Final Flashcards by Stephen Barna

Name if the tubular fluid: plasma ultrafiltrate concentration ratio increases or decreases for each substance along the PCT

1) HCO3-
2) Cl-
3) Amino acids
4) Glucose
5) Urea
6) K+
7) Na+
8) Inulin
9) PAH

** So if you are being reabsorbed more than water, your ratio goes ___ and if you are being reabsorbed less than water, your ratio goes __

1) Decreases
2) Increases
3) Decreases
4) Decreases
5) Increases
6) Does not change (1)
7) Slightlyyyyyyyy increases
8) Increases
9) Increases

down, up

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If your TF/P ratio is 2.5 or greater, you are being ___

secreted

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In the proximal tubule, there is a __transport mechanism between Na and glucose and a __transport mechanism between Na and H+

**Both of these occur on the apical membrane

The ATPase Na-K transporter pushes sodium from the tubular lumen into the interstitium and brings K in the opposite direction and occurs on the __ membrane

Co, Counter

basolateral

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As Na and H20 are reabsorbed, the concentration of Cl- and urea goes __ inside the tubular lumen; now that there is a higher concentration in the tubular lumen, the gradient allows for Cl- and Urea to flow down from the tubular lumen through __ into the capillaries to be reabsorbed

up, leaky tight junctions (paracellular)

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Factors that promote fluid movement from the tubular lumen into the capillaries are

1) __ plasma colloid osmotic pressure in the peritubular capillaries due to the filtration of fluid in the glomerulus

AND

2) __ hydrostatic pressure

High

Low

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Tubular reabsorption of glucose and amino acids occurs via __ transport and is ONLY ___

Na-Glucose __transporter brings Na and glucose into the tubular epithelial cells. Now there is a higher concentration of Glucose inside the cell than normal, so it moves out through the basolateral membrane into the interstitium via ___

Glucosuria aka excess glucose in the urine would occur if the ___ exceeds a certain rate. This is because there are only a limited number of Na-Glucose cotransporters so the TmG (tubular glucose maximum) is reached when all of the transporters are occupied

**200-300 mm/dl is TmG

**Diabetes mellitus can have this problem and same with amino acid transport diseases

Secondary active, transcellular

Cotransporter, facilitated diffusion

Filtered load (filtration rate)

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The maximum rate of glucose reabsorption by all of the nephrons combined is the __

If you inhibit the Na-K ATPase, you would ___ glucose reabsorption

Tubular glucose maximum (TmG)

decrease **Since Na wouldn’t be able to be pushed out into the interstitium, and then it would build up inside the cell and cause the concentration gradient to switch and therefore no glucose could be brought into the cell

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If you prescribe an osmotic diuretic, then water excretion will __ and sodium excretion will __

increase, increase

**This is because the drug will draw water from your cells and the vasculature into the tube of the nephron and Na will follow the H20 in order to maintain the osmolar gradient

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Secretion of organic anions (like PAH, bile salts, uric acid, and creatinine) and cations (like catecholamines, acetylcholine, dopamine, etc.) occurs via __ active transport in the PCT

tertiary

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If the PAH is to high, you can no longer use it to measure __ because the secreted transporters become saturated

RPF (renal plasma flow)

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So lets say we take in a weak acid drug. It gets filtered at our glomerulus, then it goes into the tubular lumen.

If the pH of the fluid in the tubular lumen is low (aka acidic) then that means there are many free H+ floating around. These H+ combine with the weak acid drug to form HA aka a ___ compound. Now that the molecule is not charged, it can easily make it through the tubular epithelial cells (since remember, nonpolar molecules can transverse cell membranes easily) and into the peritubular plasma

If we ingest a weak base, the acidic tubular lumen fluid will combined with the B to create BH+ aka a charged molecule. This will not be able to transverse the cell membranes and is therefore stuck in the tubular lumen

** Therefore, acidic environments aka H+ in the tubular lumen, favors __ of organic acids, but traps organic bases in the lumen and therefore favors __ of bases

neutral

reabsorption, excretion

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So lets say you have a patient who overdoses on a weak acid drug (like aspirin), how would you fix the problem?

