Renal Physiology 2 Flashcards
(151 cards)
1
Q
VR
- NaCl reabsorption
- Mg, Ca, K reabsorbed
A
A: Increase in 1 will Increase 2
Due to Solvent Drag. H2O follows NaCl, and carries w it Mg, Ca & K
2
Q
VR
- Na Reabsorption
- Cl Reabsorption
A
A: Increase in 1 will Increase 2
Na enters (+) = positive cell attracts negative = Cl follows (–). Also due to chloride concentration gradient
3
Q
QC
Sodium Reabsorption
1. Thin Descending
2. Thin Ascending
A
B: 1 < 2
4
Q
QC
Water Reabsorption
1. Thin Descending
2. Thin Ascending
A
A: 1 > 2
5
Q
QC
Density of Mitochondria
1. Thin Ascending
2. Thick Ascending
A
B: 1 < 2
6
Q
VR
- Loop Diuretics
- Sodium and Water Reabsorption
A
B: Increase in 1 will Decrease 2
Loop Diuretics increase sodium & water excretion
7
Q
QC
Sodium and Water Reabsorption
1. NKCC2 Inhibition
2. NKCC2 Activation
A
B: 1 < 2
8
Q
QC
Sodium & Water Excretion
1. NKCC2 Inhibition
2. NKCC2 Activation
A
A: 1 > 2
9
Q
QC
Luminal Osmolarity
1. Proximal Tubule
2. Loop of Henle
A
A: 1 < 2
10
Q
QC
Hypokalemic Effect
1. Thiazide Diuretics
2. Loop Diuretics
A
B: 1 < 2
11
Q
QC
Glucose
1. Reabsorption
2. Excretion
A
A: 1 > 2
12
Q
QC
Creatinine
1. Reabsorption
2. Excretion
A
B: 1 < 2
13
Q
QC
HCO3-
1. Reabsorption
2. Excretion
A
A: 1 > 2
14
Q
Urea:
1. Reabsorption
2. Excretion
A
C: 1 = 2
15
Q
K+:
1. Reabsorption
2. Excretion
A
A: 1 > 2
16
Q
Cl:
1. Reabsorption
2. Excretion
A
A: 1 > 2
17
Q
Na+:
1. Reabsorption
2. Excretion
A
A: 1 > 2
18
Q
Secretion:
1. Proximal Convuluted Tubule
2. Distal Convoluted Tubule
A
B: 1 < 2
19
Q
Route with channels or transporters
A
Transcellular Route
20
Q
Route through tight junctions
A
Paracellular Route
21
Q
Water and electrolye absorption
1. Proximal Convulated Tubule
2. Distal Convulated Tubule
A
A: 1 > 2
22
Q
- Sodium Reabsorption
- Water Reabsorption
A
**A: **Increase in 1 will Inccrease 2
23
Q
Glucose Reabsorption
1. SGLT1
2. SGLT2
A
B: 1 < 2
10% < 90%
24
Q
VR
- Na+ in Tubular Cells
- H+ in Tubular Cells
A
A: Increase in 1 will Decrease 2
as Na goes in = H goes out
25
# **VR**
1. Na+ Reabsorption
2. Amino Acid Reabsorption
This is via what transport
**A**: Increase in 1 will Increase 2
Sodium-Amino Acid Symporter
Sodium In = Amino Acid In
26
# **VR**
1. Na+ Reabsorption
2. Phosphate, Lactate, & Citrate Reabsorption
Name of Transporter
| remember PLC
**A**: Increase in 1 will Increase 2
Sodium-Phosphate / Lactate/ Citrate Transporters
27
Occurence of Glucosuria
1. 160 mg/dL of Glucose
2. 190 mg/dL of Glucose
1 < 2
| >180 glucose = glucosuria
28
# **QC**
**Glucose Reabsorption**
1. 150 mg/dL of Glucose
2. 190 mg/dL of Glucose
**A**: 1 > 2
29
Reabsorption happening in the Late PCT
Na+ with Cl reabsorption
Na enters = positive inside => Cl will follow
30
NaCl Reabsorption
1. Trancellular
2. Paracellular
1 > 2
31
**Passive Reabsorption of Na+**
1. Thin Ascending
2. Thick Ascending
**A**: 1 > 2
32
Driving force for water reabsorption in the Prox. CT
Transtubular Osmotic Gradient
33
* Transcellular water reabsorprion in the PCT is via
* Paracellular water reabsorption in the PCT is via
* Transcellular: AQP1 Channels
* Paracellular: Tight Junctions
34
Loop of Henle's 3 functionally distinct segments
* Thin Descending L
* Thin Ascending L
* Thick Ascending L
35
T or F: In the Loop of Henle, NaCl reabsorption is followed by water
F. It is not followed
36
Percentage of NaCl and Water reabsorbed in the Loop of Henle
NaCl = 25%
