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SF3- EXAM 3 (Camelita) > Basic Tubular Transport Mechanisms > Flashcards

Basic Tubular Transport Mechanisms Flashcards

(54 cards)

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1
Q

When excretion is less than filtration…

A

Reabsorption= Filtration- Excretion

Filtration= GFR x Plasma concentration

Excretion= Urine concentration x Urine flow rate

NOTE: This means that there is no net secretion

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2
Q

When excretion is greater than filtration…

A

Secretion= Excretion- Filtration

Filtration= GFR X plasma concentration

Excretion= Urine concentration x Urine flow rate

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3
Q

Glucose transport maximum

A

NOTE: Some substances have a maximum rate of tubular transport due to saturation of carriers, limited ATP, etc

EX: Glucose, amino acids, phosphate, sulfate

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4
Q

_____________ is the tubular load at which transport maximum is exceeded in some nephrons.

A

Threshold

NOTE: This is not exactly the same as the transport maximum of the whole kidney becuase some nephrons have lower transport maximums than others

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5
Q

Changes in concentration in proximal tubule

A
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6
Q

Transport in thick ascending loop of Henle

A
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7
Q

Which loop diueretics inhibit the Na-K-2Cl transporter of the thick limb of the loop of henle?

A

Furosemide

Ethacrynic acid

Bumetanide

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8
Q

Which diuretics inhibit the Na-Cl channels of the early distal tubule?

A

Thiazide diueretics

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9
Q

Which component of the distale tubule is functionally simular to the thick ascending loop?

A

Early Distal Tubule

  • Not permeable to water
  • Active reabsorption of Na+, Cl-, K+, Mg++
  • Contains macula densa
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10
Q

What relationship do the early distal tubules, late distal tubules, and collecting duct have with water and urea, respectively?

A

Early distal tubule

  • Not permeable to water
  • Not very permeable to urea

Late distal tubule

  • Permeability to H2O depends on ADH
  • Not very permeable to urea

Collecting duct

  • Permeability to H2O depends on ADH
  • Not very permeable to urea
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11
Q

Which cells secrete K+?

A

Principle cells

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12
Q

Aldosterone antagonists

A

Spironolacone

Eplerenone

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13
Q

Na+ channel blockers

A

Amiloride

Triamterene

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14
Q

Normal renal tubular Na+ reabsorption

A
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15
Q

If water is reabsorbed to a greater extent thatn the solute, the solute will become _______ (more/less) concentrated in the tubule.

A

More

Ex: Creatinine, inulin

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16
Q

If water is reabsorbed to a lesser extent than the solute, the solute will become ________ (more/less) concentrated in the tubule.

A

Glucose, amino acids

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17
Q

Changes of concentration substances in the renal tubules

A
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18
Q

Which hormones regulate tubular reabsoption?

A

Aldosterion

Angiotensin II

ADH

ANF

PTH

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19
Q

Normal urine concentration

A

1.2

NOTE: It is important for tubular reabsorption to increase when GFR increases to maintain a normal urine concentration.

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20
Q

How is peritubular capillary reabsorption calculated?

A

Reabsorption= Net Reabsorption pressure x Kf

NOTE: An increase in peritubular oncotic pressure increases reabsorption, while an increase in peritubular hydrostatic pressure leads to decrease in reabsorption.

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21
Q

Which factors determine peritubular capillary hydrostatic pressure?

A
  • Arterial pressure- Directly related
  • Increase in afferent resistance- Indirectly related
  • Increase in efferent resistance- Indirectly related
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22
Q

What factors determine peritubular capillary colloid osmotic pressure?

Study These Flashcards
A
  • Plasma protein
    • ​An increase in plasma protein concentration, leads to an increase in arterial oncotic pressure, which leads to an increase in peritubular capillary oncotic pressure
  • Filtration fraction
    • ​An increase filtration fraction leads to an increase in peritubular capillary oncotic pressure
23
Q

Factors that can influence peritubular capillary reabsorption

24
Q

What actions does aldosterone have on late distal, cortical and medullary collecting tubules?

