Renal System Flashcards
Generated from Lectures 41-47 (272 cards)
1
Q
The kidneys represent approximately ____ of the total body ATP consumption.
A
1/6
2
Q
The kidneys filter about _____ liters of plasma per day.
A
180 liters
3
Q
The filtration rate of the kidneys is approximately __________ at a blood pressure of 70 mmHg.
A
125 ml/min
4
Q
The ______________ of the male urethra is under voluntary control and has extensive cholinergic innervation.
A
primary sphincter
5
Q
The male urethra is approximately ___ cm long.
A
20 cm
6
Q
The female urethra is approximately ___ cm long.
A
4 cm
7
Q
The ____________ center in the brain controls the process of urination.
A
pontine micturition
8
Q
Pelvic floor muscles are arranged in ______ around the urethra, rectum, and vagina.
A
slings
9
Q
The functional unit of the kidney is the _______.
A
nephron
10
Q
The nephron is responsible for ________ and _________ processes in the kidney.
A
filtration, transport
11
Q
The __________ is the site of filtration in the nephron
A
glomerulus
12
Q
The _______ is responsible for transport processes in the nephron.
A
tubule
13
Q
The ___________ osmotic concentration gradient ranges from 300 to 1400 mOsm/L.
A
medullary
14
Q
The ____________ (RPF) is approximately 605 ml/min.
A
renal plasma flow
15
Q
The filtration fraction is calculated by dividing the _____ by the _____.
A
GFR, RPF
16
Q
To measure GFR, a substance must be __________(five things).
A
freely filtered, not reabsorbed, not secreted, not synthesized by the tubule, not broken down by the tubule
17
Q
The mass of a solute equals the product of the solute concentration and the solvent ________.
A
volume
18
Q
______ is a substance that can be used to measure GFR because it meets all five criteria for a substance used to measure GFR.
A
Inulin
19
Q
__________ can be used to estimate GFR.
A
Creatinine
20
Q
Creatinine overestimates GFR by approximately ____% because it is secreted by the tubules.
A
10%
21
Q
The renal clearance of a substance is the _____________ from which that substance is completely cleared by the kidneys per unit time.
A
volume of plasma
22
Q
The normal renal clearance of glucose is _____ ml/min.
A
0 ml/min, because glucose is completely reabsorbed in the tubules.
23
Q
The organic anion _______________ is secreted by the proximal tubule cells and can be used to measure effective renal plasma flow (ERPF).
A
para-aminohippurate (PAH)
24
Q
Effective renal blood flow (ERBF) can be determined by dividing ______ by (____________).
A
ERPF, 1-hematocrit
25
___________ is the volume of blood plasma that is cleared of solute-free water per unit time.
Free water clearance
26
Free water clearance can be used as an indicator of how the body is regulating _______.
water
27
The glomerulus has three filtration barriers: _______, _______, and ________.
fenestrated endothelial cells, basal lamina, slit membranes
28
Fenestrated endothelial cells in the glomerulus are _______, allowing for a high filtration rate.
leaky
29
The basal lamina in the glomerulus acts as an initial sieve and is _________ charged.
negatively
30
Slit membranes in the glomerulus are located between ________ foot processes and act as sieves to restrict the passage of molecules larger than ___ nm in diameter.
podocyte, 5 nm
31
The _______________ is a specialized structure in the nephron that is involved in the regulation of GFR.
juxtaglomerular apparatus
32
The juxtaglomerular apparatus consists of __________ epithelial cells and ___________ cells.
macula densa, juxtaglomerular
33
________ is a mechanism that helps regulate GFR by sensing changes in fluid flow through the proximal tubule and loop of Henle.
Tubular glomerular feedback (TGF)
34
Factors that decrease TGF sensitivity include _________, ________, _________, and ________.
atrial natriuretic peptide, nitric oxide, cAMP, PGI2.
