg required for reabsorption
34
what part of the kidney is impermeable to water
ascending loop of henle
35
what part of the kidney becomes permeable to water in the presence of ADH
collecting duct
36
what part of the kidney is responsible for tubuloglomerular feedback
macula densa located in distal convoluted tubule
37
what is the main electrolyte absorbed in thick asencing loop of henle
magnesium
38
eosinophillic nodular glomerulosclerosis
kimmesteil wilson lesions = diabetic nephropathy
39
glomerulonephritis associated with HIV
focal segmental glomerulosclerosis
40
spike and dome appearance of flouroscopy
membranous glomerulonephritis
41
glomerulonephritis that can be associated with solid tumours
membranous
42
what type of hypersensitivity reactionis post strep glomerulonephritis
type III
43
glomerulonephritis associated with HBV/HCV
membranoproliferative
44
glomerulonephritis associated with SLE
diffuse proliferative
45
lumpy bumpy of flouroscopy
post strep glomerulonephritis
46
splitting and tram stracks on H&S and PAS stains
membranoproliferative glomerulonephritis
47
glomerular subendothelial immune deposits
diffuse proliferative
48
glomerular mesangial immune complex deposits
membranoproliferative