Same question for a basic drug

You would want to have the drug excreted in the urine, so you would want to make sure the weak acids aren’t being reabsorbed aka you want the weak acid drug to be stuck in the tubular lumen so it can be excreted. In order to do this, give the patient a basic drug so that you can make the pH in the tubular lumen more alkalotic and therefore there will be less H+ that neutralize the acid, causing the acid to stay in the tubular lumen

For a basic drug overdose, you want to increase to pH via an acidic drug so that more protons are available to combine with the basic drug -> BH+, which makes it unable to get out of the tubular lumen and is therefore excreted

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Rule of thumb, anytime you increase total body Na, you increase ____ volume

So lets say you have hypovolemia, and you need to increase effective circulating volume. You could increase total body Na and therefore water is pulled from ICF into ECF (which includes the plasma) and that causes an increase in effective circulating volume

ECF

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Plasma Na+ is regulated primarily by changes in __ balance

If you have an increased ECF volume, you are going to ___ Na excretion. If you have a decreased ECF volume, you want to __ Na excretion

water

increase (because you want to stop holding onto water), decrease

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When low blood pressure is occurring, various pathways can cause renin to be secreted, which leads to constriction of efferent arteriole and then eventually an increase in GFR to cause Na and water to be reabsorbed

1) Renal SNS directly stimulates renin secretion via Beta-1 receptor activation in the JG apparatus
2) Tubuloglomerular feedback senses a decreased delivery of NaCl to the ___ cells and this causes secretion of renin
3) SNS causes afferent arteriole to initially constrict, and this causes GFR and RPF to __ even more and that causes even less NaCl delivery to the macula dense, and therefore even more renin secretion

macula densa

decrease

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Aldosterone’s actions are in the late DCT and the collecting duct’s __ cells and it causes Na reabsorption and K+/H+ secretion, along with Cl- reabsorption, in order to maintain electro neutrality.

So every time you see Na being reabsorbed, the secretion of __ and __ occurs to maintain electro neutrality, along with a little bit of __ reabsorption

**AKA Na is pushed from the lumen to the blood and now that there are less + ions in the lumen, it gains a negative potential difference. However, K+ is pushed back into the lumen via the Na-K pump to balance out this negative potential difference. Furthermore, some Cl- leaks from the lumen into the blood to get rid of some more of the lumen-negative potential difference and H+ secretion also occurs to balance it all out

**** ALDOSTERONE’S MAIN JOB IS TO CONTROL K+, NOT NA+

principal

K+ H+, Cl-

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__ increases Na+ and water excretion aka it does the opposite effect of aldosterone and it also causes the GFR to __ due to constriction of the EA and dilation of the AA

___ is another peptide that causes Na+ and water to stop being reabsorbed, however unlike ANP and BNP, it has NO effect on systemic circulation

ANP, increase

Urodilatin

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Intrarenal prostaglandins (PGE2) increases Na+ excretion via ___ the GFR due to dilation of the ___ arteriole

increasing, afferent

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ADH is secreted from the __ and the osmo receptors and baroreceptors are the most important for controlling ADH

**ADH and AVP are the same molecule

ADH is released during volume ___ and ___osmolality

** A ___ in the firing rate of the baroreceptors and osmo receptors occur to cause ADH secretion

Hypothalamus

depletion,hyperosmolality

decrease

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In the first part of the nephron (proximal tubule) and up to the loop of Henle, the tight junctions between the cells (at the apical surfaces) are __ and therefore water and solutes are permitted to diffuse across these junctions

In the distal tubule, these tight junctions become __ and no more water and solutes can diffuse across them easily

___ movement is going through the tubular epithelial cells themselves into the capillary lumen and __ movement is going through the tight junctions between two tubular epithelial cells into the capillary lumen

leaky

tight

Transcellular, paracellular

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__ diffusion move down its electrochemical gradient as does not need carriers

___ diffusion moves down its electrochemical gradient, but requires are specific carrier

___ transport is against an electrochemical gradient

__transport is downhill movement of one substance provides energy for uphill movement of another substance

Proteins are reabsorbed via __

Simple

Facilitate

Primary active

Secondary active

Pinocytosis

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Sodium cotransport with chloride and potassium occurs where?

