"<div><b><u>Control of Glomerular Filtration and RBF:</u></b><b><br></b></div><b><font color=""#5555ff"">Strong&nbsp;sympathetic</font></b> nervous system activation leads to {{c1::decreased GFR &amp; RBF}}""Mild-moderate would not effect GFR and RBF.<div><br><div><img src=""paste-635097a658940d600b0eae2d662e1cfae7fd5841.jpg""><br></div><div><img src=""paste-ad0e6120c676ecb6d6e51eb3c879cc10f1fdf619.jpg""><br></div></div>"
"<div><b><u>Control of Glomerular Filtration and RBF:</u></b><br></div><b><font color=""#5555ff"">Catecholamines </font></b>effect on RBF and GFR:<b>&nbsp;</b>{{c1::Decreases both.}}<b>&nbsp;</b>""&nbsp;Nor-epinephrine and epinephrine&nbsp;constric afferent and efferent renal arterioles.<div><br><div><div><img src=""paste-635097a658940d600b0eae2d662e1cfae7fd5841.jpg""><br></div><div><img src=""paste-ad0e6120c676ecb6d6e51eb3c879cc10f1fdf619.jpg""></div></div></div>"
"<div><b><u>Control of Glomerular Filtration and RBF:</u></b><b><br></b></div><b><font color=""#5555ff"">Angiotensin II</font> </b>effects both afferent and efferent renal arterioles equally.<b>&nbsp;</b>{{c1::False::T/F}}""Afferent arterioles are protected from the vasoconstrictor effect of angiotensin II, due to release of vasodilators nitric oxide and prostaglandins.<div><br><div><div><img src=""paste-635097a658940d600b0eae2d662e1cfae7fd5841.jpg""><br></div><div><img src=""paste-ad0e6120c676ecb6d6e51eb3c879cc10f1fdf619.jpg""></div></div></div>"
"<div><b><u>Control of Glomerular Filtration and RBF:</u></b><b><br></b></div><b><font color=""#5555ff"">Angiotensin II</font></b> only effects the&nbsp;{{c1::efferent arterioles}}&nbsp;and {{c1::decreases RBF}}&nbsp;but prevents a decrease in GFR.""<div><img src=""paste-635097a658940d600b0eae2d662e1cfae7fd5841.jpg""><br></div><div><img src=""paste-ad0e6120c676ecb6d6e51eb3c879cc10f1fdf619.jpg""></div>"
"<div><b><u>Control of Glomerular Filtration and RBF:</u></b><b><br></b></div><font color=""#5555ff""><b>Prostaglandins</b> </font>are Renal vascular vasodilators, so they tend to&nbsp;{{c1::increase GFR and RBF}}""<img src=""paste-8070a7fbd782a6b9e6d5ea9945452d0444dba489.jpg""><div><img src=""paste-671056ff6c4b4c65024230c347d669a5216dc6b1.jpg""><br></div>"
"<div style=""""><b><u>Control of Glomerular Filtration and RBF:</u><br></b></div><div style=""""><b><font color=""#5555ff"">Endothelial-Derived Nitric Oxide (EDRF)&nbsp;</font><span style=""font-weight: normal;"">causes&nbsp;</span></b>{{c1::vasodilation}}&nbsp;<b><span style=""font-weight: normal;"">o</span></b>f renal vessels and {{c1::increased&nbsp;<b>GFR&nbsp;</b>&amp;&nbsp;<b>RBF</b>}}&nbsp;</div><br>""<div style="""">damage to endothelium --&gt; less NO production --&gt;increased renal vasoconstriction and BP.</div><div style=""""><br></div><img src=""paste-8070a7fbd782a6b9e6d5ea9945452d0444dba489.jpg""><div><img src=""paste-671056ff6c4b4c65024230c347d669a5216dc6b1.jpg""></div>"
