Nephrology
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Questions and Answers

What is one of the functions of the kidney?

  • Producing insulin
  • Assisting in fat digestion
  • Regulating the body's water and ions (correct)
  • Aiding in muscle contraction

    • Which process can the kidney perform?

  • Gluconeogenesis (correct)
  • Photosynthesis
  • Glycolysis
  • Krebs cycle

    • What hormone is NOT produced by the kidney?

  • Erythropoietin
  • Vitamin D
  • Renin
  • Insulin (correct)

    • What is the primary purpose of the large surface area of the glomeruli in the kidney?

    <p>To facilitate filtration of blood plasma</p> Signup and view all the answers

    How does the surface area of the glomeruli impact kidney function?

    <p>It increases the efficiency of blood filtration and waste removal</p> Signup and view all the answers

    What would happen if the surface area of the glomeruli was significantly reduced?

    <p>Decreased filtration of blood plasma</p> Signup and view all the answers

    Why do mammals convert nitrogenous waste to urea?

    <p>To store the waste dissolved in water</p> Signup and view all the answers

    What is the significance of obligatory water loss in mammals?

    <p>It aids in the concentration of urea</p> Signup and view all the answers

    How does the conversion of nitrogenous waste to urea affect the urinary system in mammals?

    <p>Alters the osmolarity of urine</p> Signup and view all the answers

    What is the structural similarity between Bowman’s capsule and the pleural space of the lung or the pericardial space of the heart?

    <p>They all have a cup shape structure</p> Signup and view all the answers

    How does Bowman’s capsule function in relation to the glomerulus?

    <p>It filters blood and collects the filtrate from the glomerulus</p> Signup and view all the answers

    What role does Bowman’s capsule play in the urinary system?

    <p>Filtering blood to form the initial filtrate</p> Signup and view all the answers

    What is the function of the podocytes in the glomerulus?

    <p>To filter plasma</p> Signup and view all the answers

    If the efferent arteriole leading from the glomerulus were constricted, what effect would this have on blood pressure?

    <p>Increase blood pressure</p> Signup and view all the answers

    How does the leaky basement membrane in the glomerulus contribute to kidney function?

    <p>It allows large molecules to pass through</p> Signup and view all the answers

    What is the role of podocytes in the glomerulus?

    <p>Forming filtration slits through which filtrate enters the capsular space</p> Signup and view all the answers

    Why can ions and large molecules filter through the glomerular capillaries with podocytes?

    <p>The filtration slits between the foot processes allow the passage of ions and large molecules</p> Signup and view all the answers

    What would be the consequence of a significant reduction in the number of functioning podocytes in the glomerulus?

    <p>Decreased filtration of ions and large molecules through the glomerular capillaries</p> Signup and view all the answers

    What determines the rate at which substances diffuse across the glomerular membrane?

    <p>The concentration of the substance in the bloodstream</p> Signup and view all the answers

    Which factor does NOT influence the diffusion of substances across the glomerular membrane and podocyte barrier?

    <p>The concentration of the substance in the Bowman's capsule</p> Signup and view all the answers

    In the context of glomerular filtration, which statement is true about water and smaller molecules?

    <p>Not all water and smaller molecules will diffuse across the glomerular membrane and podocyte barrier</p> Signup and view all the answers

    Which type of nephron is specifically involved in the concentration of urine?

    <p>Juxtamedullary Nephrons</p> Signup and view all the answers

    What is the primary characteristic of Juxtamedullary Nephrons that sets them apart from Cortical Nephrons?

    <p>Long loop of Henle</p> Signup and view all the answers

    Which category of nephrons are considered the standard hard-workers of the kidney?

    <p>Cortical Nephrons</p> Signup and view all the answers

    Which renal process primarily occurs in the tubules?

    <p>Secretion</p> Signup and view all the answers

    What is the primary function of the glomerulus in the renal process?

    <p>Filtering blood to form the initial filtrate</p> Signup and view all the answers

    In the context of renal function, what role do podocytes play in the glomerulus?

