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PT 509 Physiology > Metabolism/Urinary > Flashcards

Metabolism/Urinary Flashcards

(61 cards)

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1
Q

Main goal of Adenosine Triphosphate?

A

Make ATP

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2
Q

CHO metabolism: main forms

A

Glucose
Fructose
Galactose

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3
Q

CHO is transported into…

A

Cytoplasm

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4
Q

What is the most important and common carrier?

A

GLUT

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5
Q

Rate of CHO utilization is controlled by…

A

Insulin secretion

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6
Q

Glycolysis

A 
Split glucose to 2 molecules of pyruvic acid
10 chemical reactions
Net: 2 ATP, 2 NADH
Input: glucose
Output: pyruvate
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7
Q

Glycolysis compared to Electron Transport

A

Many more ATP w/ ETC

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8
Q

CHO: Pyruvic Acid/Krebs Cycle

A

Conversion to Acetyl Co-A (2)
No ATP
H+ formation (4)
Mitochondrial matrix

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9
Q

CHO: Citric Acid Cycle

A

Acetyl Co-A (2) to CO2 & H+

2 ATP formed (1/Acetyl Co-A), spine twice

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10
Q

CHO: Oxidative Phosphorylation

A

90% of total ATP formed via oxidation of H+ from glucose degradation
Mitochondria

Chemiosmotic mechanism

  • ETC
  • ATP synthase
  • Transfer ATP to cytoplasm

32 ATP

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11
Q

ETC

A

most ATP

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12
Q

Lipid Metabolism

A

TG, Phospholipids, Cholesterol
TG to FA & glycerol
Glycerol to glycolysis

FAs enter mitochondria to Acetyl Co-A (Beta Oxidation)

Acetyl Co-A to Citric Acid Cycle

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13
Q

Protein Metabolism

A

Deamination - removal of amino groups from AAs, releases ammonia NH3
Conversion into urea (liver), excreted by kidneys
Kept acids undergo oxidation (Transamination)
Enters CAC
Produces slightly less ATP than glucose
Gluconeogenesis, Ketogenesis

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14
Q

ATP production levels

A

Protein

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15
Q

Developmental Physiology: Prenatal

A

Urine excretion - 2nd tri

Amniotic

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16
Q

Developmental Physiology: Infancy

A

Other kidney functions

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17
Q

Functional unit of kidneys?

A

Nephron

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18
Q

Male vs female: urethra

A

males have prostrate gland that can back up bladder, impact the kidneys if severe

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19
Q

Macula Densa

A

sensitive to NaCal
Vasodilation in afferent arterioles
renin release method of fluid balance
blood pressure regulation

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20
Q

Filtration* most time on

A

1) Filtration*
2) Resorption*
3) Secretion
4) Execretion

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21
Q

Bowman’s capsule

A

where glomerular filtration takes place

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22
Q

Last opportunity for filtration

A

Peritubular capillaries

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23
Q

Urinary excretion

A

Excretion = Filtration - Reabsorption + Secretion

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24
Q

Renal Handling

A

Filtration only: Creatinine
Filtration, partial reabsorption: NaCl
Filtration, complete reabsorption: AA/glucose, water
Filtration/secretion: acids/bases

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25
glomerular filtration (GFR)
125 ml/min = 180 liters/day 60 times/day Composition is about the same as plasma, except for large proteins
26
Filtration fraction (GFR/Renal plasma flow)
0.2 (20% plasma filtered)
27
Glomerular Capillary Filtration Barrier
Loops
28
Determinants of GFR
Hydrostatic pressure Bowman's capsule pressure Oncotic pressure
29
Glomerular Injury in DM
Capillaries swell, impairs the filtration system Filled with blood/glucose/inflammed Can't filter properly
30
RBF
High blood flow needed for high GFR 22% CO goes to kidneys O2 and nutrients to fuel kidneys O2 consumption related to sodium resorption
31
Autoregulation
Macala densa in the distal tubule near arterioles If NaCl low dilates (increases everything) Efferent If NaCl high constricts (decreases everything) Afferent
32
Tubular Reabsorption
``` Tubular lumen, peritubular capillaries Transepithelial transport, 5 barriers 1) luminal cell membrane 2) cytosol 3) basolateral cell membrane 4) interstitial fluid 5) capillary wall ``` Proteins are too large
33
Glucose Transport Maximum
Only filter so much glucose before the kidneys cannot keep up anymore
34
Hormone: Aldosterone, effects | Adrenal cortex
Increase NaCl, H2O reabs | Increase K secr
35
Hormone: Angiotensin II, effects | Liver
Increase NaCl, H2O reabs | Increase H secr
36
Hormone: ADH, effects | Post pit
Increase H2O | AKA Vasopressin
37
Hormone: ANP, effects | Heart
Decrease NaCl
38
Hormone: PTH, effects
Decrease PO4, Ca++ reabs
39
Reabsorbs NaCl, low BP
Aldosterone | Angiotensin II
40
Reaborbs H2O, low BP
Aldosterone Angiotensin II ADH
41
Angiotensin II
increases renal tubular sodium resorption | binds on cell receptor then uses pumps back into blood
42
ANP (heart)
``` chemoreceptors in heart goal: decrease BP, SNS output: urine input: water decreases NaCl ```
43
Main things secreted?
Hydrogen, H | Potassium, K
44
Waste Products
Urea Uric acid Creatinine Bilirubin
45
Short Term effects: Baroreceptor Reflex
``` BP drops in heart SNS vasoconstriction increase arterial pressure exercise, altitude ```
46
Long term effects: Baroreceptors
``` BP drops changes vasoconstriction changes afferent/kidneys (system) Glomerulus Bowman's Decrease GFR/BP/urine volume retaining NaCl, H2O increases BP ```
47
Uncontrolled BP.. long term leads too..
taxes out kidneys
48
RAAS
main output: increase NaCl and H2O reabs ``` Angiotensinogen - liver Renin - kidneys ACE - lungs A2 - adrenal cortex Aldosterone - kidneys, adrenal cortex ```
49
RAAS: A2 causes
Vasopressin (ADH) Thirst Arteriolar vasoconstriction NaCl/H2O reabsorption
50
Aging
Decrease blood flow to kidneys, nephrons, efficiency, volume, sodium regulation, bladder capacity
51
DM 1: Pathogenesis
Autoimmune progressive | Destruction of beta cells
52
Chronic Kidney Disease: CKD
half of kidney disease results from DM
53
CKD
sugar in blood impairs vasculature | doesn't allow normal nutrients to circulate properly
54
CKD & DM: Pathogenesis
Abnormal byproducts, hyperglycemia
55
DM neuropathy
vessels inflamed due to excess protein leads to decrease urine output increases in GFR first then when capsules die theres a decrease in GFR (RAAS)
56
Consequences of CKD
``` impaired immune skin disorders gastrointestinal neurological sexual dysfunction ```
57
CKD Dx
``` Blood GFR, creatinine levels urine test for blood/protein/albumin/creatinine imaging biopsy 5 stages 1: >90 5: ```
58
CKD, diminished
>90 ml/min normal or increase GFR nocturia, decrease []
59
CKD, insufficiency
``` headaches can't [] polyuria/olliguria increase BUN/serum/creatinine edema GFR to 30 ml/min mild anemia increase BP weak/fatigue ```
60
CKD: Tx
``` sodium restrictions diuretics dietary restrictions avoid NASAIDS sodium bicarbonate phosphate binders ```
61
CKD: Tx endstage
Dialysis | Kidney transplant

PT 509 Physiology (9 decks)

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