"<div><b><u>Autoregulation of GFR:</u></b><br></div><font color=""#5555ff"">Myogenic mechanism</font> works through {{c1::contraction of vascular smooth muscles.}}""In cases of&nbsp;<b><div style=""display: inline !important;"">Rise in blood pressure –&gt; stretching of blood vessels –&gt; increase in calcium permeability –&gt; blood vessel muscle contration –&gt; constriction –&gt; vascular resistance rises –&gt; decrease in blood flow.</div></b><br><b><br></b><div><img src=""paste-6c59637afa624812793eb404c0a206473909309a.jpg""><b><br></b></div><div><img src=""paste-e1c2cbbc6cf1d94769abcdd7bfdfb7e76014b86b.jpg""><br></div>"
"<div><b><u>Autoregulation of GFR:</u></b><br></div><font color=""#5555ff"">Macula densa mechanism</font> works to return decreased GFR to normal levels by:<div>1.Afferent arteriolar {{c1::vasodilation}}</div><div>2.Efferent arteriolar {{c1::vasoconstriction}}</div>""<img src=""paste-0e897a01cdda2f22dd38a01b5f400c6b4720f438.jpg"">"
<div><b><u>Autoregulation of GFR:</u></b><br></div>Angiotensin II helps regulate low GFR by {{c1::constriction of efferent arterioles}}&nbsp;"<img src=""paste-e193fdabe98abfa7c1db435d62763e1ef90058ac.jpg""><div><img src=""paste-0fed57cc752527e5f873ebdbcc194a866ba66904.jpg""><br></div>"
<b><div><u>Renal Clearance<br></u></div><div>Cs ml/min (Clearance) = {{c1::Us x V}} / {{c1::Ps&nbsp;}}</div></b>"<b><div>Us = Urine concentration mmol/ml&nbsp;</div><br><div>V = Urine flow rate ml per min&nbsp;</div><br><div>Ps = Plasma conc. mmol/ml&nbsp;</div></b><br><div><img src=""paste-0348acd2697ea1b5e1e5550effa5d4bc1ba90a58.jpg""><br></div>"
<div><b><u>Significance of Clearance:&nbsp;</u></b></div>Value of {{c2::GFR}}: The clearance of a substance {{c1::freely filtered}}&nbsp;at the glomerulus but {{c1::not reabsorbed or secreted}}&nbsp;in the tubules."<img src=""paste-06a764c9ddd7ad49e91df4054a5e74fdb5ecbe0a.jpg"">"
"<div style=""""><b><u>Significance of Clearance:&nbsp;</u></b><br></div><div style="""">Value of {{c2::Renal plasma/blood flow}}: The clearance of a substance {{c1::filtered}} at the glomerulus and {{c1::completely secreted}} by the tubules.</div>""<img src=""paste-06a764c9ddd7ad49e91df4054a5e74fdb5ecbe0a.jpg"">"
<div><b>Creatinine</b>&nbsp;is only filtered not secreted and no reabsortion occurs<b>.</b>{{c1::TRUE::T/F}}<br></div>"<img src=""paste-06a764c9ddd7ad49e91df4054a5e74fdb5ecbe0a.jpg"">"
"Renal clearance of <b><font color=""#5555ff"">Albumin</font></b>:&nbsp;{{c1::not filtered::Filtered/not}}""<img src=""paste-dcc3b79d10a0b04aff2c783d48396feeab2c3629.jpg"">"
"Renal clearance of <font color=""#5555ff""><b>Glucose</b></font>: {{c1::Filtered, completely reabsorbed::Filtered/not,reabsorbed/not}}""<img src=""paste-dcc3b79d10a0b04aff2c783d48396feeab2c3629.jpg"">"
"<div><b><u>Renal clearance</u>&nbsp;&nbsp;</b><br></div>Substances that are <font color=""#5555ff"">filtered </font>and <font color=""#5555ff"">partially reabsorbed</font>:<b>&nbsp;</b>{{c1::Na, urea, phosphate, chloride::hint-4}}""<img src=""paste-dcc3b79d10a0b04aff2c783d48396feeab2c3629.jpg"">"