Water 20%
37
AQP1
1. Thin Descending
2. Thin Ascending
1 > 2
| Thin Ascending = impermeable to water
38
**Osmolarity**
1. Thin Descending
2. Thin Ascending
**A**: 1 > 2
| Thin Descending - Solutes are not reabsorbed = high osmolarity
39
Density of Mitochondria
1. Thin Descending Limb
2. Thick Ascending Limb
1 < 2
| TAL = more mitochondria due to active reabsorption processes
40
1. Solute Reabsorption
2. Luminal Osmolarity
Increase in 1 will Decrease 2
41
Permeability to water
1. Thin Ascending Limb
2. Thick Ascending Limb
**C:**1 = 2
42
Main diluting segment of the nephron
Thick Ascending Limb of the Loop of Henle
43
# **VR**
1. Reabsorption of Solutes
2. Osmolarity
**B**: Increase in 1 will Decrease 2
| Reabsorption = Less Solute in the Tubules = Less Osmolarity
44
Active reabsorption of Na, Cl, and K
1. Thin Ascending Limb
2. Thick Ascending Limb
1 < 2
| Ubos na yung Na from passive reab in Thin Ascending => need na ng pump
45
Loop Diuretics act on the Loop of Henle and inhibits __ @ the thick ascending limb
* Given Examples
NKCC2
Inhibits Sodium Potaasium and Cl
* Furosemide, Ethacrynic acid, Bumetanide
46
1. Furosemide
2. Hypokalemia
Increase in 1 will Increase 2
Furosemide = Loop Diuretic inhibits NKCC2
47
1. Ethacrynic Acid
2. NaCl Reabsorption
Increase in 1 will Decrease 2
48
Active Transporters in the Thick Ascending
* NKCC2
* NHE
49
1. Loop Diuretics
2. Urine Volume
Increase in 1 will Increase 2
50
1. Loop Diuretics
2. K+ Levels
**B**: Increase in 1 will Decrease 2
51
Active Transporter in the Early Distal Tubule
NCC
52
Presence of ADH
1. AQP1
2. AQP2
1 < 2
53
1. ADH
2. AQP2
**A**: Increase in 1 will increase 2
54
Effects of Aldosterone to the Principal Cells
Stimulates
* Na reabsorption
* K secretion
55
Na in the principal cells of the DCT diffuse via the __
ENaC - Epithelial Sodium Channels
56
Substances that inhibit ENaC in the DCT
* Amiloride
* Triamterene
57
Aldosterone Receptor Antagonists inhibits __
Inhibits Aldosterone:
* Inhibit Na reabsorption and K secretion
58
**AQP2 when person is:**
1. Hydrated
2. Dehydrated
**B**: 1 < 2
| Dehydrated = Water is more needed = more ADH= More AQP2 present
59
1. Hydrated
2. ADH
**B**: Increase in 1 will Decrease 2
60
1. Hydrated
2. AQP2
**B**: Increase in 1 will Decrease 2
61
**Effect of ADH**
1. AQP1
2. AQP2
**B**: 1 < 2
62
**AQP1 Density:**
1. PCT
2. DCT
**A**: 1 > 2
63
**NKCC2 Density**
1. PCT
2. DCT
**A**: 1 > 2
| In the thick ascending Limb. NCC yung sa DCT
64
NCC Density
1. PCT
2. DCT
A: 1 < 2
Prox = NKCC2
65
**Effects of ADH & Aldosterone in:**
1. Early DCT
2. Late DCT
**B**: 1 < 2
66
**Effects of ADH & Aldosterone in:**
1. Cortical Collecting Ducts
2. Late DCT
**C**: 1 = 2
67
**Alkalosis will stimulate:**
1. Alpha Intercalated Cells
2. Beta Intercalated Cells
**B**: 1 < 2
| Beta IC => Reabsorb H => Make blood more acidic and less basic
68
**Acidosis will stimulate:**
1. Alpha Intercalated Cells
2. Beta Intercalated Cells
**A**: 1 > 2
| Alpha IC => Secrete H => Make blood more basic and less acidic
69
**Stimulated by Aldosterone**
1. Alpha Intercalated Cells
2. Beta Intercalated Cells
**A**: 1 > 2
70
**Amount of Na reabsorbed:**
1. Proximal Tubule
2. Distal Tubule
**A**: 1 > 2
71
**Amount of Water Reabsorbed**:
1. Proximal Tubule
2. Distal Tubule
**A**: 1 > 2
72
**Amount of water reabsorbed in the presence of ADH**:
1. Proximal Tubule
2. Distal Tubule