** Termed Na/K-2CL

Thick ascending loop

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Which part of the limb is permeable to water and which is not?

Descending is permeable to water

Ascending is not

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The reason why it is important for K+ to leak back into the tubular lumen is what?

It makes a positive potential in the lumen, and therefore allows for the paracellular reabsorption of K+, Ca2+ and Mg2+ (along with Na+, and NH2+)

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What is the major site of physiological control of salt and water balance?

Late DCT and collecting duct

Aldosterone works by entering the nucleus of the cell and causing an increase in __ channels inserted in the ___ membrane aka the apical side so that more Na can enter from the lumen into the cell. Now that there is more Na+ inside the cell, it must be pushed out into the interstitial space to be reabsorbed by the blood; therefore, aldosterone also causes an increase in __ inserted into the basolateral membrane

Na+, luminal, Na-K ATPase pumps

Normally, the collecting duct/late distal tubule is __ to water, however, in the presence of __, the collecting duct now becomes more permeable to water ADH accomplishes this by binding to ___ receptors on the basolateral surface of the cells and causes ___ channels to be inserted into the apical surface

impermeable, ADH V2, aquaporin

The inner medulla has a very __ blood flow and this causes the interstitial fluid solute concentration to be very __. Therefore, if you increase the blood flow in the inner medulla, it will cause the concentration to __ since more solutes will be washed away

low, high, decrease

What and where creates the Na+ gradient in the renal medullary interstitium?

Na-K-2Cl cotransport system in the thick ascending loop

If a patient is dehydrated, aka water deprivation, then ADH levels are __. That means that ADH increased the H20 permeability at the cortical and outer medullary collecting ducts and therefore the urea becomes __ concentrated. As the urea enters the inner medullary collecting duct, ADH causes urea channels to be inserted into the tube and therefore urea can move down its concentration gradient (since it is now so high) via ___ diffusion

high, more, facilitated **Thus, the corticopapillary osmotic gradient is larger when ADH levels are high because it stimulates urea reabsorption, as well as Na-K-2Cl cotransport

So what two processes cause the medullary interstitium to be concentrated?

1) Na+-K+-2Cl- Cotransporter 2) Urea reabsorption

Once the concentration gradient is established, what maintains it?

The vasa recta **Exchanges water and NaCl between the descending and ascending limbs

If you increase blood flow to peritubular capillaries or the vasa recta, what happens to concentrating ability

It will decrease **This is because an increased blood flow causes more reabsorption of the ions in the medullary inderstitium, and therefore as they are reabsorbed, it abolishes this gradient. So in other words ** low blood flow through the vasa recta contributes to the conservation of medullary hyperosmolarity

In diuresis, ADH is __ and in antidisuresis, ADH is __

Low, High

If you increase ADH, than free water clearance would ___

decrease

How does a loop diuretic work?

It increases urine output via inhibiting the Na-K-Cl cotransporter in the thick ascending limb of henle

How much of the filtered load of a substance is actually being excreted in the urine is the __ **Changes in it are a good way to know if you are volume expanded or hypovolemic, etc.

Fractional excretion

When calculating the fractional excretion, if the percentage is below 1%, it can either be a __ or __ problem If it is above 2%, it can be ___

prerenal or AGN (Acute glomerularnephritis) ^** These patients might become volume overloaded Intrarenal disease (reabsorption is not functioning properly like in ATN - Acute tubular necrosis) ^** These patients might become volume depleted because they cant reabsorb stuff

When given a loop diuretic, the fractional excretion percentage should__

increase

If you inhibit the urea-transport mechanism from the inner medullary collecting duct, what would happen to medullary hyperosmolarity? Would a high protein diet increase or decrease the urine concentrating ability?