35
Factors that increase TGF sensitivity include ________, ________, ________, ________, and ________.
adenosine, thromboxane, 5-HETE, angiotensin II, prostaglandin E2
36
Renal autoregulation helps maintain a stable GFR despite changes in ___________.
blood pressure
37
Intrinsic control mechanisms of GFR include __________ response and ____________ feedback.
myogenic response, tubuloglomerular feedback
38
Extrinsic control mechanisms of GFR include __________, __________, and _________.
intrarenal baroreceptors, hormones, the sympathetic nervous system
39
___________ act as vasodilators in the kidney, increasing GFR.
Prostaglandins
40
__________ acts as a vasoconstrictor in the kidney, decreasing GFR.
Angiotensin II
41
__________ increases blood pressure and acts as a vasoconstrictor in the kidney, decreasing GFR.
Norepinephrine
42
____ acts as a vasodilator on the afferent arteriole and a vasoconstrictor on the efferent arteriole, increasing GFR.
ANP (atrial natriuretic peptide)
43
________(medication) cause afferent vasoconstriction, decreasing GFR.
NSAIDs
44
__________(medication) decrease efferent vasoconstriction, increasing GFR.
ACE inhibitors
45
The glomerular filtration rate (GFR) can be calculated using the formula: _________.
GFR = CI = (UI * V) / PI; where CI is the clearance of inulin, UI is the urine concentration of inulin, V is the urine flow rate, and PI is the plasma concentration of inulin.
46
The ______________ is the difference between the hydrostatic and oncotic pressures across the glomerular capillary wall, which drives filtration.
net filtration pressure (NFP)
47
The rate of filtration is determined by the product of the _________, ___________, and __________.
hydraulic permeability, surface area, net filtration pressure
48
The filtration coefficient (Kf) represents the mean filtration coefficient in _______________.
glomerular capillaries
49
The _________ capillaries reabsorb fluid and solutes from the renal tubules.
peritubular
50
The ____________ is responsible for the recovery of the filtered load and is the major site of solute secretion.
proximal tubule
51
The _____________ is responsible for ion reabsorption and some water reabsorption.
loop of Henle
52
Beyond the loop of Henle, the _________ segments are responsible for fine-tuning the final amounts of substances excreted.
nephron
53
True or False: The thick ascending limb of the loop of Henle is not water permeable.
True
54
The countercurrent multiplier system is responsible for producing and maintaining the medullary __________ concentration gradient.
osmotic
55
Organic nutrients that are reabsorbed in the _____________ include glucose, amino acids, acetate, Krebs cycle intermediates, water-soluble vitamins, lactate, acetoacetate, and b-hydroxybutyrate.
proximal tubule
56
Organic nutrient reabsorption in the proximal tubule occurs via ___________, usually coupled with sodium.
active transport
57
Organic nutrient transporters exhibit ___________, meaning that there is a maximum rate at which they can transport substances.
saturation
58
True or False: Organic nutrient transporters are specific, meaning that they only transport certain substances.
True
59
True or False: Organic nutrient reabsorption can be inhibited by drugs or disease states.
True
60
Approximately _____ g/day of protein is filtered, while normally only ______ mg/day is excreted.
1.8 g/day, 100 mg/day
61
Protein reabsorption occurs via _________ and is easily saturated.
endocytosis
62
Reabsorbed proteins are ___________ within the proximal tubule cells.
metabolized
63
Small proteins are reabsorbed via ___________.
endocytosis
64
Oligopeptides are reabsorbed via _______ or ________ coupled uptake.
sodium, proton
65
Glucose reabsorption in the proximal tubule occurs via _____________.
sodium-glucose cotransporters (SGLTs)
66
SGLT2 is located in the early proximal tubule and has a low ________ for glucose but a high capacity.
affinity
67
________ is located in the late proximal tubule and has a high affinity for glucose but a low capacity.
SGLT1
68
True or False: Glucose reabsorption is a passive process.
False
69
The transport maximum (Tm) for glucose is the _________ rate at which glucose can be reabsorbed.
maximum
70
______ refers to the appearance of glucose in the urine before the Tm is reached, due to variations in the affinity and capacity of SGLTs.
