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CPR Exam 2 > Renal Transport Mechanisms - Pierce > Flashcards

Renal Transport Mechanisms - Pierce Flashcards

(60 cards)

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1
Q

Proximal convoluted tubule reabsorbs what
100%
mostly
very little

A

glucose + aa = 100%
Na, K, P, Ca, H2O = 70%
only 30% Mg

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2
Q

where is most of the Mg reabsorbed

A

thick ascending limb (also Distal straight tubule)

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3
Q

how do solutes get reabsorbed (order of layers crossed)

A
  1. apical membrane of tubule
  2. Basolateral membrane of tubule
  3. epithelium of BV
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4
Q

where can you find the brush border

A

apical side facing lumen of tubule

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5
Q

things that cross apical side of PT

not H2O

A
  1. Na/glucose (SGLT)
  2. Na/ aa
  3. NA/ HCO-3
  4. Na/ H+ (antiport) (NHE)
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6
Q

things that cross basolateral side of PT

not H2O

A
  1. Na/K+ ATPase

2. HCO-, aa, glucose (GLUT), H+ , Cl- all diffuse over to BV

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7
Q

which BV is around the PT

A

peritubular capillary

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8
Q

how does water cross the PT

A

passive transport by AQP channel on both apical and basolateral
enters BV by bulk flow

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9
Q

when reabsorbing H2O

A

NA always follows

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10
Q

which part of the LOH is h2o permeable

A

the thin LOH (think ascending and thin descending)

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11
Q

Thick Ascending Limb (TAL) reabsorption of what

A

X WATER

  1. Na,
  2. K
  3. Ca
  4. Mg *
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12
Q

TAL reabsorption on apical side

A
  1. NKCC2 channel (Na-K-2Cl)

2. ROMK (EXCRETE K+ back to urine)

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13
Q

TAL reabsorption on basolateral side

A
  1. Mg+, Ca paracellulary
  2. Na/K ATPase
  3. Cl- channel
  4. K+ channel
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14
Q

what is the role of ROMK

A

back leak of K+ into the urine (lumen) which bulids up gradient and helps Mg and Ca paracellulary leave

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15
Q

Distal convoluted tubule reabsorption + role

A 
minimal reabsorption (X WATER)
MAINTAIN REGULATION site
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16
Q

ADH and Aldosterone act on what

A

principal cells of Distal convoluted tubule

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17
Q

3 cell types of DCT

A
  1. principal cells
  2. a- intercalated cells
  3. B-intercalated cells
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18
Q

principal cells role

A

REAB : Na+, H2O

SECRETE: K+

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19
Q

a- intercalated cell role

A

REAB : K+, HCO-3

SECRETE: H+

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20
Q

B- intercalated cell role

A

REAB : H+, Cl-

SECRETE: K+, HCO-3

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21
Q

DCT uses what to reabsorb at apical end

A
  1. NCC (Na, Cl-) thiazide-sensitive
  2. TRPV5 (ligand Ca+2 channel)
  3. ENaC (Na, H2O)
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22
Q

DCT uses what to reabsorb at basal end

A
  1. Cl- channel
  2. Na/K+ ATPase
  3. NCE (Ca+ out to BV and Na+ into cell)
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23
Q

