Renal - Lecture 3 Flashcards

1
Q

What is the clearance of glucose in a normal/healthy person?

A

zero

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2
Q

Total-body balance of ___ and ___ has to be maintained to sustain normal blood pressure and life.

A

sodium and water

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3
Q

How is water lost every day (4)?

A
  • skin and lungs (insensible loss)
  • sweat
  • in feces
  • urine
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4
Q

How is NaCl lost every day (3)?

A
  • sweat
  • feces
  • urine
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5
Q

How much can water output vary?

A

0.4 L to 25 L a day

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6
Q

How much can sodium chloride output vary?

A

0.05 g to 25 g a day

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7
Q

Is sodium and water secreted?

A

no

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8
Q

How much of sodium and water are reabsorbed?

A

99%

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9
Q

Where does the majority of sodium and water reabsorption occur?

A

in the proximal tubule

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10
Q

Where does the major hormonal control of reabsorption of water and sodium occur?

A

on the DCT and CD

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11
Q

What kind of process is the sodium reabsorption?

A

active

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12
Q

Where does sodium reabsorption happen? What is the exception?

A

in all tubular segments except the descending thin limb of Henle’s loop

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13
Q

How does water reabsorption happen?

A

by diffusion

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14
Q

What is water reabsorption dependent upon?

A

sodium reabsorption

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15
Q

What happens to sodium reabsorption on the basolateral membrane?

A

the ATPase pumps transports sodium out of the cells and keep the intracellular concentration of sodium low

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16
Q

What happens to sodium reabsorption on the apical membrane?

A

sodium moves downhill from tubular lumen into the tubular epithelial cells

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17
Q

Every tubular segment has different ___.

A

mechanisms

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18
Q

What is the transport protein in the cortical collecting duct cells that allows sodium to enter?

A

sodium channel

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19
Q

What are the transport proteins in the proximal tubule that allows sodium to enter?

A

Na+-H+ antiporter
Na+-glucose cotransporter

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20
Q

How is renal sodium regulated?

A

when sodium intake increases, urinary sodium increases
when sodium intake decreases, urinary sodium decreases

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21
Q

Sodium is the major ___ solute.

A

extracellular

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22
Q

Changes in total body sodium result in similar changes in ___ fluid volume.

A

extracellular

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23
Q

Total body sodium is sensed as ___ filling by baroreceptors in the cardiovascular system.

A

intravascular

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24
Q

How is total body sodium sensed?

A

by baroreceptors

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25
Q

Is plasma concentration of sodium a marker for total body sodium?

A

no

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26
Q

What does P(Na) only reflect?

A

the relative relationship of total Na and water

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27
Q

What is the formula for sodium excreted?

A

sodium filtered - sodium reabsorbed

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28
Q

Is sodium secreted in the tubules?

A

no

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29
Q

How is sodium excretion regulated by (2)?

A
  1. GFR (minor role)
  2. sodium reabsorption (most important)
30
Q

What is the sensor of the kidney at the level of vascular filling?

A

renal sympathetic nerve

31
Q

What happens to plasma volume and venous pressure when Na and H20 decrease due to diarrhea?

A

they both decrease

32
Q

What increases the activity of renal sympathetic nerves?

A

the decrease in venous return, atrial pressure, ventricular end-diastolic volume, stroke volume, CO, arterial blood pressure

33
Q

What happens to the afferent arterioles when the activity of the renal sympathetic nerves increases?

A

they constrict

34
Q

What has a direct effect on the constriction of afferent arterioles?

A

the decrease in arterial blood pressure

35
Q

What happens to the net GF pressure when the afferent arterioles constrict?

A

it decreases

36
Q

What causes the decreases in excretion of Na+ and H20?

A

the decrease in GFR

37
Q

What is the key hormone that regulates sodium by reabsorption?

A

aldosterone

38
Q

Where does aldosterone stimulate sodium reabsorption?

A

in the DCT and CCD

39
Q

How much of the filtered load is excreted when there is no aldosterone?

A

2%

40
Q

How much of the filtered load is excreted when there is high aldosterone?

A

0%

41
Q

How much Na is reabsorbed in the proximal tubule?

A

67%

42
Q

How much Na is reabsorbed in the descending loop of Henle?

A

0

43
Q

How much Na is absorbed in the ascending loop of Henle?

A

25%

44
Q

How much na is absorbed in the distal tubule and cortical collecting duct?

A

DT: 4%
CCD: 3%

45
Q

What is the final amount of Na excreted by aldosterone?

A

1%

46
Q

What does aldosterone upregulate and activate?

A

ATPase pump, sodium channels and potassium channels

47
Q

Aldosterone stimulates sodium ___ and ___.

A

reabsorption and secretion

48
Q

What else does aldosterone increase the secretion of?

A

H+

49
Q

What secretes aldosterone?

A

adrenal cortex

50
Q

What causes the secretion of aldosterone?

A

angiotensin II

51
Q

What converts angiotensin I to angiotensin II?

A

angiotensin converting enzyme

52
Q

What converts angiotensinogen to angiotensin I?

A

renin

53
Q

What is the rate limiting step in the renin-angiotensin system?

A

the amount of renin your body has

54
Q

What other 3 thing stimulates aldosterone secretion?

A

plasma K+
ACTH
ANP

55
Q

What is found around the afferent arterioles?

A

juxtaglomerular cells

56
Q

Which cells secrete renin?

A

juxtaglomerular cells

57
Q

What 3 components activate the juxtaglomerular cells?

A
  • sympathetic nerve fiber
  • macula densa cells
  • vascular tension of afferent arteriole
58
Q

The:
___ activity of renal sympathetic nerve
___ arterial pressure
___ GFR
___ flow to macula densa
___ NaCl delivery to macula densa
causes the increase secretion of renin by renal juxtaglomerular cells

A

increase
decrease
decrease
decrease
decrease

59
Q

Does aldosterone stimulate H20 reabsorption directly in the CCD?

A

no

60
Q

What does ANP stand for?

A

atrial natriuretic peptide

61
Q

What kind of hormone is ANP?

A

peptide hormone

62
Q

What cells secrete ANP?

A

cells in cardiac atria

63
Q

Where does ANP act on?

A

the tubules

64
Q

What does ANP inhibit?

A

sodium reabsorption

65
Q

What stimulates ANP secretion?

A

increased total body sodium

66
Q

Increased blood pressure ___ sodium excretion.

A

increases

67
Q

When the plasma volume increases, the distention and ANP secretion in the cardiac atria ___.

A

increases

68
Q

What happens to plasma aldosterone when the plasma ANP increases?

A

it decreases

69
Q

What happens to the afferent arterioles and efferent arterioles when plasma ANP increases?

A

afferent: dilates
efferent: constricts

70
Q

What happens to the Na reabsorption in the tubules when plasma ANP increases?

A

it decreases

71
Q

When plasma volume increases, sodium excretion ___.

A

increases