Splay
71
When plasma glucose concentration exceeds the Tm, glucose appears in the _____.
urine
72
Organic anions and cations are secreted into the ____________.
proximal tubule
73
Organic anion secretion is mediated by __________________.
organic anion transporters (OATs)
74
Organic cation secretion is mediated by ________________.
organic cation transporters (OCTs)
75
Organic anion and cation secretion is important for the ___________ of drugs, toxins, and metabolites.
elimination
76
The ____ of the tubular fluid can affect the excretion of weak acids and bases.
pH
77
___________ can reduce the clearance of memantine, leading to drug accumulation and potential adverse effects.
Alkaline urine
78
For a weak acid, the _______ form is more lipid-soluble and therefore more readily reabsorbed.
acidic
79
For a weak base, the _______ form is more lipid-soluble and therefore more readily reabsorbed.
basic
80
Water reabsorption is primarily driven by _______, following the movement of solutes.
osmosis
81
True or False: The water permeability of different nephron segments varies.
True
82
The proximal tubule is _______ water permeable.
highly
83
True or False: The thick ascending limb of the loop of Henle is water permeable.
False, it is not water permeable
84
The _____________ has variable water permeability, regulated by antidiuretic hormone (ADH).
collecting duct
85
The loop of ________ plays a crucial role in establishing the medullary osmotic concentration gradient.
Henle
86
The ____________ actively transports sodium, potassium, and chloride ions out of the tubular fluid, creating a hyperosmotic medullary interstitium.
thick ascending limb (TAL)
87
The _______ is impermeable to water, preventing water from following the reabsorbed solutes.
TAL
88
The ___________ limb is permeable to water, allowing water to move out of the tubular fluid into the hyperosmotic medullary interstitium.
descending
89
The ___________, a specialized capillary network surrounding the loop of Henle, acts as a countercurrent exchanger, maintaining the medullary osmotic gradient.
vasa recta
90
______ recycling also contributes to the medullary osmotic gradient.
Urea
91
True or False: Sodium reabsorption is a major function of the nephron.
True
92
In the proximal tubule, sodium is reabsorbed primarily via _______________, such as SGLTs and Na+/H+ exchangers.
sodium-coupled transporters
93
In the TAL, sodium is reabsorbed via the ________ transporter.
NKCC2
94
In the distal convoluted tubule and collecting duct, sodium reabsorption is regulated by ____________.
aldosterone
95
Sodium reabsorption occurs throughout the nephron, with approximately ____% reabsorbed in the proximal tubule, _____% in the loop of Henle, ____% in the distal tubule, and ____% in the collecting duct.
67%, 25%, 5%, 3%
96
The primary monitored variable for tubular regulation of sodium is ____________.
blood pressure
97
__________ is a hormone that plays a key role in regulating sodium reabsorption in the distal tubule and collecting duct.
Aldosterone
98
__________ is a hormone that stimulates aldosterone secretion and also has direct effects on sodium reabsorption.
Angiotensin II
99
___________ is a hormone that opposes the actions of aldosterone and angiotensin II, promoting sodium excretion.
Atrial natriuretic peptide (ANP)
100
The ___________________ is a hormonal cascade that is activated in response to decreased blood pressure or decreased sodium delivery to the distal tubule.
renin-angiotensin-aldosterone system (RAAS)
101
_______ is an enzyme that is released from the juxtaglomerular cells of the kidney in response to various stimuli, including decreased blood pressure, decreased sodium delivery to the distal tubule, and sympathetic nervous system activation.
Renin
102
Renin converts _________ to _________.
angiotensinogen, angiotensin I
103
Angiotensin I is then converted to angiotensin II by __________________, which is primarily found in the lungs.
angiotensin-converting enzyme (ACE)
104
The ______________ transporter is located in the thick ascending limb of the loop of Henle and is responsible for reabsorbing approximately 25% of the filtered sodium load.
sodium-potassium-chloride cotransporter (NKCC2)
105
_________, such as furosemide, inhibit NKCC2, leading to increased sodium excretion.
Loop diuretics
106
The ___________ channel is located in the distal tubule and collecting duct and is responsible for reabsorbing approximately 3% of the filtered sodium load.
epithelial sodium channel (ENaC)
107
_________ is a potassium-sparing diuretic that inhibits ENaC.
Amiloride
108
The _______________ (NCC) is located in the distal convoluted tubule and is responsible for reabsorbing approximately 5% of the filtered sodium load.
sodium-chloride cotransporter
109
The ___________ located in the carotid sinuses, aortic arch, and cardiac atria sense changes in blood pressure.
baroreceptors
110
AVP stands for ____________; it's another name for anti-diuretic hormone (ADH).
