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Bmsc 208 > Renal 7 > Flashcards

Renal 7 Flashcards

1
Q

What is secretion of K+ for

A

Acts directly on adrenal cortex protecting body from hyperkalemia

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2
Q

What are 4 causes of aldosterone release

A
  1. Decreased BP
  2. Increased osmolarity
  3. Large drops in plasma Na
  4. Increases in K
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3
Q

How does decreased BP release aldosterone

A

Initiate a pathway that results in production of angiotensin which triggers aldosterone release

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4
Q

How does increased osmolarity trigger release of aldosterone

A

Acts directly on adrenal cortex during dehydration

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5
Q

Renin angiotensin system (RAS)

A

Multi step pathway for maintaining BP
- day to day aldosterone secretion

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6
Q

What is the multi step pathway of the renin angiotensin system

A
  • Decrease BP causes release of renin from granular cells
  • renin cleaves angiotensin to ANG I then converted to ANGII by ACE
  • ANG II travels to adrenal cortex and stimulates production of aldosterone
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7
Q

What does the renin-angiotensin pathway begin with

A

Renin secretion (enzyme)

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8
Q

What secretes renin

A

Granular cells

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9
Q

How is renin secretion indirectly stimulate

A

Sense when GFR decreases:
2. Sympathetic neurons activated by CVCC when BP decreased terminated on granular cells
3. Paracrine feedback (prostaglandins) from macula densa cells signal granular cells to secrete

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10
Q

What is the direct stimuli that cause renin secretion

A

Low BP in renal arterioles cause granular cells to secrete in response to less stretch

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11
Q

What are granular cells also known as

A

Juxtaglomerular cells

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12
Q

What is renin’s main role

A

Convert an inactive angiotensin, into angiotensin I

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13
Q

What is angiotensin

A

Plasma protein constantly circulating in blood

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14
Q

What is ACE

A

Angiotensin converting enzyme
- enzyme produced in blood vessel endothelium

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15
Q

What are angiotensin II receptors

A

G protein coupled receptors

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16
Q

Effects of ANG II

A
  1. Increased sympathetic (increased CO + BP, vasoconstriction)
  2. Proximal tubule Na reabsorption
  3. Thirst
  4. AVP secretion, increased H20 absorption
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17
Q

How does ANG II increase proximal tubule Na reabsorption

A

Stimulates an apical Na/H+ exchanger

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18
Q

What do pharmaceutical companies use ACE inhibitors for

A

Treatment of hypertension

19
Q

What does natriuretic peptide (ANP) promote

A

Na+ and water excretion
Less vasopressin

20
Q

Peptide produced and secreted by specialized myocardial cells in atria

A

Atrial natriuretic peptide

21
Q

What caused release of ANP

A

Increased blood volume causes increased stretch of atria causing myocardial cells to release

22
Q

What is the ANP receptor

A

Enzymatic membrane bound receptor acting through cGMP second messenger system

23
Q

Affects of ANP in kidney

A

Relaxes afferent arterioles to increase GFR
Reduce renin release from granular cells, reduce aldosterone and ANG II
Reduce Na reabsorption

24
Q

Affects of ANP at hypothalamus

A

Reduces AVP release
Inhibit thirst

25
Q

Affects of ANP at adrenal cortex

A

Inhibits aldosterone release

26
Q

Affects of ANP at medulla

A

Acts on CVCC to decrease BP

27
Q

Why is potassium balance complicated

A

Reabsorbed and secreted

28
Q

Where is K+ reabsorbed

A

Proximal tubule and ascending limb of loop

29
Q

Where is K+ secreted

A

Distal tubule and cortical collecting duct

30
Q

At normal K+ excretion

A

Reabsorption is less than filtered

31
Q

Low K+ does what to aldosterone

A

Decreases aldosterone
Reducing secretion which reduces excretion

32
Q

High K+ stimulates what

A

Aldosterone release
Increases secretion and excretion

33
Q

Alterations in body K levels affects what

A

The resting membrane potential of all cells

34
Q

Increased K+ in ECF

A

Hyperkalemia
Reduced efflux from cell, more K+ retained
Causes hyper excitation

35
Q

Low K+ around cell

A

Hypokalemia
Increased K+ leakage
Hyperpolarizes cell causing larger stimulus to reach threshold

36
Q

Where is potassium balance especially important

A

Excitable tissues such as heart and skeletal muscles

37
Q

What does hypokalemia cause

A

Muscle weakness because more difficult for hyperpolarized motor neurons and muscles to fire APs

38
Q

What is effects of hyperkalemia

A

More dangerous, initially leads to hyperexcitability
Eventually cells unable to repolarize and become less excitable
Arythmias in heart

39
Q

What can disturbances in K+ balance result from

A

Kidney dysfunction, eating disorders, diarrhea, diuretics

40
Q

Behavioural responses are critical for

A

Restoring to normal state, when ECF volume decreases or osmolarity deviates

41
Q

What are only way to replace los water and increase Na+ content

A

Drinking water and eating salt

42
Q

What causes relief of thirst

A

Act of drinking water, water does not have to be absorbed
Receptors in mouth/pharynx respond and decrease thirst and AVP release

43
Q

What stimulates thirst center in hypothalamus

A

Increase blood osmolarity, decreased blood volume, decreased blood pressure, dry mouth

Bmsc 208 (20 decks)

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