**A**: 1 > 2
| Mmore water reabsorption in the DCT with ADH but not as high as PCT
73
**Amount of Water Reabsorption**:
1. Presence of ADH
2. Absence of ADH
**A**: 1 > 2
74
**Permeability to Water**
1. Thin Descending
2. Thin Ascending
**A**: 1 > 2
75
**Permeability to Sodium**
1. Thin Descending
2. Thick Ascending
**B**: 1 < 2
76
**Potassium Reabsorption**
1. Thin Descending
2. Thick Ascending
**B**: 1 < 2
77
**Active Sodium Reabsorption**
1. Thin Ascending
2. Thick Ascending
**B**: 1 < 2
78
**Permeability to water with ADH**:
1. Early Distal Tubule
2. Late Distal Tubule
**B**: 1 < 2
79
**Na reabsorption through a symporter**:
1. Early Distal Tubule
2. Late Distal Tubule
**A**: 1 > 2
| EDT: NCC -- symporter
LDT: ENac -- channel only
80
**Permeability to Urea with ADH**
1. CCD
2. MCD
| CCD - Cortical CD; MCD - Medullary CD
**B**: 1 < 2
| MCD -- the only one permeable to urea
81
**Aldosterone Secreting Adrenal Cortex Tumor**
1. Hyperkalemia
2. Hypokalemia
**B**: 1< 2
| Increased Aldosterone = Increases K secretion not reabsorption
82
**Aldosterone Secreting Adrenal Cortex Tumor**
1. Alkalosis
2. Acidosis
**A**: 1 > 2
| Increased Aldosterone = Increased Secretion of H+ (acid) = basic
83
**Aldosterone Secreting Adrenal Cortex Tumor**
1. Hypertension
2. Hypotension
**A**: 1 > 2
| Increased Aldosterone = Increased Na & H2O reabsorp = increased BV
84
Tubular reabsorption of water in a transcellular path is via
Aquaporins
85
Tubular reabsorption of water in a paracellular path is via
tight junctions
86
* Side facing the tubular lumen
* Side facing the interstitium and peritubular capillaries
* On which side is the Na+/K+ ATPase pumps found
* Apical/Luminal
* Basolateral
* Basolateral
87
Na/K ATPase Pump creates a __ concentration and __ electrical potential
Low Intracellular Na+ concentration; Negative intracellular electrical potential
88
Part that absorbs most water and electrolytes
Proximal Convoluted Tubule
89
Site for secretions of organic acids and bases
Proximal Convoluted Tubule
90
Transporters in the Luminal Side of the Early PCT
* SGLT2 & SGLT 1
* NHE
* Sodium Amino Acid Symporter
* Sodium-Phosphate, Lactate, Citrate Transporters
| NHE - Sodium Hydrogen Exchanger
91
Secondary active transport for glucose in the Early PCT
* explain mechanism
SGLT
* **Sodium in = Glucose In**: Glucose is transported using the gradient produced by Sodium
92
Secondary Active Secretion for Hydrogen in the Early PCT
* describe mechanism
Sodium-Hydrogen Exchanger
* **Sodium In = Hydrogen Out**: Active Secretion of H from inside the cell into the tubular lumen, coupled to Na reabsorption
93
Where does the H ion secreted in the eartly PCT comes from?
(NHE)
H2O + CO2 => H2CO3 (Carbonic acid) => H2 + HCO3-
* H is Secreted
* HCO3 is reabsorbed
94
Transporters in the Basolateral Side of the Early PCT
* Na/K ATPase Pump
* Glucose Transporters: GLUT 1 or 2
95
GLUT is what type of transport
* GLUT 2 is found in __
* GLUT 1 is found in __
Passive: Facilitaed Diffusion
*High conc of glucose in the interstitial Cell => diffuse to the bloodstream
*
* GLUT 2 -- S1 Segment
* GLUT 1 -- S3 Segment
96
What is the Max amount of glucose that can be reabsorbed into the tubular cells
180 mg/dL
97
1. Loop Diuretics
2. Urine Volume
Increase in 1 will Increase 2
98
Water Reabsorption in the Presence of ADH
1. PCT
2. DCT
1 > 2
99
In the absence of ADH, can the distal convoluted tubule reabsorb water?