arginine vasopressin
111
When blood pressure decreases, the baroreceptors signal the ______________ to increase heart rate and constrict blood vessels, which helps to increase blood pressure.
sympathetic nervous system
112
The sympathetic nervous system also stimulates _______ release from the juxtaglomerular cells of the kidney.
renin
113
Angiotensin II constricts __________ arterioles more than __________ arterioles, which helps to maintain glomerular filtration rate (GFR) despite a decrease in renal blood flow.
efferent, afferent
114
Angiotensin II also stimulates _______, which leads to increased water intake and helps to restore fluid volume.
thirst
115
_________ increases sodium reabsorption in the distal tubule and collecting duct by stimulating the expression and activity of ENaC and sodium-potassium ATPase.
Aldosterone
116
Aldosterone also promotes _________ excretion.
potassium
117
_____ is released from the atria of the heart in response to increased blood volume or atrial stretch.
ANP
118
ANP inhibits _______ reabsorption in the proximal tubule, loop of Henle, and collecting duct, leading to increased ________ excretion.
sodium, sodium
119
ANP also inhibits ______ and aldosterone secretion, further promoting sodium excretion.
renin
120
ANP increases GFR by ___________(dilating/constricting) afferent arterioles and ___________(dilating/constricting) efferent arterioles.
dilating, constricting
121
ANP decreases ___________ nervous system activity.
sympathetic
122
__________ are a class of drugs that increase urine output and are commonly used to treat hypertension.
Diuretics
123
__________ block the conversion of angiotensin I to angiotensin II, reducing the effects of angiotensin II on blood pressure and sodium reabsorption.
ACE inhibitors
124
_______________ block the binding of angiotensin II to its receptors, preventing its effects.
Angiotensin receptor blockers (ARBs)
125
_____________ block the effects of aldosterone on sodium reabsorption.
Aldosterone antagonists
126
__________ is a condition characterized by adrenal insufficiency, leading to a deficiency in aldosterone and cortisol.
Addison's disease
127
Patients with ____________ may experience hypotension, hyponatremia, and hyperkalemia.
Addison's disease
128
__________, also known as primary aldosteronism, is a condition characterized by excessive aldosterone secretion, leading to hypertension, hypokalemia, and metabolic alkalosis.
Conn's syndrome
129
The kidneys are the major source of ____________, a hormone that stimulates red blood cell production in the bone marrow.
erythropoietin
130
Erythropoietin secretion is stimulated by __________ in the kidneys.
hypoxia
131
_________ can be caused by chronic kidney disease due to impaired erythropoietin production.
Anemia
132
Erythropoietin is a ________ hormone.
peptide
133
Renal interstitial cells are the major source of erythropoietin, with small amounts produced by the _______.
liver
134
The _____________________ is the pressure exerted by the fluid in the renal interstitium.
renal interstitial hydraulic pressure (RIHP)
135
An _________(increase/decrease) in RIHP opposes fluid reabsorption from the tubules.
increase
136
The ________________ pressure is the osmotic pressure exerted by the proteins in the peritubular capillaries.
peritubular capillary oncotic pressure
137
An increase in peritubular capillary oncotic pressure promotes ________ reabsorption into the capillaries.
fluid
138
The ________________ is the portion of the extracellular fluid volume that is effectively perfusing the tissues.
effective arterial blood volume (EABV)
139
A decrease in EABV activates the _______, leading to sodium and water retention to restore fluid volume.
RAAS
140
__________________ is an enzyme that converts cortisol to inactive cortisone in the kidney, preventing cortisol from binding to mineralocorticoid receptors and causing excessive sodium retention.
11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2
141
__________ contains glycyrrhetinic acid, which inhibits 11β-HSD2, potentially leading to sodium retention and hypertension.
Liquorice
142
___________ is a rare genetic disorder caused by a deficiency in 11β-HSD2, leading to sodium retention, hypertension, and hypokalemia.
Apparent mineralocorticoid excess (AME)
143
ADH is secreted by the __________________ and is also known as vasopressin (a vasoconstrictor).
posterior pituitary
144
_________(Increased/Decreased) pressure leads to decreased ADH, while __________(increased/decreased) pressure leads to increased ADH.
