Physio 2

Question 1

PTH - Affects what part of Nephron? Function?

Answer 1

1) PCT - inhibits Na/phosphate cotransport (P excerted)

2) DCT increases Ca/Na exchange - increases Ca resorption

Question 2

ATII - Affects what part of Nephron? Function?

Answer 2

PCT and DCT. increases Na/H exchange, increases HCO3 - can cause alkylosis.

Question 3

TAL of nephron - resorbs?

Answer 3

Mg and Ca

Na, K, Cl

Question 4

ALDO- Affects what part of Nephron? Function?

Answer 4

Collecting tubules - inserts Na channels

Question 5

ADH - Affects what part of Nephron? Function?

Answer 5

collecting ducts - inserts aquaporins on luminal surface

Question 6

Renin released in response to? By what cells?

Answer 6

decreased BP (JG cells)
decreased NA (Macula Densa cells)
increased SNS (B1 receptors)

Question 7

ATII converted by enzyme produced by?

Answer 7

Lungs/kidney

Question 8

ACE - function other than AT conversion?

Answer 8

inhibits bradykinin

Question 9

ATII acts where? (6)

Answer 9

1) AT receptors in SMC (vasoconstriction increases BP)
2) Constricts EA of kidney (up FF, but WITH compensatory Na resorption)
3) Adrenal gland (produced ALDO)
4) Post Pit (release of ADH)
5) PCT (increases Na/H activity)
6) Hypothal - thirst

Question 10

Mech for molecule released in response to increased volume?

Answer 10

ANP: increases cGMP in SMC, which will relax renal arteries, increasing GFR and decreasing renin (increasing GFR means increasing Na filtration without increasing Na resorption - loss of Na)

Question 11

Primarily regulates osmolarity?

Answer 11

ADH

Question 12

Primarily regulates volume?

Answer 12

ALDO

Question 13

EPO released by?

Answer 13

intersitial cells in the peritubular capillary bed

Question 14

Name and Location of enzyme that convert 25-OH Vit D to 1,25 VitD?

Answer 14

1a-hydroxylase. PCT cells.

Question 15

Fuctions in the kidney to vasodilate the AA to increase GFR?

Answer 15

Prostaglandins.

Question 16

Can cause acture renal failure by constriction of AA?

Answer 16

NSAIDs - inhibit prostaglandins

Question 17

Shifts K out of Cells?

Answer 17

Digitalis, hyperOsmolarity, Insulin deficiency, Lysis of cells Acidosis, B-adrenergic antagonist

DO insulin LAB

Question 18

Insulin - affect on K?

Answer 18

pushes it into cells (INsulin INto cells)

Question 19

U waves and Flattened T-waves on EKG? Suspect?

Answer 19

low K; Flatttened T waves because of impaired repol

Question 20

Wide QRS and peaked (huge) T waves

Answer 20

hyperK

Question 21

Pt with tetany and seizures?

Answer 21

HypoCa

Question 22

Pt with tetany and arrhythias?

Answer 22

hypoMg

Question 23

Pt with bone loss and increased osteoid. Electrolyte disturbance?

Answer 23

hypoPO4 (from not enough vit D)

Question 24

Pt with Stupor with nausea and malaise?

Answer 24

HypoNa

Question 25

Pt with stupor and irritability?

Answer 25

hyperNa

Question 26

Pt with bone pain, anxiety, altered mental status, and abdominal pain?

Answer 26

hyperCa (stone, bones, groans, and psychiatric overtones)

Question 27

Pt with decreasedDTRs, bradycardia, hypotension, hypoCa going into cardiac arrest?

Answer 27

hyperMg

Question 28

Pt with hypoCa and metastatic cacifications with renal stones?

Answer 28

HyperPO4

Question 29

Henderson-Hasselbalch?

Answer 29

pH = 6.1 +log(HCO3/.03Pco2)

Question 30

Predicted respiratory compensation for a simple met acidosis?

Answer 30

Pco2 = 3/2 (HCO3)+8

Question 31

Anion gap?

Answer 31

Na-Cl-HCO3

Question 32

pH<7.4 and Pco2>40; Causes?

Answer 32

Respiratory Acidosis | Hypoventilation (lung disease, opioids, weak muscles, obstruction)

Question 33

pH<7.4, anion gap over 12; causes?

Answer 33

``` Met Acidosis - MUDPILESS Methanol (formic acid) Uremia DKA Propylene glycol Iron tablets/INH Lactic acidosis Ethylene glycol Salicylates (later) Shock/infarction ```

Question 34

pH<7.4, anion gap of 10; causes?

Answer 34

``` Met Acidosis - HARDASS Hyperalimentation Addison's disease Renal tubular acidosis Diarrhea Acetazolamide Spirolactone Saline ```

Question 35

pH>7.4 and Pco2<40; causes?

Answer 35

Respiratory Alk - SHH | early salicylates, Hyperventilation, high altitude,

Question 36

pH>7.4 and Pco2>40

Answer 36

``` Met Alk - LAVA Loop Diuretics Antacid Vomiting AyperALDO ```

Question 37

Pt has Urine pH>5.5, hypoK. Defect? Risk of?

Answer 37

Distal Renal tubular acidosis - cannot excrete H. | Risk of CaPO4 stones and bone resorption

Question 38

Urine pH<5.5. HypoK. Defect? Risk of?

Answer 38

Proximal RTA. Defect in HCO3 resorption (drags out k). Increased risk for hypophosphatemic rickets

Question 39

pt with Fanconi's. May develope (re: kidneys)

Answer 39

Proximal tubles RTA (cant resorb HCO3)

Question 40

Pt with Low Mg : causes?

Answer 40

Alcoholism, diarrhea, aminoglycosides, diuretics

Question 40

pt with hyperK and low urine pH?

Answer 40

RTA from hypoALDO.