Study These Flashcards
A
  • Increases Na+ reabsorption- principal cells
  • Increases K+ secretion- principal cells
  • Increases H+ secretion- Intercalated cells
25
Conn's syndrome
**Primary aldosteronism** * Excess aldosterone * Na+ retention * Hypokalemia * Alkalosis * Hypertension
26
Addison's disease
* Aldosterone deficiency * Na+ wasting * Hyperkalemia * Hypotension
27
What factors increase aldosterone secretion?
* Angiotensin II * Increased K+ * Adrenocorticotrophic hormone (ACTH)
28
Which factors decrease aldosterone secretion?
* Atrial natrueretic factor * Increased Na+ concentration **NOTE:** ANP increases glomerular filtration rate and glomerular permeability. ANP also _inhibits_ the effect of aldosterone on the mesangial cells.
29
How does aldosterone function to increase Na+ and water reabsorption?
* Stimulates aldosterone secretion * Directly increases Na+ reabsorption * Contricts **efferent** arterioles * Decreases peritubular capillary hydrostatic pressure * Increases filtration fraction, which increases pertubular colloid osmotic pressure
30
ACE inhibitors
Captopril Benazipril Ramipril
31
Angiotension II antagonists
Losartan Candesartin Irbesartan
32
Renin inhibitors
**Aliskirin** ## Footnote **NOTE:** Renin inhibitors decrease aldosterone, _directly_ inhibit Na+ reabsorption, and decrease efferent arteriolar resistance
33
ADH is secreted by \_\_\_\_\_\_\_
Posterior pituatary **NOTE:** ADH is synthesized in the manocellular neurons of the hypothalamus
34
Mechanism of action of ADH in distal and collecting tubules
35
Feedback control of extracellular fluid osmolarity by ADH
36
Excess ADH secretion can lead to ..
Decreased plasma osmolarity Hyponatremia
37
What condition can lead to insufficient release of ADH?
**"Central" Diabetes Insipidus** * Increased plamsa osmolarity * Hypernatremia * Excess thirst
38
How does atrial natriuretic peptide increase Na+ excretion?
* Secreted by cardiac atria in response to stretch (increased blood volume) * Directly inhibits Na+ reabsorption * Inhibits renin release and aldosterone formation * Increases GFR * Helps to minimize blood volume expansion
39
PTH action on Ca++
* Increases Ca++ reabsorption by kidneys * Increases Ca++ reabsorption by gut * Decrease phosphate reabsorption * Helps to increase extracellular Ca++ **NOTE:** PTH is released by parathyroids in response to decreased extracellular Ca++
40
How does the sympathetic nervous system increase Na+ reabsorption?
* Directly stimulates Na+ reabsorpion * Stimulates renin release * Decreases GFR and renal blood flow * **Only at high levels of sympathetic stimulation**
41
How does increased arterial pressure decrease Na+ reabsorption?
* Increase peritubular capillary hydrostatic pressure * Decreased renin and aldosterone * Increased release of intrarenal natriuretic factors * Prostaglandins * EDRF
42
What effect does osmosis have on reabsorption?
* Increasing the amount of unreabsorbed solutes in the tubules decreases water reabsorption * **Diabetes mellitus** * **​**Unreabsorbed _glucose_ in the tubules causes diueresis and water loss * **Osmotic diuretics (mannitol)** **NOTE:** Water is reabsorbed _only_ by osmosis
43
Conn's syndrome
Primary aldosterone excess
44
Glucocorticoid remediable aldosteronism
Excess aldosterone secretion due to abnormal contraol of aldosterione synthase by ACTH (genetic)
45
Renin secreting tumor
Excess Angiotensin II formation
46
Inappropriate ADH syndrome
Excess ADH
47
Liddle's syndrome
Excess activity of amiloride sensitive Na+ channel (genetic)
48
Diabetes Insipidus
* Decreased water reabsorption * Hypernatremia * Nephrogenic * Lack of ADH
49
Addison's disease
* Decreased Na+ reabsorption * Decreased K+ secretion * Lack of aldosterone
50
Bartter's syndrome
* Decreased Na+, Ca++, HCO3- reabsorption * Hypotension * Decreased activity of Na-K-2Cl transporter in loop of Henle *
51
Gitleman's Syndrome
* Decreased NaCl reabsorption * Hypotension * Decreased activity of NaCl co-transporter in distal tubule
52
Fanconi syndrome
* Generalized decrease in reabsorption * Often in proximal tubules * Causes: * Genetic * heavy metal damage * Drugs (tetracyclines) * Multiple myeloma * Tubular necrosis (ischemia)
53
Renal tubular acidosis
* Decreased H+ secretion * Increased HCO3- excretion * Acidosis * Causes: * Genetic * Renal injury
54
Assessing Kidney Function

SF3- EXAM 3 (Camelita) (23 decks)

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