Increased, decreased
145
ANP acts as an ____________ in the system.
emergency brake
146
Salt sensitive hypertension can lead to ______ blood pressure.
high
147
True or False: The absence of aldosterone is always fatal.
True
148
Arginine vasopressin is human while lysine vasopressin is from ______.
pigs
149
Hypothalamic osmoreceptors (most likely sensitive to Na+ concentration) lead to _________(increased/decreased) ADH when osmolarity is increased and __________(increased/decreased) ADH when osmolarity is decreased.
increased, decreased
150
Osmoreceptor regulation of ADH is ______(more/less) sensitive than baroreceptor regulation of ADH.
more
151
V1 receptors are _______ GPCRs.
G alpha q
152
V2 receptors are ________ GPCRs.
G alpha s
153
__________ inhibits ADH secretion.
Alcohol
154
ADH is synthesized in the ___________ and released from the posterior pituitary.
hypothalamus
155
The target of ADH is the _______________, where it increases water reabsorption.
collecting duct
156
The ______________ (NTS) receives input from baroreceptors.
nucleus tractus solitarius
157
The _____ and _______ are involved in the osmoreceptor pathway.
OVLT, SFO
158
ADH increases _______ transport in the inner medullary collecting duct (IMCD).
urea
159
Increased urea reabsorption contributes to increased ___________________.
medullary interstitial osmolarity
160
___________ is the most important factor controlling thirst.
Plasma osmolarity
161
_____________ is the most common electrolyte abnormality found in hospital inpatients.
Hyponatremia
162
There are two types of diabetes insipidus: central DI and __________ DI.
nephrogenic
163
Central DI is a problem with ADH ________, while nephrogenic DI is a problem with the kidney __________ ADH.
release, perceiving
164
__________ alterations can be caused by excessive IV fluid administration, over-secretion of aldosterone, hemorrhage, severe wound drainage, and excessive sweating.
Isosmotic
165
_______________ can lead to weight loss, skin dryness, mucous membrane dryness, decreased urine output, rapid heart rate, and possibly low blood pressure.
Isosmotic volume depletion
166
_______________ can lead to weight gain, decreased hematocrit, increased blood pressure, edema, pulmonary edema, and heart failure.
Isosmotic volume excess
167
__________ is characterized by dysfunctional ADH, leading to an inability to concentrate urine and water diuresis.
Diabetes insipidus
168
_________ is a problem with ADH release from the posterior pituitary and can be acquired or congenital.
Central DI
169
___________ is a problem with the kidney perceiving ADH and is usually acquired.
Nephrogenic DI
170
Potassium is distributed with approximately ____% in the ECF and ____% in the ICF.
2%, 98%
171
__________ in the DCT and CD are responsible for potassium secretion, while _______________ are responsible for potassium reabsorption.
Principle cells, type A intercalated cells
172
Aldosterone directly stimulates potassium secretion by enhancing __________ activity.
Na/K-ATPase
173
_________(Increased/Decreased)potassium intake leads to increased potassium excretion.
Increased
174
Aldosterone plays a key role in potassium homeostasis by promoting potassium __________ in the DCT and CD.
secretion
175
Increased ________ flow rate enhances potassium secretion.
tubule
176
A high sodium diet leads to increased ___________ secretion, which in turn increases potassium secretion.
aldosterone
177
Hypokalemia is defined as serum potassium concentration less than _________.
3.5 mEq/L
178
__________ is defined as serum potassium concentration greater than 5.5 mEq/L.
Hyperkalemia
179
___________ can lead to increased neuromuscular excitability and cardiac dysrhythmias.
Hyperkalemia
180
Potential causes of ____________ include respiratory or metabolic alkalosis, insulin, dietary deficiency, diarrhea, vomiting, loop diuretics, and some antibiotics.
hypokalemia
181
Effects of _____________ include depressed insulin secretion, decreased concentrating ability, and decreased neuromuscular excitability leading to weakness and cardiac dysrhythmias.
hypokalemia
182
Potential causes of _____________ include respiratory or metabolic acidosis, insulin deficiency, increased intake, massive cell injury, hypoxia, and decreased renal secretion.
hyperkalemia
183
_______diuretics can lead to hypokalemia.
Loop
184
Diabetes insipidus is characterized by a ______ diuresis, while diabetes mellitus is characterized by an ________ diuresis.
water, osmotic
185
True or False: There is a such thing as an addiction to water.