    <p>Acting as a barrier to prevent large molecules from passing through</p> Signup and view all the answers

    What is the unique feature of the glomerular capillaries in terms of arteriole supply and drainage?

    <p>They are the only capillaries in the body fed and drained by arterioles</p> Signup and view all the answers

    What allows the high blood pressure in the glomerular capillaries to force fluid and solute out of the blood?

    <p>Feeding and drainage by arterioles</p> Signup and view all the answers

    What is the primary fate of the filtrate that is forced out of the blood in the glomerular capillaries?

    <p>It is reabsorbed by the renal tubule cells and returns to the blood through the peritubular capillaries</p> Signup and view all the answers

    What is the primary role of reabsorption in the renal process?

    <p>To move substances out of the tubules and into the peritubular capillaries</p> Signup and view all the answers

    Which process results in movement out of the collecting duct and into the bladder in the urinary system?

    <p>Excretion</p> Signup and view all the answers

    If the efferent arteriole leading from the glomerulus were dilated instead of constricted, what effect would this have on filtration in the kidneys?

    <p>Increased filtration due to higher pressure in the glomerular capillaries</p> Signup and view all the answers

    Why is the glomeruli in the kidney an efficient filter?

    <p>They have a large surface area and high permeability to water and solutes</p> Signup and view all the answers

    What happens if plasma proteins are not kept in the plasma during filtration?

    <p>Too much fluid filters out into the filtrate</p> Signup and view all the answers

    What do protein or cells in the urine indicate in the context of glomerular filtration?

    <p>A problem with the filtration membrane</p> Signup and view all the answers

    What is the primary difference between active and passive transport in tubular reabsorption?

    <p>Active transport requires ATP, while passive transport does not.</p> Signup and view all the answers

    What happens to filtered substances during tubular reabsorption?

    <p>They are brought back into the kidney's interstitial fluid.</p> Signup and view all the answers

    What type of transport is water during tubular reabsorption?

    <p>Osmosis</p> Signup and view all the answers

    What is the significance of the 'transport maximum' in tubular reabsorption?

    <p>It explains why untreated diabetic patients have glucose in their urine.</p> Signup and view all the answers

    How does the 'transport maximum' impact tubular reabsorption?

    <p>It sets the maximum rate for reabsorption of substances in the tubules.</p> Signup and view all the answers

    Why do untreated diabetic patients have glucose in their urine due to the 'transport maximum'?

    <p>The tubules can't reabsorb glucose at the same rate as in non-diabetic patients.</p> Signup and view all the answers

    In the context of normal tubular reabsorption, what percentage of glucose is reabsorbed?

    <p>100%</p> Signup and view all the answers

    What is the percentage of sodium reabsorption in normal tubular reabsorption?

    <p>99.5%</p> Signup and view all the answers

    What is the percentage of water reabsorption in normal tubular reabsorption?

    <p>99%</p> Signup and view all the answers

    What would be the consequence of an increase in glomerular filtration rate (GFR)?

    <p>Increased urine production</p> Signup and view all the answers

    How does a decrease in the GFR affect the kidneys' ability to maintain homeostasis?

    <p>It disrupts the balance of electrolytes in the body</p> Signup and view all the answers

    What happens when the glomerular filtration rate falls below the normal range?

    <p>It indicates renal disease</p> Signup and view all the answers

    What is the primary reason creatinine is easy to measure in a lab?

    <p>It is filtered but not reabsorbed</p> Signup and view all the answers

    What is the role of creatinine in the calculation of GFR (glomerular filtration rate)?

    <p>Indicator of muscle catabolism</p> Signup and view all the answers

    Why is creatinine a suitable marker for GFR estimation?

    <p>It is minimally secreted</p> Signup and view all the answers

    What influences the glomerular filtration rate (GFR) and is affected by age, gender, race, ideal body weight, actual body weight, and body surface area?

    <p>Amount of filtration surface available</p> Signup and view all the answers

    Which of the following is NOT a factor that influences the glomerular filtration rate (GFR)?

