Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Fluid, Electrolyte and Acid-Base Disorders_ Clinical Evaluation and Management > Phosphate Disorders Physiology Mnemonics > Flashcards

Phosphate Disorders Physiology Mnemonics Flashcards

(68 cards)

Start Studying
1
Q

What organs are involved in phosphate balance?

A

Bone, Kidney, Intestine

Bone stores 85% of phosphate, kidney excretes 700–900 mg/day, intestine absorbs 65% of dietary phosphate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the main intestinal phosphate transporter?

A

NaPi-2B (Na/Pi-IIb)

It is primarily located in the duodenum and jejunum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What stimulates NaPi-2B?

A

LOW

L: Low phosphate diet, O: 1,25(OH)₂D₃, W: Water.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What inhibits NaPi-2B?

A

Toxic AM

A: Arsenate, M: Mercury, T: Calcitonin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the kidney phosphate transporters?

A

SLC34A1, SLC34A3, SLC20A2

SLC34A1 is Na/Pi-IIa (proximal tubule, electrogenic), SLC34A3 is Na/Pi-IIc (proximal tubule, electroneutral), SLC20A2 is PiT-2.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the role of PTH in phosphate regulation?

A

PTH Punishes Phosphate

It degrades transporters and decreases reabsorption.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does FGF-23 do?

A

FGF-23 Flushes Phosphate

It decreases reabsorption and vitamin D levels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What hormones control phosphate homeostasis?

A

PTH, FGF-23, Vitamin D

PTH breaks down bone, FGF-23 flushes phosphate, and Vitamin D increases gut absorption.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the causes of hypophosphatemia?

A

RAPID

R: Renal wasting, A: Alcoholism, P: Poor intake, I: Intestinal malabsorption, D: Diuretics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the causes of hyperphosphatemia?

A

CRUSH

C: CKD, R: Rhabdomyolysis, U: Underactive PTH, S: Supplements, H: Hypervitaminosis D.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What types of phosphate binders are there?

A

C.M.A.

C: Calcium-based, M: Magnesium-based, A: Aluminum-based.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the mnemonic for phosphate distribution in the body?

A

B.O.N.E.S.

B: Bones (85%), O: Organophosphates (14%), N: NaPi transporters (1%), E: Excreted (700-900 mg), S: Secreted (200 mg).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does the mnemonic D.J. PASS represent?

A

Intestinal Absorption Pathways

D: Duodenum, J: Jejunum, P: Passive (ileum), A: Arsenate inhibits, S: Stimulated by 1,25(OH)₂D₃.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the three NaPi transporters in the proximal tubule?

A

NaPi-IIa, NaPi-IIc, PiT-2

NaPi-IIa is SLC34A1, NaPi-IIc is SLC34A3, and PiT-2 is SLC20A2.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does PTH do regarding NaPi transporters?

A

Degrades NaPi transporters

It reduces phosphate reabsorption.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the function of FGF-23?

A

Lowers renal Pi reabsorption

It works with Klotho and is elevated in CKD.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does Vitamin D do in relation to phosphate?

A

Delivers phosphate

It increases gut absorption and elevates FGF-23.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the clinical disorders associated with hypophosphatemia?

A

3 R’s

R: Rickets/Osteomalacia, R: Renal wasting, R: Refeeding syndrome.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What mnemonic describes the effects of PTH on phosphate?

A

PTH DUMPS

D: Degrades transporters, U: Unleashes bone phosphate, M: Makes kidneys excrete phosphate, P: Pumps up calcium, S: Suppresses if Ca²⁺ high.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the phosphate transporters in the proximal tubule?

A

SLC34A1 (NaPi-IIa), SLC34A3 (NaPi-IIc), SLC20A2 (PiT-2)

Mnemonic: ‘SLC 34-1-2-3’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does the mnemonic ‘2A vs 2C’ represent?

A

IIa: All segments (S1-S3), IIc: Central segments only (S1-S2)

Mnemonic: ‘2A vs 2C’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How many Na⁺ ions does NaPi-IIa transport?

A

3 Na⁺

Mnemonic: ‘3-2-1 Phosphate Ride’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How many Na⁺ ions does NaPi-IIc transport?

A

2 Na⁺

Mnemonic: ‘3-2-1 Phosphate Ride’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How many H₂PO₄⁻ ions does PiT-2 transport?