"<div><div><b><u>Renal clearance</u>&nbsp;&nbsp;</b></div></div><font color=""#5555ff"" style="""">Inulin&nbsp;</font>is {{c1::freely filtered}} but {{c1::neither reabsorbed nor secreted::secretion/absorption?}}""<div><br></div>Can be used to measure glomerular filtration rate<b><br></b><div><br></div><div><img src=""paste-dcc3b79d10a0b04aff2c783d48396feeab2c3629.jpg""><br></div>"
"<div><div><div><b><u>Renal clearance</u>&nbsp;&nbsp;</b></div></div></div>Which substance has the <font color=""#5555ff"">highest </font>clearance? {{c1::Para-aminohippuric acid&nbsp;}}""because it's both filtered and secreted<div><br></div><div><img src=""paste-dcc3b79d10a0b04aff2c783d48396feeab2c3629.jpg""><br></div>"
"<div style=""""><b><u>Clearance as a measure to estimate GFR:</u></b></div><div style=""""><b>Inulin </b>is {{c1::not found in body}} and {{c1::administered IV}} to measure GFR</div>""<img src=""paste-fb2fda165793854e4be6615dffd262c794c1a9e7.jpg"">"
"<b>Creatinine </b>is a perfect marker to <font color=""#5555ff"">measure </font><b>GFR</b>.{{c1::False::T/F}}""<img src=""paste-af0f84c5e0e2ac6e18efb0812504ba5ee7aa3690.jpg"">"
"If urine sample collection is not feasible, Creatinine clearance can be measured in&nbsp;{{c1::plasma}}&nbsp;which is <font color=""#5555ff"">inversely proportional</font> to GFR.""<div><img src=""paste-4906f1cc7ea3bfc69ec578e8a5ef056ed136c107.jpg""><br></div><div><img src=""paste-c00548c28da56b6aab458ae88af9f7e9f650b1ff.jpg""><br></div>"
<div><b><u>Measuring RPF:</u></b></div>{{c1::Fick’s Principle}}: amount of a substance entering organ equals amount leaving the organ."Substance neither synthesized nor degraded by organ.<div><br></div><div><img src=""paste-81cc91b9579e459dc4db1b3bcf486495453d64ca.jpg""><br></div>"
"{{c2::<b><font color=""#5555ff"">Paraamino Hippuric acid (PAH)</font></b>}}<b>&nbsp;</b>is used to measure&nbsp;{{c1::<b>RBF</b>}}&nbsp;because it's filtered and secreted by kidney.""<b>90% of it&nbsp; cleared from plasma</b><div><b><br></b></div><div><img src=""paste-81cc91b9579e459dc4db1b3bcf486495453d64ca.jpg""><b><br></b></div>"There is no known substance which is completely cleared from the plasma, PAH is 90% cleared and is called the extraction ratio.
"<div style="""">Clearance of PAH equals RPF (total plasma flow). {{c1::False::T/F}}</div>""<div style="""">It doesn't equal RPF, some blood may bypass the nephrons,&nbsp;&nbsp;</div><div style="""">so Clearance of PAH =<b>Effective</b> RPF ( this is what we are measuring )&nbsp;</div><div style="""">Total RPF is about 5 -10% more than ERPF</div><br><div><img src=""paste-856a48303f338a5e392e05bdefe3de0446ad7277.jpg""><br></div>"
