Block 1 Kidney Quiz
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Which of the following is not a toxic waste product that the kidneys filter out of the body?

  • Hemoglobin breakdown (correct)
  • Bicarbonate (correct)
  • Uric acid
  • Urea
  • Creatinine
  • What is the central function of the kidneys?

  • Production of bile
  • Regulation of water concentration (correct)
  • Synthesis of insulin
  • Filtration of lymph
  • Which is not a function of the kidneys?

  • Storage of fat (correct)
  • Excretion of foreign chemicals
  • Releasing hormones and enzyme
  • Gluconeogenesis
  • The combination of a glomerulus and a Bowman’s capsule constitutes a ____________.

    <p>Renal corpuscle</p> Signup and view all the answers

    Only about ____________% of plasma filters into Bowman's capsule.

    <p>20</p> Signup and view all the answers

    What are two ways to increase GFR?

    <p>Constrict efferent tubule, increase CHP</p> Signup and view all the answers

    What are two ways to decrease GFR?

    <p>Constriction of afferent tubule and dilation of efferent tubule</p> Signup and view all the answers

    What would be an accurate creatinine value for someone with a great GFR?

    <p>0.6 to 1.2 mg/dL</p> Signup and view all the answers

    An elevated creatinine would indicate a problem with what?

    <p>Kidney function</p> Signup and view all the answers

    What is a common cause of an elevated creatinine?

    <p>High protein diet</p> Signup and view all the answers

    What is the main responsibility of the kidneys?

    <p>Regulation of fluid balance</p> Signup and view all the answers

    Our body is made out of about 60% water, and of that about ___% is in the intracellular fluid and about ___% is in the extracellular fluid.

    <p>40, 20</p> Signup and view all the answers

    The ____________ is the microscopic unit of the kidney.

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

    Anything that stays inside the renal tubule is going to be ____________ through urine.

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

    Anything that leaves the renal tubule and goes back into the blood is said to be ____________.

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

    Filtration occurs at the ____________.

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

    When compounds are taken from blood into the renal tubule it is called ____________.

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

    What region of the kidney has the most osmolarity?

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

    What is reabsorbed in the medulla?

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

    What is the main difference between juxtamedullary nephrons and cortical nephrons?

    <p>Juxtamedullary nephrons produce more concentrated urine</p> Signup and view all the answers

    What are the slit-like processes that act like a sift in the glomerulus?

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

    What is the pressure that is forcing fluid out of the glomerulus?

    <p>Glomerular hydrostatic pressure</p> Signup and view all the answers

    What is the pressure that pushes back on the glomerulus when Bowman's capsule is full?

    <p>Capsular hydrostatic pressure</p> Signup and view all the answers

    If you have a patient that has elevated proteins within their blood, which of the following would you expect to be high?

    <p>Blood colloid osmotic pressure</p> Signup and view all the answers

    What is the correct equation for GFR?

    <p>GFR = (GHP - (CHP + Col HP))</p> Signup and view all the answers

    What does the level of creatinine in your blood predict?

    <p>Filtering ability of the kidneys</p> Signup and view all the answers

    The most common way to lower GFR is by?

    <p>Constriction of the afferent arterioles</p> Signup and view all the answers

    If you dilate the afferent arteriole how will it affect hydrostatic pressure?

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

    Decreased plasma protein would cause what effect on GFR?

    <p>Increase in GFR</p> Signup and view all the answers

    Constriction of the ureter would cause a back of fluid in the proximal tubule which would have what effect on GFR?

    <p>Decrease GFR</p> Signup and view all the answers

    Your family member has recently been diagnosed with diabetes, they tell you that they have been peeing much more (polyuria) than they used to. What is the reason for this?

    <p>Increased water excretion due to high glucose levels</p> Signup and view all the answers

    Which of the following is not a typical sign of diabetes?

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

    What is one of the reasons why diabetics are excreting glucose in their urine?