True, known as psychogenic polydipsia
186
In diabetes mellitus, glucose builds up in the blood due to dysfunction of ________.
insulin
187
The increased filtered glucose in diabetes mellitus can ________ the transport maximum (Tm) of glucose transporters in the proximal tubule.
saturate
188
Glucose that is not reabsorbed in diabetes mellitus acts as an _______ in the collecting duct, preventing water reabsorption.
osmolyte
189
The amount of _______ in the extracellular fluid is the major determinant of extracellular volume.
sodium
190
Renal regulation of total-body sodium also achieves regulation of ____________.
extracellular volume
191
Potassium secretion is regulated by regulating ______ and potassium channels.
ENaCC
192
True or False: BK is only used when a lot of potassium secretion is required.
True
193
True or False: Increases in extracellular potassium increase aldosterone release.
True
194
99% of total body calcium is stored in bone as __________.
hydroxyapatite
195
The active, ionized form of calcium in plasma makes up about ______% of total plasma calcium.
45%
196
Around 40% of plasma calcium is buffered by _____________.
plasma proteins
197
Increased pH leads to __________ calcium binding to plasma proteins.
increased
198
Roughly 15% of plasma calcium is complexed with anions such as __________ and ___________.
citrate, phosphate
199
The major site for homeostatic control of calcium balance is the ________, where absorption is normally low.
GI tract
200
Approximately ______% of plasma calcium is filtered by the kidneys.
60%
201
___________ hormone increases serum calcium and decreases serum phosphate.
Parathyroid (PTH)
202
___________ (calcitriol) increases both serum calcium and serum phosphate.
Vitamin D3
203
_____________ decreases serum calcium but is only vestigial in humans.
Calcitonin
204
Longitudinal bone growth occurs at the ___________.
growth plates
205
Factors influencing longitudinal bone growth include:
local factors, growth hormone (GH), insulin-like growth factor (IGF-1), thyroid hormone, sex hormones
206
_____________ occurs when estrogen stimulates receptors in the growth plates, converting cartilage into bone and terminating longitudinal growth.
Epiphyseal closure
207
Why do long bones have spongey bone?
For strength-to-weight ratio (think cardboard)
208
___________ build bone, while ___________ resorb bone.
Osteoblasts, osteoclasts
209
What triggers epiphyseal plate closure?
Estrogen release during puberty (both males and females)
210
Roughly ____% of calcium reabsorption occurs in the proximal tubule, and around ____% occurs in the thick ascending limb of the loop of Henle.
50%, 80%
211
Chronic hypercalcemia can lead to _________________ ability in the kidneys.
reduced concentrating ability
212
What is osteoid?
Nonmineralized organic matrix in bone tissue
213
What is the signal for adaptive remodeling of bone?
Bone fluid flow (encouraged by exercise)
214
Approximately ______% of phosphate is filtered by the kidneys.
90-95%
215
____ inhibits phosphate reabsorption in the proximal tubule.
PTH
216
_____ stimulates both calcium and phosphate absorption in the intestine.
1,25-D3
217
Parathyroid hormone secretion is stimulated by _____(high/low) plasma calcium and high phosphate levels.
low
218
PTH secretion is inhibited by _____(low/high) plasma calcium and severe ____________.
high, hypermagnesemia
219
______ acts as the distributive control of calcium.
Bone
220
_________ is required for PTH secretion.
Magnesium
221
PTH stimulates bone __________ and calcium __________ in the kidneys.
resorption, reabsorption
222
PTH, ________, and thyroid hormones stimulate bone resorption.
cortisol
223
RANKL, also known as OPG ligand, is essential for ___________ differentiation.
osteoclast
224
RANKL stands for ________.