A

1 H₂PO₄⁻

Mnemonic: ‘3-2-1 Phosphate Ride’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What does PTH do to phosphate transporters?
Degrades transporters, endocytosis via PKA/PKC, stimulates bone resorption, targets NaPi-IIa first, reduces reabsorption, osteoclast activation, yields phosphaturia, sparing of calcium ## Footnote Mnemonic: 'PTH DESTROYS'
26
What is the role of FGF-23 in phosphate handling?
Lowers NaPi-IIa/IIc, upregulates phosphaturia, suppresses 1,25(OH)₂D₃, helped by Klotho, enhances renal excretion, skeletal origin ## Footnote Mnemonic: 'FGF-23 FLUSHES'
27
What are the causes of hypophosphatemia represented by the mnemonic 'DROP'?
* Diuretics (chronic) * Renal wasting (Fanconi) * Osteomalacia (FGF-23 excess) * Poor intake (alcoholism) ## Footnote Mnemonic: 'DROP'
28
What are the causes of hyperphosphatemia represented by the mnemonic 'CRUSHED'?
* CKD * Rhabdomyolysis * Uremia * Suppressed PTH * Hypervitaminosis D * Excess intake * Drugs (bisphosphonates) ## Footnote Mnemonic: 'CRUSHED'
29
What does the mnemonic 'PiT-2 Loves ACID' indicate?
* Active at Acidic pH * Ceases at Circumneutral pH * Inhibited at Increased pH * Divalent preference (but transports monovalent) ## Footnote Mnemonic: 'PiT-2 Loves ACID'
30
What does the mnemonic 'PIN' stand for in renal phosphate handling?
* Proximal tubule * Inward (lumen→blood) * Na⁺-dependent ## Footnote Mnemonic: 'PIN'
31
How can the kidney be visualized as a factory?
NaPi-IIa = Fast conveyor belt (3 workers/package), NaPi-IIc = Slow belt (2 workers/package), PiT-2 = Acid-loving robot (1 worker/package), PTH = Wrecking ball smashing belts, FGF-23 = Supervisor shutting down lines ## Footnote Memory Palace Tip: Visualize the kidney as a factory
32
What is the overall effect of PTH on phosphate?
PTH sends phosphate to the urine (↓ reabsorption, ↑ excretion) ## Footnote Mnemonic: "PTH – Phosphate To Heaven (urine)"
33
What does PTH block to reduce phosphate reabsorption?
PTH blocks Na/Pi cotransporters ## Footnote Alternative mnemonic: "No PI (π) for PTH"
34
What are the receptor pathways activated by PTH?
A-B-C Pathways: * A - Apical → PKC * B - Basolateral → PKA * C - Common outcome: Cotransporters degraded ## Footnote Mnemonic: "A-B-C Pathways"
35
What does the mnemonic 'PKC Ate, PKA Baked' represent?
It represents the PTH receptor pathways: * Apical → PKC * Basolateral → PKA ## Footnote Alternative mnemonic for receptor pathways
36
What is the role of NHERF1 in Na/Pi-IIa regulation?
PDZ domains in NHERF1 'park' Na/Pi-IIa at the membrane ## Footnote Mnemonic: "NHERF’s PDZ – Parking Zone for NaPi"
37
How does PTH affect Na/Pi-IIa?
PTH phosphorylates NHERF1, leading to internalization of Na/Pi-IIa ## Footnote Alternative mnemonic: "Ezrin the Bridge, PTH the Quake"
38
What are some inhibitors of phosphate reabsorption?
Inhibitors include: * Dopamine * FGF-23 * Glucocorticoids * PTH * (Bonus: Acidosis, High phosphate, Diuretics) ## Footnote Mnemonic: "Dopamine Fights Glucocorticoids, PTH, FGF"
39
What is included in PTH's foe list?
Foes include: * FGF-23 * Other hormones (dopamine, glucocorticoids) * Expanded volume (↓ Na⁺ reabsorption) * Low pH (acidosis) ## Footnote Alternative mnemonic: "PTH’s Foe List"
40
What promotes phosphate reabsorption?
Promoters include: * Volume contraction * Insulin * Parathyroidectomy * Growth hormone * Hypermagnesemia ## Footnote Mnemonic: "Calcitriol’s VIP Guests"
41
What does the mnemonic 'G.I. Protect Phosphate' refer to?
It refers to promoters of phosphate reabsorption: * Growth hormone * Insulin * Parathyroidectomy * Phosphate restriction ## Footnote Alternative mnemonic for promoters
42
What is a quick summary of PTH's effect on NaPi?
PTH Kicks NaPi Out: * PKC/PKA pathways * Target NHERF1/ezrin * Hurls Na/Pi-IIa to lysosomes * Kidney excretes phosphate! ## Footnote Mnemonic: "PTH Kicks NaPi Out"
43
What does FGF-23 do to phosphate levels?
Blocks phosphate (↓ Na/Pi-IIa) ## Footnote FGF-23 is responsible for lowering phosphate levels in the body.
44
How does FGF-23 affect calcitriol?
Opposes calcitriol (↓ 1α-hydroxylase) ## Footnote FGF-23 inhibits the enzyme responsible for activating vitamin D.
45
What is the effect of FGF-23 on PTH secretion?
Negates PTH (↓ secretion) ## Footnote FGF-23 reduces the secretion of parathyroid hormone.
46
What is the role of FGF-23 in phosphate excretion?
Excretes phosphate (↑ urine) ## Footnote FGF-23 increases phosphate excretion through urine.
47
What is the skeletal origin of FGF-23?