    <p>Lack of carriers for glucose to be reabsorbed</p> Signup and view all the answers

    Which of the following is not a toxin that is being secreted into the proximal tubule to eventually be excreted?

    <p>Na+</p> Signup and view all the answers

    The majority of reabsorption and secretion of the nephron occurs where?

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

    Which describes the permeability of the descending loop of Henle?

    <p>Permeable to water, impermeable to solutes</p> Signup and view all the answers

    The ascending loop of Henle is important in the reabsorption of all the following except?

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

    In the distal convoluted tubule, what hormones affect the permeability of certain ions?

    <p>Aldosterone and PTH</p> Signup and view all the answers

    What hormone increases sodium reabsorption and potassium secretion in the distal convoluted tubule through the sodium-potassium pump?

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

    Why does aldosterone increase blood pressure?

    <p>Increases sodium reabsorption, increasing blood volume</p> Signup and view all the answers

    Why would an aldosterone antagonist lower blood pressure?

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

    What hormone is released when low calcium in the blood is sensed and causes the activation of membrane proteins in the DCT to reabsorb calcium?

    <p>Parathyroid hormone</p> Signup and view all the answers

    What structure do the collecting ducts contain that allows for water reabsorption and is stimulated by ADH?

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

    What does the juxtaglomerular apparatus release when it senses low blood pressure?

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

    Which of the following is the correct order of the RAA system?

    <p>Angiotensinogen → Renin → Angiotensin I → ACE → Angiotensin II → Aldosterone</p> Signup and view all the answers

    Angiotensin II causes an increase in ____________ activity.

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

    Which of the following is not a function of Angiotensin II?

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

    Where is aldosterone released from?

    <p>Adrenal cortex</p> Signup and view all the answers

    Angiotensin II would have what effect systemically?

    <p>Arteriolar vasoconstriction</p> Signup and view all the answers

    Angiotensin II causes the secretion of what hormone from what organ?

    <p>ADH from posterior pituitary gland</p> Signup and view all the answers

    Where is ADH released from?

    <p>Posterior pituitary gland</p> Signup and view all the answers

    What is the liver constantly producing that has the ability to eventually raise blood pressure?

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

    What part of the RAA system do the lungs release?

    <p>Angiotensin-converting enzyme (ACE)</p> Signup and view all the answers

    What is a common class of medication that has to do with the RAA system and lowering blood pressure?

    <p>ACE inhibitor</p> Signup and view all the answers

    Study Notes

    Kidney Functions

    • The kidneys filter toxic waste products from the body: urea, creatinine, uric acid, hemoglobin breakdown products
    • The central function of the kidneys is to regulate water concentration
    • The kidneys do not store fat
    • The kidneys perform many functions, including:
      • Excretion of foreign chemicals
      • Gluconeogenesis
      • Releasing hormones and enzymes

    Kidney Structures

    • The combination of a glomerulus and a Bowman’s capsule constitutes a renal corpuscle
    • Only about 20% of plasma filters into Bowman's capsule, the remaining blood leaves the glomerulus via the efferent arteriole
    • The nephron is the microscopic unit of the kidney

    Glomerular Filtration Rate (GFR)

    • GFR is the amount of filtrate formed each minute by the kidneys
    • Two ways to increase GFR:
      • Dilate the afferent tubule and constrict the efferent tubule
      • Constriction of the efferent arteriole
    • Two ways to decrease GFR:
      • Constriction of the afferent tubule and dilation of the efferent tubule
      • A decrease in the glomerular capillary pressure (GCP)
    • Normal GFR is indicated by creatinine levels between 0.6 to 1.2 mg/dL
    • An elevated creatinine level indicates a problem with kidney function
    • High protein diets are a common cause of elevated creatinine
    • The kidneys are responsible for the regulation of fluid balance

    Body Fluid Compartments

    • Our body is about 60% water
    • About 60% of our body water is in the intracellular fluid and about 40% is in the extracellular fluid
    • Extracellular fluid is comprised of interstitial fluid (which contributes to edema) and plasma