It would decrease (since urea accounts for about 50% of the hyperosmolarity, and it also would be able to flow into the thin ascending limb to force out NaCl Increase (low protein diet would decrease it) **Because urea can be made from proteins, so it increases the medullary hyperosmolarity

Thiazide diuretics bind to the __ transporter in the __

Na-Cl cotransporter, early distal tubule

Countercurrent __ is an active process that establishes the corticopapillary osmotic gradient and countercurrent __ is a purely passive process that helps maintain the gradient

multiplication, exchange

In ___ hyponatremia, both Na+ concentration AND osmolality are below normal In ___ hyponatremia, Na+ concentrations are low but osmolality is normal **In other words, it refers to those disorders in which marked elevations of substances, such as lipids and proteins, result in a reduction in the fraction of plasma that is water and an artificially low measured serum sodium concentraiton So what are the two most common pseudohyponateremia

True Pseudo Hyperglycemia (excess glucose) or antifreeze **Both pull water into the vasculature to dilute the Na+ and cause hypoonatremia

In normal people, ADH levels are __ when the osmolarity is low. When someone is pregnant, they might present with mild __ because the threshold for release of ADH and thirst is reset at a ___ level and therefore ADH is released at a lower osmolarity, which dilutes the Na plasma concentration and causes hyponatremia

low, hyponatremia, lower

Desmopressin is a synthetic analogue of __, so if a patient has Central/Neuro DI and desmopressin is given, their urine osmolarity would___ In a patient with nephrogenic DI, their urine osmolarity would __ (because they can't respond to the desmopressin)

ADH, increase, not change

Patients with hyperkalemia are at risk for __ Patients with hypokalemia are at risk for ___ Diabetics are at risk for __

acidosis **Since you are pushing out K from the plasma into cells and in exchange, H+ is brought back into the plasma alkalosis **Since you push K+ out of cell into plasma and H+ are exchanged hyperkalemia **This is because diabetics have low insulin in their blood. Insulin is needed to bring K+ out of the ECF into the cells, and therefore, since it is low in diabetics, K+ doesn't leave the ECF (plasma) and builds up.

If you have hyperaldosteroneism, aka increased aldosterone, then Na reabsorption will increase. What will happen with K+ and H+ ions?

K+ and H+ will be secreted in order to maintain electroneutralilty ** If you were reabsorbing to much K+, then Na and H+ would be secreted

An ___ in the tubular flow rate cause K+ to be excreted more Therefore, if you treat someone with a diuretic, they are at risk for __

Increase **This is because you are diluting the K+ as you have more urine flowing through the tube, and that causes the K+ gradient to decrease, and therefore even more K+ can flow out of the cell (where it is high) into the tube and then it gets excreted hypokalemia

If you have a patient with hyperkalemia, you could treat them with a drug that delivers more Na+ to the DCT and CDs because Na+ would be exchanged with ___ in order to get rid of the excess K. You could also give them a diuretic to increase K ___

K secretion/excretion

The amount of K secreted for an acidotic patient is ___ because there are lots of protons in the blood in acidosis. So these protons get exchanged with K+ as the body trys to balance it back to normal. Therefore, less K+ is secreted Vice-Versa for alkalosis

decreased

Increased in plasma K is the main reason why aldosterone secretion __

increases

Mannitol is an __ diuretic and inhibits the reabsorption of water, and secondarily, Na Carbonic anhydrase inhibitors inhibit NaHCO3- ___, one example is ___ Thiazide diuretics work to inhibit the __ at the distal convoluted tubule and result in increased Na, Cl and K excretion and a __ in Ca++ excretion (aka increased reabsorption that can lead to hypercalcemia)

Osmotic reabsorption Acetazolamide Na-Cl cotransport decrease

An increase in protons, due to acidosis, causes them to compete with ___ bound to proteins, and it knocks the ca2+ off the proton in order to create more free calcium. Since only free calcium can be filtered, there is an increased number of filtered calcium So a patient who is acidotic is at risk for ___ A patient who is alkalotic is at risk for ___

Ca2+ hypercalcemia hypocalcemia

What are the three mechanisms of PTH when Ca is decreased?

