PHGY 210 > Renal > Flashcards

Renal Flashcards

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1
Q

Both ____ and ____ are freely filtered but ~99% is reabsorbed (not secreted)

A

Na

H2O

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2
Q

The majority of sodium and water reabsorption (~2/3) occurs in the _____.

A

Proximal tubule

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3
Q

The major hormonal control of reabsorption occurs on the ____ and ____.

A

DCT

CD

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4
Q

Sodium reabsorption is an active process occurring all all tubular segments except…

A

The descending thin limb of Henle’s loop

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5
Q

Water reabsorption occurs by ____ and is dependent on….

A

Diffusion

Sodium reabsorption

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6
Q

How does Na get transported on the basolateral membrane?

A

Active Na+/K+-ATPase pumps transport sodium out of the cell and keep the intracellular concentration of sodium low

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7
Q

How does sodium move on the apical (luminal) membrane?

A

Downhill from the tubular lumen into the tubular epithelial cells.

Note: each tubular segment has different mechanisms

Ex: in proximal tubule, Na+-H+ is an antiporter
In the CCD: diffusion via Na+ channel

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8
Q

____ is the major extracelular solute

A

Sodium

(Thus changes in total body sodium results in similar changes in extracellular fluid volume)

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9
Q

Total body sodium is sensed as ____ by ____ in the cardiovascular system

A

Intravascular filling

Baroreceptors

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10
Q

True or false?

Plasma concentration of sodium is a marker for total body sodium

A

False!

PNa only reflects the relative relationship of total body Na and water

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11
Q

True or false?

Sodium is secreted in the tubules

A

False

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12
Q

Sodium excretion could be regulated by…
(2)

A
  1. GFR (minor role)
  2. Sodium reabsorption (most important)
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13
Q

What is the key hormone in regulation of sodium (control by reabsorption)?

A

Aldosterone

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14
Q

______ secretes angiotensinogen

A

Liver

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15
Q

______ secrete renin

A

Kidneys

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16
Q

Renin turns _____ into ______

A

Angiotensinogen —> angiotensin I

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17
Q

True or false?

Aldosterone stimultes sodium and H2O reabsorption

A

False!

Does NOT stimulate H2O reabsorption (only Na)

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18
Q

Atrial natriuretic peptide (ANP) acts on the ____ to inhibit _____ and increase _____.

A

Tubules

Sodium reabsorption

GFR

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19
Q

Increased total body sodium (thus increased extracellular fluid/plasma volume) stimulates ____ secretion

A

Atrial natriuretic peptide (ANP)

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20
Q

True or false?

Increased blood pressure increases sodium excretion

A

True

(Pressure natriuresis)

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21
Q

How does blood flow in the kidneys?

A

Renal artery -> interlobar artery -> arcuate artery -> interlobular artery -> afferent arteriole

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22
Q

Each nephron consists of…

A
  • Renal corpuscle (glomerulus and bowman’s capsule)
  • Tubule
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23
Q

The capillary wall of a glomerulus consists of…

A

-endothelial cells
-glomerular basement membrane
-visceral epithelial cells (podocytes)

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24
Q

____ filters blood to make urine.

A

Glomerulus

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25
Urine formation begins with the filtration of….
Plasma from the glomerular capillaries into Bowman’s space (glomerular filtration)
26
True or false? Glomerular filtrate (fluid in Bowman’s space) is cell-free and contains **all** the substances in plasma in virtually the same concentrations as in plasma.
False, Contains all except for proteins
27
Tubules —> peritubular capillaries = ____. Peritubular capillaries —> tubules = ____.
Reabsorption Secretion
28
Glomerular filtration rate (GFR) is regulated by… (3)
1. Net filtration pressure (most important) 2. Membrane permeability 3. Surface area available for filtration
29
How to decrease glomerular filtration rate? (2)
1. Constrict afferent arteriole 2. Dilate efferents arteriole
30
______: total amount of any freely filtered substance
Filtered load
31
Filtered load = ____ x ____
Glomerular filtration rate Plasma concentration of the substance
32
Filtered load > amount excreted in urine =…
Net reabsorption
33
Filtered load < amount excreted in the urine=___
Net secretion
34
Reabsorption by diffusion: often across….
The tight junctions connecting the tubular epithelial cells
35
Reabsorption by mediated transport: occurs across…
Tubular cells (Transcellular epithelial transport)
36
What are the most important substances secreted by the **tubules**?
Hydrogen ions Potassium
37
Tubular secretion is usually coupled to the …
Reabsorption of sodium
38
Most homeostatic controls are exerted in the _____.
DCT/CD
39
_______: the volume of plasma from which that substance is completely removed by the kidneys per unit time
Clearance
40
What is the equation for clearance?
Clearance of S = (Mass of S excreted per unit time) / (Plasma concentration of S (Ps))
41
Clearance of a substance > GFR is _____ at tubule.
Secreted
42
Clearance of a substance < GFR is ____ at tubule.
Reabsorbed
43
The higher the solution osmolarity, the ___ the water concentration.
lower
44
the majority of **water reabsorption** (~2/3) occurs in the ______ but the major **hormonal** control of reabsorption occurs in the _______.
proximal tubule Collecting duct (predominantly in medullary part)
45
Water reabsorption depends on ______ reabsorption
Na+
46
When water intake is small...
kidney reabsorbs more water
47
The dynamic regulation of water balance takes place in the ...
medullary collecting duct
48
Urinary concentration depends on the ___________ of the ISF
hyperosmolarity
49
In the presence of __________ (hormone), water diffuses out of the ducts into the ISF in the medulla to be carried away.
vasopressin
50
In addition to NaCl, ___ also contributes to medullary hyperosmolarity
urea
51
vasopressin stimulates the insertion of ______ in the luminal membrane of the collecting duct cells and _____ water permeability.
aquaporins increases
52
when **vasopressin** is present, collecting ducts become ______ to water.
permeable (leads to water reabsorption)
53
Diabetes insipidus (DI) is caused by malfunction of the ______ system
vasopressin
54
What are the 2 mechanisms to regulate vasopressin secretion?
1. Osmoreceptor control (most important) 2. Baroreceptor control (less sensitive)
55
define **hyperkalemia**
high concentration of K in the extracellular fluid (>5 mEq/L)
56
define **hypokalemia**
low concentration of K in the extracellular fluid ( <3.5 mEq/L)
57
true or false? only **hypokalemia** causes abnormal rhythms of the heart and abnormalities of skeletal muscle contraction.
false both hypokalemia and hyperkalemia cause this.
58
K+ is freely filtered at _______
glomerulus
59
true or false? Unlike Na+ or water, K+ can be **secreted** at the **cortical collecting duct**
true
60
Changes in K+ excretion are due mainly to changes in K+ secretion in the ______.
cortical collecting duct (some in the DCT)
61
Potassium secretion is regulated by (2)
1. Dietary intake of K+ 2. Aldosterone
62
True or false? Hypoaldosteronism leads to hypokalemia.
False, **hyper**aldosteronism leads to **hypokalemia**.
63
Metabolic alkalosis is often seen in _____.
hyperaldosteronism
64
When bicarbonate ion is lost from the body, it is the same as if the body has ____ (lost/gained) a hydrogen ion.
gained
65
Name 3 nonvolatile acids
phosphoric acid sulfuric acid lactic acid
66
Any substance that can reversibly bind **hydrogen** ions is called a _____.
buffer
67
true or false? buffering eliminates hydrogen ions from the body
false! it only keeps them ''locked up''/bound
68
Ultimate balance of hydrogen ions is controlled by
1. Respiratory system (by controlling CO2) 2. Kidneys (by controlling HCO3-)
69
Low H+ concentration --> kidneys ___ HCO3.
excrete
70
High H+ concentration --> kidneys ____ HCO3.
produce (and add to the plasma)
71
HCO3 excretion = ....
HCO3 filtered (+ HCO3 secreted) - HCO3 reabsorbed
72
True or false? Normally the kidneys reabsorb all filtered HCO3-.
True (exception: alkalosis)
73
Addition of new HCO3- to the plasma is achieved by... (2)
1. H+ secretion and excretion on nonbicarbonate buffers (such as phosphate) 2. Glutamine metabolism with NH4+ excretion
74
Addition of new HCO3- to the plasma occurs mainly in the...
proximal tubule
75
In **metabolic** acidosis, HCO3- ____ (increases/decreases).
decreases
76
in **respiratory** acidosis, HCO3- ____ (increases/decreases).
increases
77
in **metabolic** alkalosis, HCO3- ____ (increases/decreases)
increases
78
in **respiratory** alkalosis, HCO3- ____ (increases/decreases)
decreases
79
hyperventilating leads to _____ (acidosis/alkalosis)
respiratory alkalosis
80
respiratory failure with CO2 retention leads to _____ (acidosis/alkalosis)
respiratory acidosis
81
diarrhea (and/or renal failure) leads to _____ (acidosis/alkalosis)
metabolic acidosis
82
vomiting (and/or hyperaldosteronism) leads to _____ (acidosis/alkalosis)
metabolic alkalosis
83
What are diuretics?
drugs used clinically to increase the volume of urine excreted
84
**diuretics** act on the _____ to inhibit the reabsorption of ____, along with ______ and/or ____, resulting in increased excretion of these ions. **Water increases**, too.
tubules Na+ Chloride Bicarbonate
85
Loop diuretics act on the ______. They inhibit the cotransport of __, __, and ___.
thick ascending limb of the loop of Henle (where Na+ is actively reabsorbed) Na+ Chloride K+
86
Potassium-sparing diuretics inhibit **sodium** reabsorption in the ____ and also inhibits potassium secretion there.
CCD
87
Potassium-sparing diuretics block the action of _____ (hormone)
aldosterone
88
3 types of renal replacement therapy:
1. Hemodialysis 2. Peritoneal dialysis 3. Kidney transplantation
PHGY 210
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