    Nephron Processes

    • Anything that stays inside the renal tubule is excreted in urine
    • Anything that leaves the renal tubule and goes back into the blood is reabsorbed
    • Filtration occurs at the glomerulus
    • When compounds are taken from the blood into the renal tubule, this is called secretion

    Renal Medulla

    • The medulla of the kidney has the highest osmolarity
    • The high osmolarity in the medulla causes water reabsorption

    Nephron Types

    • Juxtamedullary nephrons have longer loops of Henle and produce more concentrated urine than cortical nephrons

    Glomerular Filtration

    • Podocytes are specialized cells that act like a sift in the glomerulus, preventing large molecules from entering the filtrate
    • Glomerular hydrostatic pressure (GHP) is the force that pushes fluid out of the glomerulus
    • Capsular hydrostatic pressure (CHP) is the force that pushes back on the glomerulus when Bowman's capsule is full
    • GFR = (GHP - (CHP + Col HP))
    • An elevated blood colloid osmotic pressure (BCOP) is associated with high levels of proteins in the blood
    • Creatinine levels in the blood predict the filtering ability of the kidneys

    GFR Regulation

    • Constriction of the afferent arterioles is the most common way to lower GFR
    • Dilating the afferent arteriole increases hydrostatic pressure
    • Decreased plasma protein levels lower GFR
    • Constriction of the ureter decreases GFR

    Diabetes

    • Individuals with diabetes often experience polyuria (increased urine production) due to high glucose levels in the blood, which overwhelms the kidneys' ability to reabsorb all glucose
    • Common signs and symptoms of diabetes include:
      • Polyuria (increased urination)
      • Polydipsia (increased thirst)
      • Polyphagia (increased hunger)
      • Polygonal (increased size of cells due to excessive glucose)
    • Diabetics excrete glucose in their urine because of a lack of carriers for glucose to be reabsorbed

    Tubular Reabsorption and Secretion

    • Most reabsorption and secretion occurs in the proximal convoluted tubule
    • Toxic substances such as drugs, H+, creatinine, and ammonia are secreted into the proximal tubule for excretion

    Loop of Henle

    • The descending loop of Henle is permeable to water but impermeable to solutes
    • The ascending loop of Henle plays a vital role in the reabsorption of Na+, K+, and Cl-
    • Urea is not, however, reabsorbed by the ascending loop of Henle
    • The loop of Henle plays a critical role in concentrating urine

    Distal Convoluted Tubule (DCT)

    • The DCT is regulated by aldosterone and parathyroid hormone (PTH) to control the permeability of specific ions
    • Aldosterone increases sodium reabsorption and potassium secretion in the DCT
    • Aldosterone agonists lower blood pressure
    • Conversely, aldosterone antagonists lower blood pressure by reducing sodium reabsorption
    • PTH regulates calcium levels in the blood, increasing calcium reabsorption in the DCT

    Collecting Duct

    • The collecting duct contains aquaporins which are activated by antidiuretic hormone (ADH), allowing for water reabsorption

    Renin-Angiotensin-Aldosterone System (RAA System)

    • The juxtaglomerular apparatus releases renin in response to low blood pressure:
      • Renin converts angiotensinogen (from the liver) to angiotensin I
      • ACE (released by the lungs) converts angiotensin I to angiotensin II
    • The RAA system is as follows: Angiotensinogen → Renin → Angiotensin I → ACE → Angiotensin II → Aldosterone
    • Angiotensin II increases sympathetic nervous system activity
    • Angiotensin II functions to:
      • Increase blood pressure
      • Reabsorb Na+ and Cl-
      • Reabsorb water
      • Excrete K+
    • Aldosterone is released from the adrenal cortex
    • Angiotensin II causes systemic vasoconstriction
    • Angiotensin II stimulates the release of ADH from the posterior pituitary gland
    • ADH is released from the posterior pituitary gland
    • Angiotensinogen is produced by the liver and is an important precursor in the RAA system
    • ACE inhibitors are commonly used medications to lower blood pressure

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