Increased vitamin D3 (calcitriol) occurs in the kidney, this goes on to allow an increased reabsorption of Ca from GI, increase tubular reabsorption of Ca and increased excretion of phosphate, and finally, bone resorption of bone to release more Ca **So if a patient has kidney problems, the kidneys increase more PTH but since they cant reabsorb CA, it continues to release PTH and since bone reabsorption is one of these effects, you have hyperthyroidism

Ca2+ and mg2+ is reabsorbed in the TAL via ___cellular reabsorption due to the positive gradient inside the lumen set via K diffusing back in. ** If you give someone a loop diuretic, you abolish this gradient and therefore Ca2+ reabsorption decreases

paracellular

If you are prescribed a thiazide diuretic, you will __ more calcium

maintain **This is because you block the Na-Cl cotransport system. Therefore, not enough Na is being brought into the cell (it is staying in the tube lumen). The cell needs more Na, so it increases the Na-Ca countertransport that causes Na to flow into the cell to restore the volume, however this causes Ca to be reabsorbed leading to an increase in Ca in the blood

Phosphate reabsorption is inhibited by __, which decreases the transport maximum for Na-Pi cotransport on the apical membrane, causing there to be an __ in excretion Chronic hypocalcemia can result in secondary _____thyroidism due to the fact that this is increased when calcium is low

PTH, increase hyperparathyroidism

Volatile acid like carbonic acid can be removed via your ___, however fixed acids such as non-carbonic acids generated metabolically must be rid via your ___

respiratory tract, kidneys

In patients that are acidotic, you would see an increased ___ excretion

NH4+ (ammonium)

Alpha intercallated cells secrete __ and Beta intercallated cells secrete __

H+, HCO3-

An increase in CO2 causes __dosis If you use a carbonic anhydrase inhibitor, you become __dotic

acidosis (refer to formula) and therefore H+ are going to be secreted acidotic (since you can no longer reabsorb bicarbonate)

The major pathway of GFR impairment are caused by __ depletion in vascular and tubular cells and puts a patient at risk for __ The pro-inflammatory response when the cells are injured causes vasoconstriction and therefore hypoxia due to the decreased amount of red blood cells carrying oxygen that get get through

ATP, metabolic acidosis

Most renal problems are sterile aka it is not due to an infection. How then, if an infection is not present, do inflammatory mechanisms get activated if there are no danger signals being released via some infection agent? Well, sterile inflammation occurs in response to __ released from dying cells. The kidney cells express a subset of __, (one of many pattern-recognition receptors), which can react to these DAMPS to initiate NF-KappaB activation and a pro-inflammatory response. DAMPs can also bind to __, leading to MAC formation and even further increase in pro-inflammatory response, furthering increasing the level of tubular necrosis and apoptosis The DAMP in the renal tubular is __, what other two DAMPs are important?

