GoodGirl
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Today I'm doing renal physiology from Kaplan Physiology Bank, and the questions are driving me insane. First all the calculations are taking me too long( does it have meaning to calculate them at all ?) ,than the pathophysiology concept ,can not find polite words to say....
For example, below is Q with explanation :
Where the heck they came up with this High protein diet explanation, it gives sense to me, but I'm not so good to come up with it myself, and hyperglycemia highering GFR , thought it is caused by osmotic diuresis.
Am I missing something here?
And what is the mechanism behind the action of glucocorticoids increasing GFR and lowering vasc. resistance ?
At least I got the PG right .
Someone please calm me down, otherwise I wil not have computer by tonight ( remember that video about guys smashing PCs posted by NNL, that's how I feel ) .
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| GoodGirl
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Here is the question I was reporting to :
Attached Files:
GFR.JPG (104 KB, 56 downloads)
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| keepgoing
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HI GG,its true its not mentioned anywhere in kapaln books or perhaps i have overlooked but reason why cortiso,aa,hyperglyceia increases GFR,cud be
1.Cortisol-->catabolic hormone-->protein-->AAs---->arginine(NO precursor-->EDRF-->vasodilate(lower resistence)-->Inc GRF
2.HYperglycemia-->suppression of tubuloglomerluar feedback--->inc GFR
hope it helps...
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| GoodGirl
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Oh my, what a explanation for the cortisol effect. I would like to have your brain ! It would never occurred to me....
Thanks, will do more reading about it, just renal physio in Kaplan is so  
Isn't the tubuloglomerular feedback more about regulation of RBF ?
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| Kalyann
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now those r qs wich only physiologists cud attempt.......
i mean............ the answer and its explanation in the Q&A pic posted is ok
but the explanations for others are like... u know it or u dont... and certainli u cant know and retain all the stuff for usmle........
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| GoodGirl
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Keepgoing, Isn't the tubuloglomerular feedback more about regulation of RBF ?
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| new_n_lost
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GoodGirl wrote:
Keepgoing, Isn't the tubuloglomerular feedback more about regulation of RBF ?
GG i know the feeling of the calculations and i also hate them.
In regards to your question above here is a excerpt from Ganong which might help you understand the TGF and GFR part.
Signals from the renal tubules feed back to affect glomerular filtration. As the rate of flow through the ascending limb of the loop of Henle and first part of the distal tubule increases, glomerular filtration in the same nephron decreases, and, conversely, a decrease in flow increases the GFR . This process, which is called tubuloglomerular feedback, tends to maintain the constancy of the load delivered to the distal tubule. The sensor for the response appears to be the macula densa, and GFR is adjusted by constriction or dilation of the afferent arteriole. Constriction may be mediated by thromboxane A2.
Conversely, an increase in GFR causes an increase in the reabsorption of solutes, and consequently of water, primarily in the proximal tubule, so that in general the percentage of the solute reabsorbed is held constant. This process is called glomerulotubular balance, and it is particularly prominent for Na+. The change in Na+ reabsorption occurs within seconds after a change in filtration, so it seems unlikely that an extrarenal humoral factor is involved. One factor is the oncotic pressure in the peritubular capillaries. When the GFR is high, there is a relatively large increase in the oncotic pressure of the plasma by the time it reaches the efferent arterioles and their capillary branches. This increases the reabsorption of Na+ from the tubule. However, other as yet unidentified intrarenal mechanisms are also involved.
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| new_n_lost
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I m open for any lengths of discussion on Renal Physio cos this is the topic along with CVS that will haunt you on the exam day.
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| Kalyann
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Hmmmmmmmmmmmm........now it makes some sense...
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| GoodGirl
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Thanks NNL, will come back, need to take a brake, my brain is like a hot engine, can not go anymore . 
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| ShweHope99.9998
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NNL , may I request that ... could you please dig out our old thread that used to post Qs ... answer , explaination ... to post Qs like old time , let say start with renal physio 10 q a aday then , lets do all physio Qs 750 , then later other Qs .
