Interactive Lecture Quiz

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Interactive Lecture Quiz 10 on Chapters 19
20- Renal Physiology

• Spring, 2008
• By Patricia L. Mansfield, Ph.D.
• Directions. Take this quiz using your powerpoint
  viewer to test yourself and to get immediate
  feedback on your answer choice.
• I obtained some figures, animations or videos
  from internet classes or from your textbook
  author to demonstrate the important principles
  covered in this quiz.
• See the complete review of each part of the
  nephron at the end of this powerpoint!

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5/11/2008
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Anatomy Review

• Parts of Urinary System
• Locations of major organs
• Functional Unit

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1. If the concentration of tubular fluid is 1,200
mOsm/L in the collecting tubule, how should you
describe the urine excreted in this patient?a.
dilute b. concentrated c. cloudy d.
foamy e. none of these
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2. Which part(s) of the nephron contain(s) fluid
that is isosmotic to plasma? Code all answers
that apply on the same line.a. Bowmans capsule
b. PCT c. end of loop of Henle d.
collecting duct
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Mechanism of Reabsorption 10 Active Transport

• Na Passive diffusion through open channels at
  APICAL SURFACE of cell into cell
• Active Transport-- Antiport
• Na to ECF
• K into cell
• Na-K ATP-ase
• Na Reabsorption ECF? peritubular capillaries
  (blood)

APICAL SURFACE
BASAL SURFACE
Figure 19-11 Sodium reabsorption in the proximal
tubule
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Mechanism of Reabsorption Secondary Active
Transport

• Na linked 20 transport
• Symport
• Glucose
• Ions (e.g. HCO3-)
• Amino acids
• Location PCT

• Na linked 20 transport
• Compare to antiport and slide 20-21.

Figure 19-12 PCT Sodium-linked glucose
reabsorption
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Mechanism of Reabsorption Passive Transport
Trancytosis

• Passive Transport of urea
• Na pumped out
• H2O follows
• Passive
• ? urea
• urea higher than ECF
• Passive diffusion to ECF
• Trancytosis of proteins

What is the source of urea? What organ generates
it? (You do not need to memorize the details of
the urea cycle for this course.)
Figure 19-13 Passive reabsorption of urea in the
proximal tubule
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3. If resistance increases in the afferent
arteriole, what happens?a. blood dams up in
the glomerulus b. ?glomerular capillary pressure
c. no change in blood flow. d. ?GFR e. none
of these
What would cause resistance to increase in the
afferent arteriole?
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4. Which calculation is the most important when
determining a patients GFR?a. MCV b.
pulse pressure c. P-R interval d.
renal threshold e. MAP
MAP DP SP DP 3
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Glomerular Flow Rate (GFR)
Figure 19-5 The filtration fraction
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5. Which important concept(s) from the
Physiology of the Cell Membrane lecture helps you
understand what happens when the renal threshold
for glucose is reached?a.competition
b.noncompetitive inhibition c.agglutination
d.Tm
Examine each graph carefully!
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6. Which part of the nephron is a major site
for hormone action?a. PCT b. DCT c.
Bowmans capsule d. loop of Henle
Silverthorn focuses on the collecting duct, but
the distal nephron should be considered here
distal DCT, collecting tubule and duct!
Schedule time to study the animations at
http//www.interactivephysiology.com to review
all of this material.
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7. Which hormone, important in diuresis, shows a
circadian rhythm with increased levels occurring
at night?a. melatonin b. vein c. ANP d.
erythropoietin e. vasopressin
Key words increased levels at night!
Relate Increased levels of this hormone to urine
volume? What happens with alcohol ingestion?
What happens with aging? What happens in
bed-wetters?
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Formation of Water Pores Mechanism of
Vasopressin Action
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8. When blood volume increases,
___________?a. blood pressure increases b.
blood osmolarity increases c. blood
osmolarity decreases d. a and b e. a and c
Renin-Angiotensin-Aldosterone Pathway Maintains
BP , Blood Volume Osmolarity Renin,
Angiotensinogen, ANGI, ACE, ANG II, Aldosterone
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8. When blood volume increases,
___________?a. blood pressure increases b.
blood osmolarity increases c. blood
osmolarity decreases d. a and b e. a and c
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9. Blood CO2 levels are important in
__________.a. water balance b. electrolyte
balance c. acid-base balance d. blood pressure
regulation e. all of these
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9. Blood CO2 levels are important in
__________.a. water balance b. electrolyte
balance c. acid-base balance d. blood pressure
regulation e. all of these
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10. What are the major urinarybuffers?a.
phosphate ionsb. ammonia c. bicarbonate d. a
and b e. a and c
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11. Changes in blood volume trigger ________
reflexes.a. cardiovascular b. respiratory
c. somatic d. any of these
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Excretion All Products of Filtration that are
not reabsorbed
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Urination Micturation reflex Differentiate
between AUTONOMIC and VOLUNTARY responses!
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Summary of Renal Physiology per Silverthorn with
my modifications. ?

• Electrolyte balance (look at your electrolyte
  chart) depends on integration of circulatory,
  excretory and behavioral physiology.
• Water recycling and ECF/plasma balance depend the
  on descending loop of Henle and ADH-regulated
  distal nephron for conservation.
• Osmolarity depends on aldosterone and
  angiotensin.
• Along with respiration, PCT and distal tubule
  cells reabsorb or excrete H HCO3- to balance
  pH.
• PLUS, remember that the distal nephron is the
  LAST chance for reabsorption to occur. It is the
  site of hormone action, and is very important in
  homeostasis.

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Answers
1. B 6. B 11. A 2. AB 7. E 3. B 8.
E 4. E 9. C 5. D 10. D
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COLLOID OSMOTIC PRESSURE PRACTICE
1.-4. Identify the NET DIRECTION OF FLUID FLOW
FOR EACH SITUATION BELOW. (Pressures are
measured in mmHg.) Use one of the following
choices INTO THE CAPILLARY or OUT OF THE
CAPILLARY Also, if the fluid is going out of the
capillary, note where the fluid is going.
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COLLOID OSMOTIC PRESSURE PRACTICE
Solution strategy (1) Analyze the direction in
which the pressure causes fluid to accumulate,
i.e. inside the capillary (?) or outside the
capillary (?) (2) Combine pressures that cause
fluid to accumulate in the same direction (3)
Subtract this total from pressures that cause
fluid to accumulate in the opposite direct.
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COLLOID OSMOTIC PRESSURE PRACTICE Edema is a
serious outcome when it occurs in the
interstitial spaces of the body OR in the lungs
OR in the kidney!
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Study this material You will see patients with
kidney failure!
Schedule time to study the animations at
Interactive Physiology at http//www.interactiveph
ysiology.com to review all of this material.