Receptor Activator of Nuclear factor-kB Ligand
225
__________ inhibits osteoclast differentiation.
OPG
226
Osteoclasts resorb bone by secreting _____ to dissolve the mineral component and _______ to degrade the organic matrix.
acid, enzymes
227
_________ diuretics act on the distal convoluted tubule to inhibit calcium reabsorption.
Thiazide
228
___________ is a hormone that decreases phosphate reabsorption in the kidneys.
FGF23 (fibroblast growth factor 23)
229
___________ deficiency can contribute to increased bone resorption and osteoporosis.
Estrogen
230
_________ is important for muscle contraction, nerve function, and blood clotting.
Calcium
231
__________ is an important component of DNA, RNA, and ATP.
Phosphate
232
__________ can cause symptoms such as fatigue, constipation, and kidney stones.
Hypercalcemia
233
______ are the regulators of active vitamin D3 by adding a hydroxyl group.
Kidneys
234
__________ can cause symptoms such as muscle cramps, tingling sensations, and seizures.
Hypocalcemia
235
True or False: Calcium is the most abundant mineral in the body.
True
236
__________ deficiency can lead to rickets in children and osteomalacia in adults.
Vitamin D
237
True or False: High levels of phosphate can stimulate bone resorption.
True
238
True or False: Calcitonin levels do not matter in a healthy individual.
True, vestigial; may be used as a therapy in people with osteoporosis
239
Calcium release in parathyroid cells _______ vesicular fusion, unlike in most other cell types.
inhibits
240
________ triggers vesicular fusion in parathyroid cells.
Magnesium
241
__________ increase the degradation of parathyroid hormone.
Leukotrienes
242
Acidemia is defined as a blood pH below _____.
7.37
243
Alkalemia is defined as a blood pH above _____.
7.42
244
Parathyroid hormone _______ phosphate reabsorption.
inhibits
245
Arterial blood pH values below 6.8 or above 8.0 are considered _______.
lethal
246
The major source of H+ gain is ______, with a production rate of 15-20 moles/day.
CO2
247
Although a large amount of CO2 is produced daily, it does not normally result in a net gain of H+ because _______________.
it's exhaled by the lungs
248
Diarrhea can lead to a loss of HCO3-, resulting in a __________ in blood pH .
decrease
249
Vomiting can lead to a loss of H+, resulting in an ________ in blood pH.
increase
250
____________ leads to a decrease in PCO2 and an increase in blood pH.
Hyperventilation
251
Pulmonary insufficiency can lead to _______ retention, leading to a decrease in blood pH.
CO2
252
________ help to minimize changes in H+ concentration and pH.
Buffers
253
True or False: Buffering does not eliminate H+ from the body; that is the role of the kidneys.
True
254
Major extracellular buffers include: ___________
CO2-HCO3- system, phosphates, and proteins (such as hemoglobin)
255
Intracellular buffering accounts for ____-____% of the body's buffering capacity.
50-90%
256
The amount of HCO3- filtered by the kidneys each day is approximately ______ mmol.
4320 mmol (about 4 moles)
257
New HCO3- is generated in the proximal tubule by ________ and __________.
glutamine uptake, NH4+ secretion.
258
_______________cells in the distal convoluted tubule and collecting duct are responsible for reabsorbing HCO3-.
Type A intercalated
259
H+ secretion in the distal nephron contributes to the formation of _________.
titratable acids
260
NH3 is produced from __________________ in the proximal tubule.
glutamine metabolism
261
The pKa of the NH3/NH4+ buffer system is _____.
9.2
262
The normal arterial plasma concentration of NH4+ is approximately _____.
40 nM
263
The pKa of the HPO42-/H2PO4- buffer system is _____.
6.8
264
Approximately ____ mmol/day of phosphate is available for H+ buffering in the urine.
36 mmol/day
265
_________ metabolism usually bears most of the compensatory burden in acid-base regulation.
Glutamine
266
Normal bicarbonate concentration in the plasma is ____.
24
267
_______________ is characterized by excessive CO2 loss (blowing off CO2).
Respiratory alkalosis
268
_________________ is characterized by CO2 retention.
Respiratory acidosis
269
_____________ is characterized by an increase in acid other than carbonic acid or a loss of HCO3-.
Metabolic acidosis
270
________________ is characterized by a loss of H+ or excessive intake of HCO3-.
Metabolic alkalosis
271
______ therapy can lead to metabolic alkalosis due to loss of K+, fluid volume contraction, and stimulation of aldosterone and angiotensin II.
Diuretic
272
Liver failure can cause hepatic ___________ in the brain, due to a rise in blood ammonium from liver metabolism dysfunction.
encephalopathy