DAMPs (Damage Associated Molecular Patterns) TLRs (Toll-like receptors) ** HSPs(Heat shock proteins), HMGB1 and Uric acid

Monocytes are the precursors for __ and ___ Incase of infection, the first phenotype macrophage to the site is __ and this results in acute renal injury due to perpetuating the acute phase of inflammation in the kidney. The inflammatory cytokines to promote M1 differentiation are __ Once infection is resolved, the same macrophage phenotype changes to __, which is responsive for tissue remodeling by releasing anti-inflammatory cytokines __ and __, and this results in chronic kidney disease. The inflammatory cytokines to promote M2 differentiation are __ and ___ **** in other words, if you you acute kidney injury, the macrophages present are ___ and if you see chronic kidney disease then the macrophage present is ___

Dendritic cells and macrophages M1, IFN-gamma M2, IL-10 and TGF-Beta IL-4 and IL-13 M1, M2

Activated T cells differentiate into various T cells, one of them is TH__ caused by IL-__ and this new helper cell releases __, which causes tissue inflammation by recruiting even more neutrophils via section of the chemokine __, monocytes via secretion of the chemokine __, more TH17 cells via secretion of __, and other helper cells/ chemokines. T cells can also differentiate into TH1 cells via __, and TH2 cells via __

Th17, IL-23, IL-17 Il-8, MCP-1, CCL20 IL-12, IL-4

Name the type of grafts 1) Grafts exchange from one part to another part of the same individual 2) Grafts exchange between different individuals of identical genetic constitutions 3) Grafts exchange between nonidentical members of the same species 4) Graft exchanged between members of different species **Most graphs we do are allografts

1) Autografts 2) Isografts 3) Allografts 4) Xenografts

The success of transplantation is dependent on matching of the ___ antigens, in humans these are called HLA complex

MHC (class 1 and class 2)

To test for Class 1 MHCs, you get a donor cell and recipient cell, add __, then add __ and then add __ and in the end, if the cells match, they should be express the taken up dye. ** If they don't match, one will have dye expression and the other will not To test for Preformed antibodies, such as if a women who was pregnant and possible acquired immunity to the child's cells and therefore could possibly reject the transplantation, or a blood transfusion in the past, etc. This is done by taking the __'s cells and mixing it with the __'s __, then adding __ and then adding __ and if dye is present, then preformed antibodies ARE present To test for Class 2 MHC, you __ donor cells so that they can no longer proliferate, then you mix with __, then add __. If the recipients cells and Donor cells do not match, then the recipients cells will __ since recipient cells will be activated by mismatched class 2 MHC, and lots of thymidine will be present. ** If they do match, no proliferation will occur ** So a __ amount of radioactivity is the best result for a match

antibodies, complement, dye donor, recipient's serum, complement, dye irradiate, recipient, H3-Thymidine proliferate Low

When you receive a transplant and your cells attack the donors transplant, this is __ vs __ disease, which is an adapative immune response You can either have direct allorecognition or indirect. In direct, the T cell receptors on recipient T cells directly recognize the donor MHC molecules. ** AKA my T cells DIRECTLY recognize his MHC donor molecules On indirect response, the recipients T cells recognize donor MHC molecules that have been processed by the recipients APCs aka **Donor MHC molecules presented as peptides in the context of RECIPIENTS MHC class II (AKA my own) Which one is more important during chronic rejection?

Host vs graft Indirect allorecognition

Hyperacute graft rejection is mainly a __ response and occurs due to ___ antibodies and __ ** Occurs in minutes Acute graft rejection is a __ response if it is cellular and __ if it is vascular ** Occurs in a few days or weeks Chronic graft rejection occurs due to occlusion of blood vessels and subsequent ischemia of the organ ** Occurs in months to years

humoral, pre-formed, complement Cellular, Humoral

__ vs __ disease is when T-cells from the transplant end up attacking the recipient's tissue This often occurs in patients with __ immune systems since they are unable to reject the allogenic cells in the graft, and therefore the donor's APCs can activating CD8+ T cells to destroy the recipients cells What three transplants do these most often occur in?

Graft vs host compromised Small bowel, lung, or liver transplants **Because there a lots of mature T cells already made here

End organ damage would results in hypertensive __ vs hypertensive __ that would be seen in patients with no end organ damage

emergency, urgency

If the FEna is below 1%, would you want to give them fluid? What about if it was above 2%

Yes (because they have low blood volume) No (because they have high blood volume)

How do you treat a hyperkalemic emergency? Name 3 things **** THIS WILL BE A TEST QUESTION

Insulin & glucose, Calcium, and albuterol

Positive Chvostek sign means __

hypocalcemia ** Extracellular hypocalcemia causes spontaneous muscle twitching

If you have a high anion gap, what two things out of the MUDPILES should you think about for the sake of this test?

