EXCRETION

CHARTS, DISCUSSION AND

CALCULATIONS
DEPARTMENT OF PHYSIOLOGY
KGMC
CHARTS
1. Identify the structure.
2. Identify A, B and C.
3. Mention the functions of A, B and C.
4. Explain how the above structure maintains BP.
5. Where is ACE present and mention its function.
1. Juxta glomerular apparatus.
2. A - Juxta glomerular cells, B – Macula densa
cells, C – Lacis cells.
3. A – secretion of renin. B – helps in tubulo -
glomerular feedback and autoregulation.
C – supporting cells and secrete
erythropoietin.
4. Maintains blood volume and blood pressure
through renin angiotensin aldosterone
mechanism.
5. Pulmonary capillaries of lung. Converts
Angiotensin I to Angiotensin II.
1. Name the 2 types of nephron.
2. Mention the difference between two types.
3. Mention the function of loop of Henle.
4. Mention two epithelial cells of collecting duct with their
functions.
5. What is the function of vasa recta?
1. Cortical nephron and juxtamedullary nephron.
2. Cortical nephron – 85%, efferent arteriole
forms peritubular capillaries, helps in urine
formation. Juxtamedullary nephron – 15%,
efferent arteriole forms vasa recta, helps in
urine concentration.
3. Acts as counter current multiplier.
4. Principal cells – involved in Na and ADH
involved water reabsorption. Intercalated cells
– helps in H+ secretion and bicarbonate
transport.
5. Acts as counter current exchanger.
1. What is tubular maximum.
2. What is renal threshold.
3. Mention the tubular maximum and renal threshold
of glucose.
4. Explain the reason for splay.
5. Mention the factors affecting renal threshold of
glucose.
1. An upper limit to the rate at which the
substances are actively reabsorbed or secreted.
2. The concentration of the solute in the plasma at
or above which the solute first appears in the
urine.
3. TmG – 375 mg/min in males and 300mg/min in
females. Renal threshold for glucose –
200mg/dl.
4. TmG is not same in all the nephrons. Some
nephrons begins to excrete glucose even when
others not reached their maximum.
5. Old age and diabetes mellitus.
1. Identify A, B and C.
2. Name the nerve for filling and emptying.
3. Mention the urethral sphincters with innervations.
4. Mention the anatomical and physiological capacity of
adult bladder.
5. What is atonic bladder.
1. A - pelvic nerve (parasympathetic), B – hypo
gastric nerve (sympathetic) , C – pudendal nerve
(somatic).
2. Nerve of filling – sympathetic. Nerve of emptying
– parasympathetic.
3. Internal sphincter – both sympathetic and
parasympathetic. External sphincter – somatic
pudendal nerve.
4. Anatomical capacity – 1 L, physiological – 600ml.
5. Due to deafferentation, bladder loses it control,
becomes distended thin walled and hypotonic,
over flow dribbling occurs, seen in Tabes dorsalis
1. Identify the graph.
2. What are micturition waves.
3. Mention the center for micturition.
4. Name the facilitatory and inhibitory areas.
5. Mention the abnormalities of bladder.
1. Normal cystometrogram showing relation
between intra vesicular pressure and volume
of urine in bladder.
2. Periodic acute raise in the pressure in
cystometrogram superimposed on the tonic
pressure changes during filling of bladder.
3. Spinal cord – S 2,3,4 segment. Spinal reflex.
4. Facilitatory areas – pons and posterior
hypothalamus. Inhibitory areas – midbrain.
5. Atonic bladder, automatic bladder and
neurogenic bladder.
1. Identify the structure and name the layers.
2. What type of capillaries are present here. Mention the
size of the pore.
3. Mention different pressures acting with normal value.
4. What is normal GFR and renal plasma flow.
5. What is filtration fraction.
1. Glomerular capillary membrane. Capillary
endothelium, basement membrane and foot
process of podocytes.
2. Fenestrated capillaries. 100 nm in size.
3. Glomerular hydrostatic pressure – 60 mm/Hg,
Glomerular oncotic pressure – 32 mm/Hg,
Bowman’s hydrostatic pressure – 18 mm/Hg.
4. GFR – 125 ml/min, 170 – 180 L/day. RPF – 650 –
700 ml/min.
5. The fraction of RPF that is filtered.
FF = GFR/ RPF. 0.16 – 0.20.
CALCULATIONS
Calculate the maximum urea clearance from the
following data:
• Blood urea concentration: 20 mg%
• Urine urea concentration: 500 mg%
• Urine flow: 3cc/min

1. Mention normal standard urea clearance and

maximum urea clearance?
2. What blood parameters would indicate severe
renal failure?
• Maximum urea clearance = U × V
P
= 500 × 3 / 20
= 75 ml/min.