No gurl
100
Border between the TALH and the Early Distal Tubule
Macula Densa
101
Thiazide Diuretics inhibits __
NCC
Inhibit absorption of Na and Cl
102
AKA the Aldosterone Sensitive Segment of the Nephron
Late Distal Tubule
103
3 Cell types in the Late Distal Tubules and Cortical Collecting Ducts
* Principal Cells
* a intercalated cells
* b intercalated cells
104
1. Amiloride
2. Na reabsorption
Increase in 1 will Decrease 2
Amiloride = ENaC Blocker
105
1. Amiloride
2. ENac
Increase in 1 will Decrese 2
106
1. Spirolactone
2. K+ ions
Increase in 1 will Increase 2
107
1. Spirolactone
2. Urine Concentration
Increase in 1 will Increase to
| Na is not reabsorbed = concentrated urine
108
1. Spirolactone
2. Urine Osmolarity
Increase in 1 will Increase 2
109
1. Spirolactone
2. Aldosterone
Increase in 1 decrease 2
110
1. Spirolactone
2. Hyperkalemia
Increase in 1 will Increase 2
111
Processes in the a incarlated cells
* Secrete
* Reabsorb
* Stimulated by
* Secrete H (H+/K+ ATPase)
* Reabsorb HCO3 & K (H/KATPase)
* Stimulated by Aldosterone
112
a intercalated cells is mainly for
acid secretion
113
Aldosterone in the a intercalated cells
1. Metabolic Alkalosis
2. Metabolic Acidosis
1 > 2
| Aldosterone increases K & HCO3 reabsorption
114
K+ Ions reabsorption in the presence of ADH in the
1. Principal Cells
2. a intercalated cells
1 < 2
| Principal: ADH = K Secretion
115
H+ reabsorption
1. a-intercalated
2. b-intercalated
1 < 2
| B: increase H reabsorption; A: increase H secretion
116
1. Urea Reabsorption in the presence of ADH
2. Urine Concentration
Increase in 1 will Increase 2
117
1. Tubular Load (Inflow)
2. Reabsorption Rate
Increase in 1 will Increase 2
118
1. GFR
2. Total Reabsorption Rate
Increase in 1 will Increase 2
119
1. Na in prox tubule
2. Reabsorption rate
Increase in 1 will Increase 2
120
1. GFR
2. Reabsorption Rate in Prox Tubule
C? Does not affect => kasi constant at 65% yung gfr absorbed sa pct?
121
Reabsorption in the Peritubular Capillaries
1. Hydrostatic Pressure
2. Oncotic Pressure
1 < 2
| Oncotic = fluid stays within = more time for reabsorption
122
1. BP
2. Reabsorption Rate
Increase in 1 will Decrease 2
123
1. Efferent Arteriole Constriction/Resistance (Moderate)
2. Reabsorption
Increase in 1 will Increase 2
124
1. Albumin
2. Reabsorption Rate
Increase in 1 will Increase 2
125
1. Filtration Fraction
2. Reabsorption Rate
Increase in 1 willl Increase 2
126
1. Renal Blood Flow
2. Reabsorption Rate
Increase in 1 will Decrease 2 ??
127
1. Reduced Effective Circulating Video (Low BP/BV)
2. Aldosterone Secretion
Increase in 1 will Increase 2
128
1. Low BP or BV
2. Na Reabsorption
Increase in 1 will increase 2
129
1. K Levels
2. Aldosterone
Increase in 1 will Increase 2
130
1. Decreased BP & BV
2. Na and H2O reabsorption
Increase in 1 will Increase 2
131
1. Decreased BP
2. Angiotensin II release
Increase in 1 will Increase 2
132
1. Low BP
2. Aldosterone Secretion
Increase in 1 will Increase 2
133
1. Low BP
2. Peripheral Vasoconstriction
Increase in 1 will Increase 2
| to increase gfr
134
1. Low BP
2. Peripheral Vasoconstriction
Increase in 1 will Increase 2
| to increase gfr
135
1. ADH
2. Vasoconstriction
Increase in 1 will Increase 2
136
1. BP/BV
2. Atrial Natiriuretic Hormone
Increase in 1 will Increase 2
137
1. BP/BV
2. Na reabsorption
Increase in 1 will Decrease 2
138
1. BP/BV
2. Urine Output
Increase in 1 will Increase 2
139
1. Moderate Sympathetic Activation
2. Renin Release
Increase in 1 will Increase 2
140
1. High Sympathetic Activation
2. Reabsorption
Increase in 1 will Decrease 2
141
1. Sympathetic NS activation in physiologic levels
2. reabsorption
Increase in 1 will Increase 2
142
1. Plasma Osmolarity
2. ADH Secretion
3. Water Reabsorption
Increase in 1 will Increase 2 and 3
| to increase water content
143
Plasma Osmolarity
1. Hydrated Person
2. Dehydrated Person
1 < 2
144
Urine Osmolarity
1. Hydrated Person
2. Dehydrated Person
1 < 2
145
ADH Secretion
1. Hyperoxia
2. Hypoxia
I < 2
146
ADH Secretion
1. Hypertension
2. Hypotension
1 < 2
147
ADH Secretion
1. Morphine
2. Clonidine
1 > 2
148
ADH Secretion
1. Nicotine
2. Alcohol
1 > 2
149
Urine Concentration
1. Nicotine
2. Alcohol
1 > 2
150
Urine Concentration
1. Morphine
2. Clonidine
1 > 2
151
1. ECF Osmolarity
2. Thirst Receptors
Increase in 1 will Increase 2