    <p>Conversion factors used in labs</p> Signup and view all the answers

    What are the primary factors that affect the glomerular filtration rate (GFR) as mentioned in the passage?

    <p>Filtration surface available and filtration membrane permeability</p> Signup and view all the answers

    How does systemic blood pressure relate to the glomerular filtration rate (GFR) in the absence of other regulation?

    <p>Increases in systemic blood pressure lead to an increase in GFR, while decreases in systemic blood pressure lead to a decrease in GFR</p> Signup and view all the answers

    How does the glomerular filtration rate (GFR) respond to fluctuations in filtration pressure?

    <p>GFR is directly proportional to the filtration pressure, so fluctuations in filtration pressure lead to corresponding changes in GFR</p> Signup and view all the answers

    What is the relationship between systemic blood pressure and glomerular filtration rate (GFR) when considering other regulatory factors?

    <p>Systemic blood pressure may not have a direct linear relationship with GFR due to the presence of other regulatory factors</p> Signup and view all the answers

    How do the afferent and efferent arterioles influence the glomerular filtration rate (GFR)?

    <p>By constricting or dilating to control the blood flow to the glomerulus</p> Signup and view all the answers

    What is the primary impact of vasoconstriction of the efferent arteriole leading from the glomerulus?

    <p>Increased glomerular capillary pressure</p> Signup and view all the answers

    In the context of kidney function, what is the role of vasodilation of the afferent arteriole?

    <p>Increased blood pressure in the glomerular capillaries</p> Signup and view all the answers

    What is the key mechanism by which the kidney manages water balance?

    <p>Water reabsorption and sodium reabsorption/secretion</p> Signup and view all the answers

    If the kidney was primarily involved in potassium reabsorption instead of sodium reabsorption/secretion, what would be the most likely consequence?

    <p>Imbalance in electrolytes</p> Signup and view all the answers

    In the context of kidney function, what is the primary role of glomerular filtration?

    <p>Filtration of blood to form urine</p> Signup and view all the answers

    What is the term for the range of daily urine volume as mentioned in the passage?

    <p>Polyuria</p> Signup and view all the answers

    If the daily urine volume falls below 400 ml, what medical condition might this indicate?

    <p>Oliguria</p> Signup and view all the answers

    What is the term for a condition characterized by the excretion of abnormally large amounts of urine?

    <p>Polyuria</p> Signup and view all the answers

    In which part of the nephron does sodium reabsorption not occur?

    <p>Descending limb of the loop of Henle</p> Signup and view all the answers

    What determines water reabsorption in the renal tubules?

    <p>Presence of water channels (aquaporins)</p> Signup and view all the answers

    What process is responsible for the movement of sodium in the renal tubules?

    <p>Active transport</p> Signup and view all the answers

    Where does the majority of renal water reabsorption occur?

    <p>Proximal tubule</p> Signup and view all the answers

    What is the primary factor that determines the presence and concentration of aquaporins throughout the tubule segments?

    <p>Anti-diuretic hormone (ADH)</p> Signup and view all the answers

    How are aquaporins compared to a water fall in terms of their function?

    <p>They let H2O in at a faster rate</p> Signup and view all the answers

    What effect does Vasopressin have on water reabsorption/secretion in the kidney?

    <p>It stimulates water reabsorption in the kidney</p> Signup and view all the answers

    Which of the following best describes the role of Vasopressin in controlling water balance?

    <p>It decreases the permeability of the collecting duct to water</p> Signup and view all the answers

    What is the primary effect of Vasopressin on the osmotic gradient in the renal medulla?

    <p>It increases the osmotic gradient in the renal medulla</p> Signup and view all the answers

    What is the primary consequence of vasopressin binding to the receptor on the basolateral membrane of tubule cells?

    <p>Increase in cAMP and stimulation of protein phosphorylation</p> Signup and view all the answers

    What is the immediate effect of increased plasma osmolarity from dehydration?

    <p>Vasopressin release from the anterior pituitary</p> Signup and view all the answers

    What is the ultimate result of vesicles full of AQP’s fusing with the luminal membrane in response to increased cAMP?