"<div><b><u>Control of Glomerular Filtration and RBF:</u><br></b></div><div><b><font color=""#5555ff"">Endothelial-Derived Nitric Oxide (EDRF)&nbsp;</font></b>causes vasoconstriction that leads to increase in&nbsp;{{c1::afferent arteriole resistance}} and a decrease in {{c1::GFR and RBF}}</div>""<img src=""paste-1ce8708aff7eaa244d53d31aea197c9737ebeec9.jpg""><div><img src=""paste-ab2b8698009dcface9f3bde6c8328eb0b13b58a2.jpg""><br></div>"
7555763373b540d2ac79d13e54c0c20c-ao-1"<img src=""tmpnpm305qn.png"" />""<img src=""7555763373b540d2ac79d13e54c0c20c-ao-1-Q.svg"" />""<img src=""paste-da86ab231ad9e1a17327249c6296df6bef50b27b.jpg"">""<img src=""7555763373b540d2ac79d13e54c0c20c-ao-1-A.svg"" />""<img src=""7555763373b540d2ac79d13e54c0c20c-ao-O.svg"" />"
7555763373b540d2ac79d13e54c0c20c-ao-2"<img src=""tmpnpm305qn.png"" />""<img src=""7555763373b540d2ac79d13e54c0c20c-ao-2-Q.svg"" />""<img src=""paste-da86ab231ad9e1a17327249c6296df6bef50b27b.jpg"">""<img src=""7555763373b540d2ac79d13e54c0c20c-ao-2-A.svg"" />""<img src=""7555763373b540d2ac79d13e54c0c20c-ao-O.svg"" />"
a2ef14632af8478aae181b95a0520fbb-ao-1"<img src=""tmpgblfvqui.png"" />""<img src=""a2ef14632af8478aae181b95a0520fbb-ao-1-Q.svg"" />""<img src=""a2ef14632af8478aae181b95a0520fbb-ao-1-A.svg"" />""<img src=""a2ef14632af8478aae181b95a0520fbb-ao-O.svg"" />"
a2ef14632af8478aae181b95a0520fbb-ao-2"<img src=""tmpgblfvqui.png"" />""<img src=""a2ef14632af8478aae181b95a0520fbb-ao-2-Q.svg"" />""<img src=""a2ef14632af8478aae181b95a0520fbb-ao-2-A.svg"" />""<img src=""a2ef14632af8478aae181b95a0520fbb-ao-O.svg"" />"
a2ef14632af8478aae181b95a0520fbb-ao-3"<img src=""tmpgblfvqui.png"" />""<img src=""a2ef14632af8478aae181b95a0520fbb-ao-3-Q.svg"" />""<img src=""a2ef14632af8478aae181b95a0520fbb-ao-3-A.svg"" />""<img src=""a2ef14632af8478aae181b95a0520fbb-ao-O.svg"" />"
a2ef14632af8478aae181b95a0520fbb-ao-4"<img src=""tmpgblfvqui.png"" />""<img src=""a2ef14632af8478aae181b95a0520fbb-ao-4-Q.svg"" />""<img src=""a2ef14632af8478aae181b95a0520fbb-ao-4-A.svg"" />""<img src=""a2ef14632af8478aae181b95a0520fbb-ao-O.svg"" />"
"<b><u>Autoregulation of RBF:&nbsp;</u></b><div>RBF remains relatively constant, that’s because {{c2::<font color=""#5555ff"">renal resistance</font> <b><font color=""#5555ff"">rises</font></b>}}<b>&nbsp;</b>as {{c1::<font color=""#5555ff"">renal arterial pressure <b>rises</b></font>}}, and {{c2::<font color=""#5555ff"">renal resistance <b>falls</b></font>}}<b>&nbsp;</b>as r{{c1::<font color=""#5555ff"">renal arterial pressure <b>falls</b></font>.}}<b><u><br></u></b></div>""<div><img src=""paste-9e0d25150a66fad592bbd620f47e859afcf11299.jpg""><br></div>"
<b><u>Autoregulation of RBF:&nbsp;</u></b><div>If <b>MAP</b> increases greatly, it would result in <u>two phenomena</u> that are known as {{c1::pressure natriuresis}} and {{c1::pressure diuresis}}<b><u><br></u></b></div>"<div><img src=""paste-15a49f812fa9ae6dc4d969a86de7e6d24a51417f.jpg""><br></div>"
2d69a1d45f0d435887b65242857dd29e-ao-1"<img src=""tmp9olufdd3.png"" />""<img src=""2d69a1d45f0d435887b65242857dd29e-ao-1-Q.svg"" />""<img src=""2d69a1d45f0d435887b65242857dd29e-ao-1-A.svg"" />""<img src=""2d69a1d45f0d435887b65242857dd29e-ao-O.svg"" />"