1. Maximum urea clearance = > 75 ml /min.

Standard urea clearance = 57 ml /min.
2. Blood urea nitrogen and serum creatinine.
Calculate the renal blood flow from the following
data:
• Plasma conc of PAH= 0.02 mg%
• Urine volume= 0.8 ml / min
• Urine conc of PAH = 15 mg %
• PAH extraction ratio = 0.9
• Haematocrit = 45%

1. What is normal renal blood flow?

2. What are the other substances used to
measure renal blood flow?
• PAH clearance = U × V
P
= 15 × 0.8 / 0.02
= 600 ml/min.
• RPF = PAH clearance/ extraction ratio
= 600/0.9 = 666 ml/min.
• RBF = RPF / (1 – Hct) = 666 / ( 1- 0.45)
= 1210 ml/min.

1. 1200 to 1300 ml/min.

2. PAH, Diodrast, I 131.
Calculate the effective and actual renal plasma flow:
During an infusion of Para Amino Hippuric acid:
• Peripheral venous plasma level of PAH is: 0.02
mg/ml
• Urinary level of PAH: 16 mg/ml
• Urine production rate: 1 ml/min
• PAH extraction ratio = 0.9

1. What is the extraction ratio.

2. What is normal renal plasma flow.
• PAH clearance = U × V
P
= 16 × 1 / 0.02
Effective RPF= 800 ml/min.

• Actual RPF = PAH clearance/ extraction ratio

= 800/0.9 = 888 ml/min.

1. Arterial conc. – Venous conc.

Arterial conc.
2. 600 to 700 ml/min.
Calculate the GFR from the following data:

• Urine flow over a 10 minute period: 25 ml

• Concentration of substance % in urine: 120
mg/ml
• Concentration of substance % in plasma: 2
mg/ml

1. Define GFR and mention its normal value.

2. Name the substances used to measure GFR?
• GFR = U × V
P
= 120 × 2.5 / 2
= 150 ml/min.

1. The amount of filtrate formed by both the

kidneys per minute is called GFR.
125 ml/min or 170 to 180 L/day.
2. Inulin, creatinine.
Calculate the filtration fraction from the following
data:

• Urine flow: 3 ml/min

• Concentration of inulin in urine: 10 mg/ml
• Concentration of inulin in plasma: 0.25 mg/ml
• Renal plasma flow: 640 ml/min

1. Define filtration fraction.

2. What is its normal range.
• GFR = U × V
P
= 10 × 3 / 0.25
= 120 ml/min
• FF = GFR / RPF
= 120 / 640
= 0.18

1. The fraction of RPF that is filtered.

2. 0.16 – 0.20
DISCUSSIONS
A 10 years old girl landed in the out-patient
department with reduced urine output, puffiness
of face, periorbital oedema and swelling of feet.

1. Identify the condition.

2. Mention the pathophysiology.
3. Name the investigations to be done.
4. What is normal serum albumin and urinary
excretion of protein per day.
5. What is normal colloidal oncotic pressure in
Bowman’s capsule.
1. Nephrotic syndrome.

2. Glomerular injury - Decreased albumin -

decreased oncotic pressure, increased alpha 2
macroglobulin and hyperlipidemia.

3. Urine protein – massive proteinuria, lipid

profile, total proteins.

4. 3 – 5 g/dl. < 150 mg/day.

5. 0 mmHg.
A 18 year old male is reported with complaints of
excessive thirst, increased frequency of micturition
and pale coloured urine. The specific gravity of
urine is 200 mOsm/L and dexamethasone test was
positive.
1. What is the diagnosis.
2. Mention the types with two causes for each.
3. Mention the treatment.
4. Mention types of aquaporin channels in
nephron.
5. What is obligatory urine volume.
1. Diabetes insipidus.
2. Central DI – head injury, pituitary tumours,
Nephrogenic DI – hypercalcemia, drugs –
lithium
3. Central DI – desmopressin or vasopressin,
Nephrogenic DI – stoppage of drugs, Ca
infusion.
4. PCT – Aquaporin -1, CD - Aquaporin – 2 , 3 & 4.
5. Minimum volume of urine that must be
excreted to remove the solutes per day. 500 ml.