Comlex renal 2015

ruhland1's version from 2015-06-22 19:01

Section 1

Question Answer
AT2vaso con efferent
ProstglandinVaso dil afferent
measure ECFinulin
T1/20.7 Vd/Cl
plasma vol1/4 ECF
Interstital vol3/4 ECF
measure GFRcreatinine clearance (overestimate, b/c clearance<100%)
clear>filternet sec ("clears through, filters back)
ureter constrictud RPF, dn GFR b/c up hydrostatic P
eff constrictdn RPF, up GFR, up FF
radio albumin measureplasma vol (albumin only in plasma and sec at constant rate)
up prostaglandinup RPF so up GFR but ud FF (aff vasodil)
water under bridgeureter posterior to uterine a
ICF %2/3
FF normal20%
up plasma proteins concno change RPF, up onc so down gfr, dn FF
RPF flow measurePAH
PAHall entering kidney is excreted.
eff constrictdn RPF up GFR up FF

Section 2

Question Answer
when free water cleance = 0isotonic urine
when is isotonic urine seenloop diur
reabs=(cleared at glom and secreted at capillary)-excreted (cleared = filtered glom- reabs at Glom)
filterd fluid can befiltered does not include peritub sec, so filtered fluid can only be cleared at glom or reabs at glom.
RPF can befiltered(acted at Glom=GFR) or bypass glom (bypass + filtered at glom=RPF)
renin sec byJGA (down renal bp up JGA renin sec up Na+)
Rclearance=([x in urine]*[urine flow])/[x in plasma]
dn Trp transporterHartnup (up pellegra)
PTH on Vitdup Vit1,25
Vit1,25 effectup Ca and PO4 abs instestein
masula densaNa+ sensor in DCT
secretion defperitubular capillary to nephron (filtered rate= GFR) (excretion= filtered at glom +secreted peritubular - reabsorbed at glom/peritubular)
reabs defwhat has not been cleared during GFR and what that part left that is sec by peritub that is not excreted.
excretion defcollecting duct to outside body
GFR * [x]plasmaplasma load
dn O2 so up EPOendothelial cells of peritubiular cap

Section 3

Question Answer
insulinK into ICF (hypokal) Mechanism: up insulin so up glc in ICF so up metabo so up ATP so up Na/K ATPase so up K in and Na out, result=hypokalemia
up PHK into ICF (K/H exch)
winter dn HCO3 for ?dn HCO3 1 * dn PCO2 0.7 (resp comp for metab acid)
aldo and pHup aldo so Up Na * dn K meaning less K to exchange for H so more H excreted so up pH
RTA IIHCO3- reabs def
RTA II dxNH4Cl acidifies basic urine of HCO3- =dx
cells but no casts meandistal to kidney (stone/bladder cx)
hypo kalemia, cant sec H+RTA I (dn pH so up stones)
hypO aldo causesRTA IV
RTA IVhypO aldo, up K+, so cant exch NH3 w K+, so dn NH3 in urine, so down urine pH
RTA Icant sec H+, Low K+ in blood because cant exchange exchange K+ and H+ in collecting duct.

Section 4

Question Answer
low Nastupor/coma
low Cl2ndary to up pH, dn K+, hypovol, up aldo
Cl followsK
low KU wave
flat T wavelow K
low PO42ndary to bone loss b/c up excretion po4 to up bone turnover to up Ca++
high cl-non AG acidosis
peaked T wavehi K
dn DTRdn Ca or up Mg
hi PO4up stones
ACEi NFB loss of ATII compensationup renin
sartanARB (no cough)

Section 5

Question Answer
amilorideK sparing
triamterene mechK sparing block Na+ channel in coleectin tubule
eplerenoneK spring
aldosterone mechaldo rec antag at collecting tubule
hyperaldo txK spare
causes acidemiaacetazolamide (drug induced RTA II)