52e5efc1ebf945059e66b0dab7a17596-ao-1"<img src=""tmp1fz7u72b.png"" />""<img src=""52e5efc1ebf945059e66b0dab7a17596-ao-1-Q.svg"" />""<img src=""52e5efc1ebf945059e66b0dab7a17596-ao-1-A.svg"" />""<img src=""52e5efc1ebf945059e66b0dab7a17596-ao-O.svg"" />"
52e5efc1ebf945059e66b0dab7a17596-ao-2"<img src=""tmp1fz7u72b.png"" />""<img src=""52e5efc1ebf945059e66b0dab7a17596-ao-2-Q.svg"" />""<img src=""52e5efc1ebf945059e66b0dab7a17596-ao-2-A.svg"" />""<img src=""52e5efc1ebf945059e66b0dab7a17596-ao-O.svg"" />"
52e5efc1ebf945059e66b0dab7a17596-ao-3"<img src=""tmp1fz7u72b.png"" />""<img src=""52e5efc1ebf945059e66b0dab7a17596-ao-3-Q.svg"" />""<img src=""52e5efc1ebf945059e66b0dab7a17596-ao-3-A.svg"" />""<img src=""52e5efc1ebf945059e66b0dab7a17596-ao-O.svg"" />"
52e5efc1ebf945059e66b0dab7a17596-ao-4"<img src=""tmp1fz7u72b.png"" />""<img src=""52e5efc1ebf945059e66b0dab7a17596-ao-4-Q.svg"" />""<img src=""52e5efc1ebf945059e66b0dab7a17596-ao-4-A.svg"" />""<img src=""52e5efc1ebf945059e66b0dab7a17596-ao-O.svg"" />"
"+ If GFR <b>decreases </b>to <font color=""#5555ff"">one eighth</font> – plasma cr {{c1::increases:: increases or decreases}} eight times<div>+&nbsp;If GFR <b>decreases </b>to <font color=""#5555ff"">1/4th</font> – plasma cr {{c1::increases:: increases or decreases}} four times</div>""<div>++&nbsp;<b>Steady state relationship</b> between GFR and serum creatinine concentration</div><div><br></div><img src=""paste-c0fdf0f83d8c4e06a6eba35c7b408ce21929a310.jpg"">"
"<b><u>PAH clearance as an estimate of RPF:&nbsp;</u></b><div><font color=""#5555ff"">Eqaution </font>for calculating clearance</div>"+ RPF = Us x V / Ps&nbsp;<div>+ RPF= U PAH x V / RA PAH - RV PAH<div></div></div>"<img src=""paste-a16f8ced80e7a8e98335deac6e39df4ec42dff3e.jpg""><div><img src=""paste-9f60fd9aa80ba725bb3f04d684d171fe505b593e.jpg""><br></div>"
"<b><u>PAH clearance as an estimate of RPF:&nbsp;</u></b><div><font color=""#5555ff"">Eqaution </font>for Renal blood flow?&nbsp;</div>""<font color=""#5555ff""><b>+ renal blood flow = RPF/1-PCV&nbsp;</b></font><div>+ 1-PCV=Plasma</div>""<img src=""paste-928d8354753271cdc4210f11d617ff137360c799.jpg""><div><img src=""paste-9f60fd9aa80ba725bb3f04d684d171fe505b593e.jpg""><br></div>"
"<b><u>PAH clearance as an estimate of RPF:&nbsp;</u></b><div><font color=""#5555ff"">Eqaution </font>for ER?&nbsp;</div>""<font color=""#5555ff"">ER= RA (PAH) - RV (PAH) / RA&nbsp;</font><div>+&nbsp; PAH = 0.9</div>""<img src=""paste-928d8354753271cdc4210f11d617ff137360c799.jpg""><div><img src=""paste-9f60fd9aa80ba725bb3f04d684d171fe505b593e.jpg""><br></div>"
"<b><u>PAH clearance as an estimate of RPF:&nbsp;</u></b><div><font color=""#5555ff"">Eqaution </font>for Total RPF?&nbsp;</div>"Total RPF = PAH clearance / PAH ER"<img src=""paste-928d8354753271cdc4210f11d617ff137360c799.jpg""><div><img src=""paste-9f60fd9aa80ba725bb3f04d684d171fe505b593e.jpg""><br></div>"