principal cells use what to reabsorb Na+ and H2O

apical

A

ENaC on apical side

*where aldosterone binds to

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24
Q

principal cells use what to reabsorb Na+ and H2O

basolateral

A

Na/K ATPase

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25
principal cells use what to secrete K+
ROMK + BK, when Na+ is reabsorbed by ENaC
26
B-intercalated cells use what on apical side
1. HCO-3/Cl- (HCO-3 to urine, Cl- reab) | 2. K+ leak channel
27
B-intercalated cells use what on basal side
1. Cl- channel | 2. H+/K+ ATPase channel (H+ to BV, K+ to cell)
28
a-intercalated cells use what on apical side
1. H/K ATPase (K into cell, H to urine) | 2. Cl- channel
29
a-intercalated cells use what on basal side
1. K+ leak channel | 2. HCO-3/Cl- (HCO-3 to BV, Cl- into cell)
30
4 things causing NA reabsorption
1. NA deficiency 2. Hyponatremia 3. severe diarrhea (loss of NA) 4. too much H2O (normal Na levels however very dilute)
31
2 things causing NA secretion
1. hypernatremia | 2. ANP
32
salt deficiency what happens in steps | what kind of urine will you have
``` DIURESIS 1. decrease ADH (to increase osmo of envir) 2. more water will be excreted 3. decrease in BP and Blood Volume 4. Renin and NA reab. = hypotonic urine ```
33
salt excess what happens in steps | what kind of urine will you have
``` ANTI- DIURESIS 1. increase ADH (to dilute Envir) 2. increase water reab 3. increase BP and Blood volume 4. stimulate ANP 5. inhibit aldosterone = no na+ reab = hypertonic urine ```
34
what 2 things cause K+ secretion
1. Aldosterone | 2. increased K+ in serum (nothing to do with water amount)
35
where is most K+ reab
PT
36
where is most K+ secreted
CD
37
what 3 things cause K+ reabsorption
1. severe diarrhea (K+ loss) 2. K+ deficiency 3. Hypokalemia
38
ADH is sensitive to what
changes in osmolality | not Blood volume
39
what gets activated to activate ADH
1. Osmoreceptors : hypothalamus and liver | 2. Baroreceptors : aortic and carotid sinus
40
dail recommended Na intake``
500mg/dl
41
3 roles of ADH
1. act on principal cell AQP2 to reab H2O 2. increase Urea reab. to interstitium (inner medulla CD) 3. increase NKCC2 on TAL (reab Na, Cl, K) + K+ backleak(Mg, Ca)
42
how does ADH cause Urea diffusion out of tubule
more h2o is reabsorbed the father you get down the CD = urea builds up and then diffuses out ----> goes to LOH to be secreted* = makes medulla salty during high NA in blood
43
the longer the LOH and CD
the more concentrated the bottom can get (up to 1200 in humans)
44
countercurrent exchange
NaCl leaves Ascending LOH H2O leave Descending LOH = the NaCl causes the interstitium to get more and more salty and the BV cant pick up as much moving down (also getting more and more salty) = the h2o is reab on the way up diluting the interstitium and BV
45
BV involved in LOH
vasa recta
46
what impacts CC exchange
BF rate (going in opposite direction) needs time to pick up Na and H2O
47
Countercurrent Multiplication
NaCl leaves Ascending LOH H2O leave Descending LOH = new fluid is continuously put into descending LOH, increasing H2O diffusion out as it travels down( concentrated urine) = Na+ keeps getting reab on the way up to dilute urine
48
what 2 things determine how salty the medulla can get
1. BF rate | 2. the length of the LOH
49
what prevents the medullary high osmolality from disappearing
the vasa recta
50
what will a vasodilator or increased arterial P do
both increase BF rate through the kidney = the urine will not get as concentrated at the most inner medulla
51
osmolar clearance | what is it and how to calculate it
how to clear all of a solute from blood | Cosm = (Uosm x V) / (Posm)
52
free water clearance | what is it and how to calculate it
how fast the body excretes water with NO solutes in it Ch2o = V - Cosm V = urine flow rate
53
free water clearance is - | free water clearance is +
1. excess solutes in urine (conserving water) | 2. excess h2o in urine (dilulte)
54
Obligatory urine volume is calculated how
``` OUV = (minimum solute you need to excrete) / Max urine concentration ability OUV = 600/ 1200 OUV = 0.5L / day of urine (to not have excess solute build up) ```
55
minimum solute you need to excrete per day for the average person and their diet
600mOsm/ day
56
reason drinking sea water makes you dehydrated even more
1. you are ingesting 1800mOsm if you drink 1L 2. OUV = 1800/ 1200 OUV = 1.5 L per day 3. you did not even drink that much 4. body takes water from cells to excrete all the solutes and make 1.5L
57
Diuresis is what
REAB SOULTES | EXCRETE H2O
58
Anti-diuresis requires what
1. high ADH (body needs water) | 2. high osmolality in renal medulla INTERSTITIAL FLUID (medulla is too hyperosmolalitied)
59
what 2 things makes the medulla salty
1. NaCl | 2. Urea
60
Natriuresis what is it what 3 things causes it
LARGE NA+ EXCRETION that is NOT preportional to amount of H2O excreted 1. Drug 2. H (ANP) 3. high renal perfusion pressure = Na+ doesn't have time to get reabsorbed

CPR Exam 2 (22 decks)

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