NNL , sorry typo error , fix it........... what I like to request is , is that possible you can find the thread we used to , actually the whole group from study partner group used to post the Qs in one big thread , so you & we all can do same liek last year .. post Qs then answer, discuss there , so we will do like last year as you KG, GG , etc been doing Qs at there .
So we all can also see Qs posts at there in last year too . Thank you .
It will be fun like old time .
Just my 2 cents bro .
Thanx GG ......... am with u re physio Q banks 
Thanx`NNL , by posting Ganong explaination ........ no patient to re-read it though used to drink it , love it , spill over ...... raed ahaed b4 lecture & explain to class mate by their request .
GL  
Edited by ShweHope99.9998 on 03/22/08 - 03:56 AM
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| new_n_lost
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I m sorry Shwe but i m not sure that i understood you.........Can please explain it or repost.
Thanks.
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| ShweHope99.9998
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NNL , had edit the previous post, sorry there is typo error b4 , thnx for asking me to repost it , please see the post # 11 again , thanks .
GL to us , all
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| GoodGirl
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Hello Swe,
did you mean this link : http://www.prep4usmle.com/forum/thread/62446/ ?
Truly, I don't feel safe to post here copy righted Qs as much I would like, for sure not all of them. I think you understand . What I had in my mind ( maybe NNL too ) was to ask about the doubts I come across reading text or questions.
Have nice weekend !
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| GoodGirl
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I found my handwritten note made during my Kaplan center prep :
'' Removed 1 kidney---> leads to decrease Tmax for glucose by ½ . Because Tmax = No of functioning carriers ''
Considering I did not do Renal pathology yet, neither UW , and might later on run into this topic, still my questions now are :
How are renal functions affected by removal of 1 kidney ?
Any change in GFR, RPF etc, ? How this 1 kidney works ?
Is someone willing to discuss it ?
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| new_n_lost
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GG there is a thread which i made on that exact same topic in Physio forum will have to search it and sure would like to go thru it.
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| new_n_lost
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Found it
man did i do some serious study during that last time. I really need to get back in that same speed and motion and kick some serious ass.
http://www.prep4usmle.com/forum/thread/49891/
http://www.prep4usmle.com/comments.php?id=37655
Edited by new_n_lost on 03/22/08 - 07:01 PM
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| GoodGirl
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Thanks, let me go trough that once more. Ahhhhh..... it really is becoming pain in the ass. Such a complicated organ.
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| new_n_lost
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Do let me know what you comments are on this topic.
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| GoodGirl
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My boys ( family ) are on the way home , so later .....
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| GoodGirl
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In the first link, what B.P. stands for ?
is it a blood pressure ?
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| GoodGirl
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Let me write here, so we are not skipping....
Well, went through some online articles, and found all what was already previously mentioned by you.
Just what caught my eye, is long term consequences, but I doubt they will test us on it, some articles say, that 1/4 of them become mildly hypertensive after >25 years.
But all were more about the statistic data, and not pathophysiology behind.
Here is one easily readable , if anyone is interested http://ndt.oxfordjournals.org/cgi/content/full/18...
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| new_n_lost
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Here is another link that you might find helpful
http://cjasn.asnjournals.org/cgi/content/full/1/4...
These 2 helpful and were similar to the from where i made my conclusions.
http://www.blackwell-synergy.com/doi/full/10.1111...
http://www.blackwell-synergy.com/doi/full/10.1034...
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| ShweHope99.9998
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http://www.prep4usmle.com/forum/thread/36145/48/
GG , I meant this one .
Thnx for the links NNL & GG , check the link that we used to post Qs thread there , that is waht I meant NNL , thnx .
GL
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| GoodGirl
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Where the conversion of 25-OH to 1,25-(OH)2 vit D takes place in kidney, where is 1alfa hydroxylase ? Is it thick ascending limb loop of Henle?
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