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Q & A on Urinary Physiology by Dr Khaled A Abulfadle Empty
مُساهمةموضوع: Q & A on Urinary Physiology by Dr Khaled A Abulfadle   Q & A on Urinary Physiology by Dr Khaled A Abulfadle Emptyالجمعة نوفمبر 06, 2015 2:24 pm


Q: What is the normal value of glomerular capillaries hydrostatic pressure? why? What is the importance?

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A: The glomerular capillary hydrostatic pressure is 60 mmHg (the highest capillary hydrostatic pressure all over the body) as they are present between two arterioles (afferent & efferent) with narrow efferent. This is essential for filtration (it is a filtration force).

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Q: Why there is anemia in chronic renal failure?
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A: Anemia in chronic renal failure is due to:
a. Increased hepcidin which is iron regulatory peptide hormone that causes hypoferremia.
b. Decreased erythropoietin secretion.
c. Depression of bone marrow by toxic substances.
d. Severe anorexia (loss of appetite).
e. Shorter life span of RBC’s in uremic patient.
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Q: What is the expected effect of sympathetic action of the afferent arteriole on
filtration fraction?
=====
A:

Filtration fraction is the ratio of the GFR to the renal plasma flow.

At rest, this has a value of about 0.2. This means that a fifth of the total renal plasma flow is filtered.

If the renal sympathetic nerve vasoconstricts only the preglomerular afferent arteriole we can think about the effects on RBF and the GFR.

There will obviously be a decrease in RBF (the renal plasma flow is just ~ 55 % of RBF if the hematocrit is 45 %) with the increased vascular resistance.

The effect on GFR will be mediated by any effects of sympathetic nerve  on the Starling’s forces that contribute to the net filtration pressure that produce the GFR. Since the glomerulus is “downstream” from the afferent preglomerular arteriole, the hydrostatic pressure that promotes filtration will be reduced. GFR will be decreased.

Since sympathetic action decreases both the renal plasma flow and the GFR, the filtration fraction is unchanged.


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Q: A 17-year-old male complained to you that the frequency and amount of urination are increased since winter is started. on inquiry, he informed you that other than this he is totally normal. What is your comment?
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A: It is a normal condition as in the winter there is cold exposure which decreases ADH secretion with subsequent decrease in water reabsorption from the kidney and increased its excretion and urine output.


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Q: Mention factors affecting thirst sensation
========
A: Factors affecting thirst sensation



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Question

Why hypo- and hypernatremia are acompoanied by muscle twitches, seizures and coma


===============
Answer

-Symptoms of moderate hyponatremia include tiredness, disorientation, headache, muscle cramps, and nausea. Severe hyponatremia can lead to seizures and coma. These neurological symptoms are thought to result from the movement of water into brain cells, causing them to swell and disrupt their functioning.

-Also, due to the sensitivity of the brain to sodium level, hypernatremia causes brain dysfunction with subsequent
occurrence of confusion, muscle twitching, seizures, coma, and death if severe hypernatremia is present.




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Q: Compare compensated and uncompensated respiratory acidosis
=============
Answer

=COMPENSATED: When PCO2 is high, but pH is normal instead of being acidic, and if HCO3 levels are also increased, then it means that the compensatory mechanism has retained more HCO3 to maintain the pH.
=UNCOMPENSATED: If pH is abnormal and if the value of PCO2 is abnormally increased.


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Question

Which is true

K+ secretion in DCT and collecting duct occurs by primary active transport or secondary active transport
==========
Answer

K+ secretion in DCT and collecting duct is dependent mainly on the function of the Na+/K+ ATPase transporter on the basolateral membrane of the cells. Thus, it is mainly primary active transport.
NB: For more details, follow this link;
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