    <p>Enhanced water reabsorption in the kidney</p> Signup and view all the answers

    What is the primary consequence of the active pumping of Na+ via Na+/K+ ATPase in the renal tubules?

    <p>Generation of a favorable electrochemical gradient for passive entrance of other substances</p> Signup and view all the answers

    Which process is primarily responsible for the movement of Na+ in the renal tubules?

    <p>Active transport via Na+/K+ ATPase</p> Signup and view all the answers

    What is the primary impact of the active reabsorption of Na+ in the renal tubules on the movement of other substances?

    <p>Creates a favorable environment for passive entrance of other substances</p> Signup and view all the answers

    What is the primary role of Na+/K+ ATPase in the context of sodium reabsorption in the renal tubules?

    <p>It maintains the low intracellular [Na+] by transporting Na+ out of the cell.</p> Signup and view all the answers

    How does primary active sodium reabsorption contribute to the movement of other solutes in the renal tubules?

    <p>It fuels the diffusion of other solutes into or out of the cell by maintaining low intracellular [Na+].</p> Signup and view all the answers

    In the context of renal tubular reabsorption, what is the role of interstitial water and Na+ moving into the peritubular capillaries?

    <p>They help in creating an osmotic gradient for passive diffusion of water and solutes out of the tubular epithelial cells.</p> Signup and view all the answers

    What is the primary effect of elevated serum osmolarity at the site of osmoreceptors in the hypothalamus?

    <p>Stimulates vasopressin secretion</p> Signup and view all the answers

    What is the primary effect of decreased osmolarity at the site of osmoreceptors in the hypothalamus?

    <p>Inhibits vasopressin secretion</p> Signup and view all the answers

    How do baroreceptors in the atria and carotid arteries affect vasopressin production?

    <p>Stimulate release of vasopressin</p> Signup and view all the answers

    What is the primary role of urea recycling in the medullary osmotic gradient?

    <p>To contribute to the impermeability of the descending limb to water</p> Signup and view all the answers

    How does the countercurrent mechanism in the loop of Henle contribute to water reabsorption in the kidney?

    <p>By maintaining a concentration gradient in the medulla</p> Signup and view all the answers

    What is the specific function of the descending limb of the loop of Henle in a countercurrent multiplier system?

    <p>Passively allowing solutes to diffuse into the medullary interstitium</p> Signup and view all the answers

    What is the primary role of the countercurrent multiplier system in urine concentration?

    <p>To maintain a dilute urine entering the distal tubule</p> Signup and view all the answers

    How does the countercurrent multiplier system contribute to increasing urine concentration?

    <p>By maintaining a hypertonic interstitium in the kidney</p> Signup and view all the answers

    What effect does ADH (Vasopressin) have on the water content of urine in the distal tubule and collecting duct?

    <p>It increases the water reabsorption in the distal tubule and collecting duct</p> Signup and view all the answers

    What is the primary mechanism by which the kidney manages water balance?

    <p>Secretion of substances from the DCT and collecting duct cells</p> Signup and view all the answers

    How does the kidney release a good bit of water and make dilute urine?

    <p>By secreting substances from the DCT and collecting duct cells into the urine</p> Signup and view all the answers

    What is the role of the DCT and collecting duct cells in urine formation?

    <p>They secrete substances into the urine and allow the kidney to retain water</p> Signup and view all the answers

    What is the role of ADH in the process of making concentrated urine?

    <p>Triggers the insertion of aquaporins into the membranes</p> Signup and view all the answers

    In the context of urine concentration, what is the primary impact of decreased osmolarity at the site of osmoreceptors in the hypothalamus?

    <p>Decreased secretion of vasopressin (ADH)</p> Signup and view all the answers

    What is the mechanism by which ADH contributes to the concentration of urine?

    <p>Stimulating insertion of aquaporins into the collecting ducts</p> Signup and view all the answers

    What is the primary function of aldosterone in the renal system?