Skeletal origin (osteocytes) ## Footnote FGF-23 is produced by osteocytes in the bones.
48
What does Klotho do in relation to FGF-23?
Required for FGF-23 to work ## Footnote Klotho acts as a cofactor necessary for the function of FGF-23.
49
What are the two forms of Klotho?
* Key (transmembrane - cofactor) * Lone (secreted - independent action) ## Footnote Klotho has both a membrane-bound form and a secreted form that can function independently.
50
What does the FGF-23 activation pathway involve?
* FGFR binds FGF-23 * Includes Klotho * Results in ERK activation * Ends with NHERF1 phosphorylation → ↓Na/Pi-IIa ## Footnote This pathway is crucial for the action of FGF-23 in regulating phosphate levels.
51
How is FGF-23 regulated by phosphate levels?
* Phosphate ↑ → FGF-23 ↑ * Osteocytes make it * PTH stimulates release ## Footnote Increased phosphate levels lead to higher production of FGF-23.
52
What clinical condition is associated with increased FGF-23?
Tumor-induced osteomalacia (↑FGF-23) ## Footnote This condition is characterized by excessive production of FGF-23, leading to bone disease.
53
What is the effect of FGF-23 on vitamin D activation?
Inhibits vitamin D activation ## Footnote FGF-23 reduces the activation of vitamin D, impacting calcium absorption.
54
What condition does FGF-23 cause in terms of phosphate levels?
Causes hypophosphatemia ## Footnote FGF-23 leads to lower phosphate levels in the blood.
55
What is the relationship between Klotho and FGF-23?
Klotho-dependent ## Footnote The action of FGF-23 is dependent on the presence of Klotho.
56
How does FGF-23 compare to PTH in phosphate regulation?
* FGF-23 lowers phosphate * Inhibits both calcitriol and PTH * PTH increases calcitriol (opposite effect) ## Footnote FGF-23 and PTH have opposing actions on phosphate and vitamin D metabolism.
57
What mnemonic phrase helps recall FGF-23's mechanism?
First Get Free (FGF) 23 cents to call KLOTHO long-distance to ERASE phosphate ## Footnote This phrase aids in remembering the relationship between FGF-23 and Klotho in phosphate regulation.
58
What does the mnemonic 'CALM DAD' represent in dietary phosphate regulation?
Hypophosphatemia response: * C: Ca²⁺ increases (inhibits PTH) * A: Alpha-hydroxylase activates * L: Lots of Mighty calcitriol (1,25(OH)₂D₃) * M: Decreased PTH * D: Absorption up * A: Decreased excretion * D:
59
What does the mnemonic 'FURY MOM' represent in dietary phosphate regulation?
Hyperphosphatemia response: * F: FGF-23 spikes * U: Unchecked PTH (due to low Ca²⁺) * R: Reduced calcitriol * Y: Yes to wasting (excretion) * M: More PTH * O: Output phosphate * M: Maintain balance
60
What is the role of PTH in the 'PTH vs FGF-23: The Sibling Rivalry' mnemonic?
PTH (older sibling): * Wants calcium (↑Ca²⁺ reabsorption) * Dumps phosphate (↓NaPi-IIa)
61
What is the role of FGF-23 in the 'PTH vs FGF-23: The Sibling Rivalry' mnemonic?
FGF-23 (younger sibling): * Controls phosphate (↑excretion via ↓NaPi-IIa) * Turns off vitamin D (↓calcitriol)
62
What does the mnemonic 'BONEY KID' summarize?
Key pathways in phosphate regulation: * B: Bone makes FGF-23 * O: Osteocytes sense phosphate * N: NaPi-IIa downregulated * E: Excretion occurs * Y: Your kidneys balance it * K: Klotho required * I: Intestine absorbs less (when FGF-23 high) * D: Vitamin D controlled (calcitriol regulation)
63
What key points are covered in the mnemonic 'PHOS PHATE'?
Clinical connection: * P: PTH - Phosphate excreter * H: High phosphate? FGF-23 activates * O: Osteocytes are sensors * S: Serum levels tightly controlled * P: Phosphate binders used in CKD * H: Hypophosphatemia? Calcitriol helps * A: Alpha-hydroxylase key enzyme * T: Tubular reabsorption variable * E: Excretion matches intake
64
What does the quick recall acronym '3P Balance' stand for?
Quick responders in phosphate regulation: * P: PTH * P: Phosphate sensors (bone) * P: Pathways (FGF-23/Klotho)
65
Fill in the blank: The visual mnemonic shows that [DIET] leads to [GUT] and is influenced by _______.
[1,25D]
66
True or False: The visual storytelling in the mnemonics uses family analogies.
True
67
What anatomical structures are involved in the phosphate regulation pathways?
Structures involved: * Gut * Bone * Kidney * Parathyroid
68
What is the significance of Klotho in phosphate regulation?
Klotho is required for phosphate excretion and regulation

Fluid, Electrolyte and Acid-Base Disorders_ Clinical Evaluation and Management (42 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions