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92 Cards in this Set
- Front
- Back
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Glomerular Filtration Barrier (3)
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Fenestrated capillary endothelium
Fused basement membrane with heparan sulfate Epithelial layer consisting of podocyte foot processes |
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Fused basement membrane with heparan sulfate is a barrier for
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Negative charge barrier
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Fenestrated capillary endothelium is a barrier for
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Size barrier
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Nephrotic syndrome losses what barrier
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Negative charge barrier
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Total resistance in a series is equal to?
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RT= R1+R2+R3
Total resistance is the sum of the individual resistance |
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Renal Blood Flow is how much of CO
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25%
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Vasoconstriction of the renal arterioles leads to what in RBF
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Decrease
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Angiotension II works where
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Efferent arterioles
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Efferent arteriole constriction by AngII causes
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An increase GFR
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ACEI will do what to the GFR
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Decrease it by dilating the efferent arterioles
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Myogenic Mechanism
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The renal afferent arterioles contract in response to stretch. Stretch is from an increase pressure.
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Tubuloglomerular feedback
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Increased renal arterial pressure leads to increased delivery of fluid to macula densa, which causes constriction of nearby arterioles.
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What substance is used to measure renal clearance flow
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PAH
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PAH- what action is taken by renal tubules
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Filtered
Secreted |
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Clearance Equation
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C= UxV/Px
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C<GFR
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Net tubular reabsorption
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C>GFR
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Net tubular secretion
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C=GFR
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No secretion or reabsorption
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RBF equation
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RBF= RPF/1-Hematocrit
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GFR equation
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UinulinV/Pinulin
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Filtratiion fraction equation
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FF= GFR/RPF
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Normal FF is
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20%
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Filtered Load
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Filtered load= GFR x plasma concentration
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What dilates the afferent arterioles
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Prostaglandins
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GFR and Starling equation
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GFR= Kf [(Pgc-Pbs)-(πgc- πbs)]
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Pgc
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Promotes filtration
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Pbc
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Opposes filtration
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Pbc is increased when
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Obstruction
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πgc
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Increases along the length of the length of the glomerular capillary
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πbs
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Is zero because little protein is filtered
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Reabsorption
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Reabsorption = filtered load-excreted
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Secretion
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Secretion= Excreted-filtered load
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Filtered Load> Excretion
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Net reabsorption
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Filtered Load<Excretion
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Net secretion
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Filtered Load
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=GFR x plasma
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Excretion Rate
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= Vx [urine]
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Reabsorption of Glucose
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Na+-glucose cotransport in the proximal tubule reabsorbs glucose from tubular fluid into body
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Glucosuria begins at?
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160-200mg/dl
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Splay
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is between threshold and Tm
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Filtered load of PAH
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As with glucose the filtered load of PAH increases in direct proportion to the plasma PAH concentration
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Secretion of PAH
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From peritubular capillary blood into tubular fluid via carriers in the proximal tubule
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Substances with Highest Clearance are
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PAH
- Both secreted and filtered |
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Substances with Lowest Clearance
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Proteins
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Relative clearance list: Highest to lowest
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PAH>K+> INULIN> UREA> Na+> GLUCOSE, A.A. AND HCO3-
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TF/P= 1.0
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The Plasma concentration is equal to the tubular concentration
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TF/P<1
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Reabsorption of the substance is greater than water and the concentration in tubular is less than that in plasma
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TF/P>1
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Reabsorption of the substance is less than water or there has been secretion of the substance
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How much sodium is reabsorbed in the proximal tubule
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67% of the filtered sodium and water
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Proximal is the site of
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Glomerulotubular balance
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The proximal tubule re-absorption of sodium = osmotic
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Isosmotic
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What is cotransported with sodium in the PCT
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Cotransport with glucose, amnio acids, phosphate, lactate
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What is countertransported with sodium in the PCT
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Na+- H+ exchange
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Where does Carbonic anhydrase inhibitors works
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PCT
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What is sodium reabsorbed with in the late proximal tubule
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Glucose
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Early PCT generates and secretes what?
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Ammonia which acts as a buffer to secreted H+.
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Early PCT has what type of cells
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Brush Border cells
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PTH inhibits what in the PCT
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Na+/phosphate cotransporter--> phosphate is excreted
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ATII stimulates what in the PCT
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Na+/H+ exchange
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Thick ascending loop of Henle reabsorbs what percent of Na+
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25%
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Thick ascending loop of Henle contains what transporter
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Na+-K+-2Cl+ cotransporter
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What is the site of loop diuretics
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Thick ascending loop of Henle
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What about water in the thick ascending loop of henle
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It is imperable to water
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DCT reabsorbs how much sodium
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8%
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What transporter is found in the DCT for sodium
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Na-Cl cotransporter
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DCT is the site of what drug
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Thiazide diuretics
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What about water in the DCT
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Imperable to water
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Principal cell is found where
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Late DCT
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Function of principal cell
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Reabsorbs Na and Water
Secretes K |
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Aldosterone does what in the DCT
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Increases sodium reabsorption and increases K+ secretion
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ADH does what action in the DCT
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Increase water permeability
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How does ADH increase water permeability in the DCT?
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By directing the insertion of H20 channels in the luminal membrane
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Alpha-Intercalated cells function
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Secrete H+ by a H+-ATPaase which is simulated by aldosterone
Reabsorb K+ |
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K+ is most located where in the body
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ICF
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Percentages of K+ Reabsorbation in Nephron
PCT- Thick Ascending loop |
- 67%
-20% |
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Secretion of K+ in the DCT occurs by which cell
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Principal cells
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A diet high in K+ does what to K+
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Increases secretion
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Aldosterones effect on K+
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Increases secretion
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Hyperaldosteronism does what to K+
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Hypokalemia
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Hypoaldosteronism does what to K+
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Hyperkalemia
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Potassium Shifts:
-Shifts into the cell causing hypokalemia (4) |
Insulin
Beta-adrenergic Alkalosis Hypo-osmalrity |
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Potassium Shifts:
-Shifts out the cell causing hyperkalemia (6) |
Insulin deficiency
Beta- Adrenergic antagonists Acidosis Hyperosmolarity Digitalis Cell lysis |
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Symptoms of Electrolyte disturbances
- Low serum concentraion of Na |
Disorentation
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Symptoms of Electrolyte disturbances
-High serum concentration of Na |
Neurologic: Irritability, delirium, coma
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Symptoms of Electrolyte disturbances
- Low serum concentration of K+ |
U-waves on ECG,
Flattened T waves Arrhytmias, paralysis |
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Symptoms of Electrolyte disturbances
-High serum concentration of K+ |
Peaked T waves
wide QRS arrthymias |
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Symptoms of Electrolyte disturbances
-low serum concentration of Calcium |
Tetany
Neuromuscular irritability |
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Symptoms of Electrolyte disturbances
-High serum concentration of Calcium |
Delirium
Renal stones abdominal pain |
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Symptoms of Electrolyte disturbances
- Low serum levels of Magnesium |
Neuromuscular irritabiliy
arrhythmias |
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Symptoms of Electrolyte disturbances
-High serum levels of Mg2+ |
Delirium,
decrease deep tendon reflexes Cardiopulmonary arrest |
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ANP hormone is secreted in response to
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Increase atrial pressure
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ANP hormone MOA
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Guanylate cyclases cGMP
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ANP actions on the kidney
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causes increase GFR and increase sodium filtration with no compensatory sodium reasborption in the DCT
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