    <p>Increasing sodium reabsorption in the distal tubule and the collecting ducts</p> Signup and view all the answers

    How does aldosterone's action on sodium reabsorption differ from ADH's action?

    <p>Aldosterone is slow-acting while ADH is fast-acting</p> Signup and view all the answers

    What is the role of aldosterone in controlling sodium reabsorption in the renal system?

    <p>It increases sodium reabsorption in the distal tubule and collecting ducts</p> Signup and view all the answers

    What triggers the production of renin by the cells of the JGA?

    <p>Stimulation of the JG cells by the SNS</p> Signup and view all the answers

    Where is renin produced in response to a decrease in blood pressure, as noted by the pressure receptors of the JG apparatus?

    <p>Cells of the JGA</p> Signup and view all the answers

    What stimulates the JG cells to secrete more renin when they are stretched less?

    <p>High blood pressure</p> Signup and view all the answers

    What is the primary function of Atrial Natriuretic Factor (ANF) or atrial natriuretic Peptide (ANP) in the heart?

    <p>Regulates sodium loss</p> Signup and view all the answers

    Which of the following is a common misconception about Atrial Natriuretic Factor (ANF) or atrial natriuretic Peptide (ANP)?

    <p>It promotes water reabsorption</p> Signup and view all the answers

    What is the role of Atrial Natriuretic Factor (ANF) or atrial natriuretic Peptide (ANP) in the regulation of blood pressure?

    <p>It decreases blood pressure by promoting sodium excretion</p> Signup and view all the answers

    What is the primary role of the kidneys in maintaining pH control in the bloodstream?

    <p>Excreting H+ ions</p> Signup and view all the answers

    In the context of pH control, how do the lungs and kidneys differ in their mechanisms?

    <p>Lungs quickly reduce H+ ions, while kidneys slowly excrete H+ ions</p> Signup and view all the answers

    How does the kidney's role in pH control contribute to overall homeostasis?

    <p>By controlling the number of H+ ions in the bloodstream</p> Signup and view all the answers

    What is the primary function of tubular secretion in the renal system?

    <p>Eliminating undesired substances or end products reabsorbed by passive processes</p> Signup and view all the answers

    Which substances move from the peritubular capillaries into the tubular lumen during tubular secretion?

    <p>Hydrogen ion, potassium, and organic anions</p> Signup and view all the answers

    What is an important function of tubular secretion in the renal system?

    <p>Eliminating drugs and drug metabolites</p> Signup and view all the answers

    What role do the kidneys and the respiratory system play in maintaining homeostasis?

    <p>Balancing H+ ion concentrations</p> Signup and view all the answers

    What is the primary function of the descending limb of the loop of Henle in a countercurrent multiplier system?

    <p>Reabsorbing water and ions</p> Signup and view all the answers

    In the context of glomerular filtration, which statement is true about water and smaller molecules?

    <p>Water and smaller molecules are both passively filtered from the blood into the Bowman's capsule.</p> Signup and view all the answers

    What is the primary function of the CO2/HCO3- system in the blood stream?

    <p>Decreasing the concentration of H+ ions in the bloodstream</p> Signup and view all the answers

    Which mechanism is favored by the kidneys as intracellular buffers?

    <p>Phosphate and proteins</p> Signup and view all the answers

    What is the role of proteins in the buffering system of the blood stream?

    <p>Acting as intracellular buffers</p> Signup and view all the answers

    How do the kidneys adjust the body’s pH to increase blood pH?

    <p>By increasing plasma bicarbonate concentration</p> Signup and view all the answers

    What is the primary mechanism used by the kidneys to decrease blood pH?

    <p>Secreting bicarbonate into urine</p> Signup and view all the answers

    Which process is used by the kidneys to decrease blood pH?

    <p>Decreasing plasma bicarbonate concentration</p> Signup and view all the answers

    What is the primary reason for using the term 'reabsorbed' in the context of kidney function?

    <p>To denote the movement of bicarb from the tubule cell into the interstitium</p> Signup and view all the answers

    What is the role of H+ in the process of normal reabsorption of bicarb in the kidneys?