Ketoacidosis or Lactacidosis

If you measure someones serum sodium and it seems to be extremely high, but the osmolarity has not changed, then it is most likely due to __. **AKA errors in lab measurements of Na What are the two most likely causes of this Hypertonic hyponatremia, is when there is an increased amount of an osmolar active substance that ends up drawing water into the tubes and therefore dilutes the urine causing hyponatremia. What are the two most common? Finally, true hyponatremia aka hypotonic hyponatremia has various pathways that can lead to this, but in the end, you end up with less Na in the blood either from loss of Na or dilution of it. If the urine is dilute due to low ADh levels, what are the most likely causes? If urine is concentrated due to high ADH levels, what is the most likely cause? ** Hypernatremia can be caused via dehydration (due to extrarenal water loss) or diabetes insipidus (causing polyuria and therefore water loss)

pseudohyponatremia Hyperlipidemia or hyperproteinemia Hyperglycemia (increased glucose) or antifreeze Pregnancy or polydipsia (increased thirst) SIADH

A flat T wave means __ and a heightened T wave means __ **Remember, low K+ brings the resting membrane potential further away from the threshold, so it is harder to get action potentials

Hypokalemia Hyperkalemia

Most diuretics are going to __ K+ excretion, this is because they increase the delivery of Na to the distal tubule and collecting duct, so Na reabsorption increases there, and K+ secretion follows... Don't get confused though, because even though Na reabsorption increases causing K+ secretion to increase, there is so much more Na flowing there that you still end up with an increase in Na excretion

increase

What is the pneumonic for a high anion gap?

E. ELM PARK ``` Ethanol Ethylene glycol Lactic Acid Methanol Paraldehyde Aspirin Renal Failure Ketone Bodies ```

NSAIDs inhibit ___, which causes a decrease in PGE2 When you inhibit prostaglandins locally, you can ___ edema. This is because the suppression prevents inflammation due to various immune responses and lowers prevents the edema NSAIDs can also affect peripheral mechanisms (renal problems) and this causes a __ in edema/___tension

Cyclooxygenase decrease increase, hypertension

NSAIDs, ___ the afferent arteriole resulting in a __ GFR. Diuretics ___ plasma volume due to the fact that they make you excrete it all And ACE inhibitors cause the efferent arteriole to __, leading to an increased RPF and __ GFR **THIS IS LIKE A TRIPLE WHAMMY and can lead to acute renal failure

constrict, decreased reduce dilate, decreased

Thiazides ___ the risk for osteoporosis due to Ca+ reabsorption and Loop Diuretics __ the risk for osteoporosis due to Ca+ excretion

decrease, increase

Patients with diabetes mellitus have low insulin, this causes ___kalemia because insulin is an important regulator of K+ So if you have a patient with hyperkalemia, how would you fix this?

hyperkalemia give someone insulin to reduce the K+ levels via reuptake of the K+ into the cell

When given NSAID, loop diuretics, or thiazide diuretics, they compete for the transport mechanism of urate, and block it from being secreted. Therefore, you end up with __ and this can lead to __

hyperuricemia, gout

If you had crystal deposition in the renal tubules, a weak acid deposition, how would you get rid of this? You would want to cause ____ diuresis via ___

Alkaline (want to make the tubule more basic) Carbonic anhydrase inhibitor

An increase in calcium reabsorption leads to phosphate __

Excretion **And vice versa, they are opposites

If a woman is pregnant, how do you stop them from peeing all the time because remember, they are at a volume expanded state?

You reset and lower the ADH threshold so that they are not constantly diuresing

Final Flashcards

(88 cards)