Renal 4: Salt Balance Flashcards

1
Q

the kdneys match salt out to salt ___

A

in

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2
Q

____ is the main determinant of extracellular fluid volume

A

na

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3
Q

Na reabsorption is regulated by the ____ system of hormones; by ____ and also by ____ nervous system activity

A

renin-angiotensin; ANP; sympathetic

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4
Q

increased Na / blood volume causes a ___ in Na excretion

A

increase

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5
Q

decreased Na / blood volume causes a ___ in Na excretion

A

decrease

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6
Q

Na reabsorption is inhibited by ___ drugs that are used to reduce BP

A

diuretic

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7
Q

the kidneys match K excretion to K ___

A

intake

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8
Q

K can be secreted by ___ parts of the nephron to allow control of body K homeostasis

A

distal

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9
Q

K secretion is regulated by plasma ___ and the hormone ___

A

K concentration; aldosterone

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10
Q

as Na increases, the extracellular fluid volume __

A

increases

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11
Q

what is the effect of the renin-angiotensin-aldosterone system on Na reabsorption and excretion?

A

increase reabs ; decrease excretion

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12
Q

what is the effect of ANP on the reabsorption and excretion of Na>

A

decrease reabsorption; increase excretion

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13
Q

what is the effect of sympathetic activity on Na excretion?

A

decreases GFR by constricting BV; lowers excretion

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14
Q

decribe the pathway of the renin-angiotensin-aldosterone system

A

low na –> low ECF volume –> release of renin / formation of angiotensin 2 –> aldosterone –> increase Na and water reabsorption –> increased ECF volume

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15
Q

angiotensin 2 ____ (directly or indirectly) increases Na reabsorption in the nephron

A

directly

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16
Q

angiotensin 2 acts on ___ receptors of tubular epithelial cells

A

AT1

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17
Q

angiotensin 2 increases the activity of ___

A

Na transport proteins

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18
Q

angiotensin 2 stimulates the secretion of ___ from the adrenal gland

A

aldosterone

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19
Q

aldosterone increases the activity of apical ___ channels in the collecting duct and also increases the ___ of ENaC and Na/K pump

A

ENac Na; genetic expression

20
Q

aldosterone ___ the reabsorption of Na

A

increases

21
Q

describe the pathway of ANP

A

high sodium –> high ECF volume –> release of ANP –> decrease Na and water reabs –> decreased ECF

22
Q

ANP is the antagonist to ___

A

aldosterone

23
Q

ANP is released from the

A

heart

24
Q

diuretic drugs act on the ____ to ___ Na reabsorption

A

renal tubular Na transport proteins; reduce

25
Q

how much more urine does a person produce when on diuretics?

A

very little, because the Na out will be matched to Na in

26
Q

loop diuretics act on what transport proteins? where?

A

NKCC; loop of henle

27
Q

thiazide diuretics act on what transport proteins? where?

A

NCC; distal tubule

28
Q

K sparing diuretics act what transport proteins? where?

A

ENaC; late distal tubule and collecting duct

29
Q

what are 2 ENaC channel mutations?

A
  1. Pseudohypoaldosteronism

2. liddle’s syndrome

30
Q

what happens in pseudohypoaldosteronism?

A

loss of ENaC function, more Na excretion, reduced ECF, hypotension

31
Q

what happens in liddle’s syndrome?

A

excessive ENaC function, decreased Na excretion, raised ECF, hypertension

32
Q

K homeostais must be maintained within a very ___ rnage

A

narrow

33
Q

t/f a small rise in K in the plasma can be fatal

A

t

34
Q

K homeostasis is controlled by the ___

A

kidneys

35
Q

K excretion is highly __

A

variable

36
Q

K secretion is regulated by what hormone?

A

aldosterone

37
Q

1% excretion of K in cases of ___

A

hypokalemia

38
Q

100% excretion of K in cases of ___

A

hyperkalemia

39
Q

depending on the K concentration, the distal tubule is capable of either ___ or ___

A

K reabsorption or K secretion

40
Q

____ cells in the ____ and ___ parts of the nephron secrete K

A

principal; late distal tube and collecting duct

41
Q

____ cells in the ____ and ____ parts of the nephron reabsorb K

A

intercalated; late distal tube and collecting duct

42
Q

how is K absorbed by intercalated?

A

H/K atpase pump in apical membrane

43
Q

how is K secreted by principle cells?

A

K channels

44
Q

what happens in a principle cell when plasma K is incresed?

A

Na/K pump on baso side bring K in then out on apical end by K channels, aldosterone in secreted by the adrenal cortex

45
Q

aldosterone increases the expression of __ and ___ and the permeability of K on the ___ end of the principle cells

A

Na/K pump on baso; ENac channels; apical