    <p>It combines with bicarb to form water and CO2 in the tubule cell</p> Signup and view all the answers

    Which statement accurately describes the movement of bicarb during normal reabsorption in the kidneys?

    <p>It diffuses from the filtrate into the tubule cell</p> Signup and view all the answers

    Study Notes

    Kidney Functions and Hormonal Production

    • Kidneys regulate blood composition, removing wastes and maintaining ion balance.
    • They perform filtration, reabsorption, and secretion processes.
    • Kidneys do not produce hormones like glucagon; they primarily produce renin and erythropoietin.

    Glomeruli and Filtration

    • Large surface area of glomeruli maximizes filtration efficiency for nutrients and waste.
    • A significant reduction in glomerular surface area would decrease filtration rates, leading to waste accumulation.

    Nitrogenous Waste and Water Management

    • Mammals convert nitrogenous waste to urea to minimize toxicity and conserve water.
    • Obligatory water loss is vital to prevent dehydration and maintain osmotic balance.

    Bowman’s Capsule and Glomerulus Interaction

    • Bowman’s capsule, similar to pleural and pericardial spaces, encapsulates the glomerulus.
    • Functions to collect filtrate from the blood, beginning the urine formation process.
    • Podocytes in the glomerulus regulate filtration, allowing selective permeability for ions and small molecules.

    Impact of Arterioles on Blood Pressure and Filtration

    • Constriction of the efferent arteriole increases glomerular pressure and filtration.
    • Efferent dilation reduces filtration and increases peritubular capillary pressure.

    Structural Integrity and Function

    • The leaky basement membrane aids in filtration by allowing passage of essential small molecules.
    • A loss of podocytes compromises filtration efficiency and may lead to proteinuria.

    Glomerular Filtration Dynamics

    • The diffusion rate across the glomerular membrane is influenced by size and charge of molecules.
    • Water and smaller molecules pass freely during filtration due to their size.

    Nephron Types and Functions

    • Juxtamedullary nephrons concentrate urine; they have longer loops of Henle and deeper renal medulla.
    • Cortical nephrons, also known as standard nephron types, are primarily involved in routine functions.

    Rate of Filtration and Reabsorption

    • Glomerular filtration rate (GFR) is influenced by systemic blood pressure, which directly correlates with urine production.
    • An increase in GFR can overwhelm reabsorption abilities, leading to loss of essential nutrients.

    Creatinine as a GFR Marker

    • Creatinine is a byproduct of muscle metabolism, easily measurable and used to estimate GFR.
    • It provides insights into kidney function, unaffected by dietary intake.

    Regulatory Mechanisms

    • Vasoconstriction of the afferent arteriole reduces blood flow, decreasing GFR; vasodilation increases it.
    • Baroreceptors respond to blood pressure changes, influencing vasopressin production for water balance.

    Tubular Reabsorption and Transport Mechanisms

    • Active transport predominates in tubular reabsorption; sodium is often actively reabsorbed via Na+/K+ ATPase.
    • Water follows sodium passively due to osmotic gradients; this enhances nutrient reabsorption.

    Aquaporins and Water Regulation

    • Aquaporins facilitate rapid water movement in renal tubules, adjusting urine concentration.
    • Vasopressin increases aquaporin expression, enhancing water reabsorption in response to dehydration.

    Countercurrent Mechanism

    • The loop of Henle uses a countercurrent multiplier system to enhance concentration gradients, vital for urine concentration.

    Aldosterone's Role

    • Aldosterone promotes sodium reabsorption in renal tubules, assisting in fluid balance and blood pressure regulation.

    Urine Characteristics and Disorders

    • Normal urine volume ranges widely; less than 400ml per day may indicate oliguria, while excessive urine output suggests polyuria.
    • Management of urine concentration is crucial for homeostasis, heavily influenced by hormonal control and kidney function.

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    Explore the various functions of the kidney, including the regulation of water, ions, pH, and glucose production, as well as the removal of waste and synthesis of hormones such as Erythropoietin, Renin, and Vitamin D.

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