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ADV. Human Phys > Test 5 Study Guide Part 6 > Flashcards

Test 5 Study Guide Part 6 Flashcards

1
Q

How can the glomerular filtration rate be measured?

  • General theory:
  • Specific methods:
A
  • General theory:
    Find substance which is neither selectively secreted or reabsorbed
  • Specific methods:
    Inulin (actively added)
    Creatinine (product of creatine breakdown, measure amount in plasma, and amount in urine)
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2
Q

Selective reabsorption of glucose and amino acid occurs how?

A

In the proximal tubule, by secondary active transport (using Na+ as the favorable gradient)

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3
Q

Diabetes:
Mellitus:

A

Excessive urination

Sweet

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4
Q

Plasma Renal Threshold:

  • Define:
  • What is the number?
A
  • Define:
    The conc. of glucose at which renal Na/glucose symporters will be overwhelmed and glycosuria will occur
  • What is the number?
    190 mg/dl of glucose
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5
Q

Parathyroid hormone primary effect on the kidney:

A

Promote reabsorption of Ca2+

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6
Q

Aldosterone:

  • Effect:
  • What is the name of the membrane next to the interstitial (peritubular) fluid?
A
  • Effect:
    Activates the ATPase 3Na+/2K+ channels into the interstitial fluid -> intracellular K+ rises, Na+ decreases -> K+ diffuses into the filtrate -> Na+ diffuses from the filtrate
  • What is the name of the membrane next to the interstitial (peritubular) fluid?
    Basolateral membrane
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7
Q

How much potassium is reabsorbed before reaching the distal tubule?
How much Na+?
Is this reabsorption regulated?

A

90%
90%
No, it’s constant.

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8
Q

What combats increased plasma K+?

What combats decreased plasma Na+?

A

Aldosterone

Aldosterone

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9
Q

Aldosterone-Independent K+ secretion:

A

Increased blood K+ causes ‘exocytosis’ of K+ channels towards the lumen of the descending duct
Visa versa also occurs

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10
Q

Explain how voltage may effect K+ secretion?

A

Na+ reabsorption -> filtrate more negative, basolateral side positive -> K+ enters filtrate to compensate

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11
Q

Increased sodium concentration reaching the distal tubule will have what effect on K+ secretion?

A

Increase it.

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12
Q

distal tubules have what specialized sensor of flow rate?

A

Primary cilium

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13
Q

Primary cilium of the distal tubules:

- Potassium effect:

A

Cause excretion of K+ when activated by increased flow rate (like that caused by water being brought with high Na+)

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14
Q

Increased Na+ reaching the distal tubules means increased ______ will also reach the distal tubules:

A

Water

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15
Q

Diuretics:

  • Normal mechanism of action:
  • Effect on K+?
A
  • Normal mechanism of action:
    Stop reabsorption of Na+, increase water loss
  • Effect on K+?
    Increased secretion of K+ as Na+ tries to be reabsorbed.
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16
Q

High levels of plasma K+ concentration:

  • Self regulation:
  • Direct or indirect?
A
  • Self regulation:
    High plasma K+ -> depolarizes the aldosterone secreting cells of adrenal cortex -> increased aldosterone
  • Direct or indirect?
    Direct
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17
Q

Low levels of plasma Na+ concentration:

  • Self regulation:
  • Direct or indirect?
A
  • Self regulation:
    Low Na+ -> low H20 level -> hypotension -> rennin-angiotensin-aldosterone -> increased Na+ absorption
  • Direct or indirect?
    Indirect
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18
Q

Where is the juxtaglomerular apparatus located?

A

Where the afferent arteriole meets with the last portion of the ascending limb of the loop of henle.

AKA: right before the distal tubule

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19
Q
  • What cells of the juxtaglomerular apparatus excrete renin?

- What do these cells act as?

A
  • The granular cells, which lie next to the afferent arteriole
  • Baroreceptors
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20
Q
  • Where other then the lungs is Angiotensin II produced?

- What does it do there?

A
  • In the kidneys.

- Regulate reabsorption, renal blood flow, and embryonic kidney development

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21
Q

Inadequate intake of NaCl will cause what issue?

A

Hypotension, activation of osmoreceptors.

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22
Q

Beta-1 adrenergic receptors and renin secretion:

A

Granular cells activated to secrete renin.

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23
Q

When Na+ is brought into a cell in the filtrate, what must enter the filtrate to replace it?
Why?
Implication:

A
  • K+ or H+
  • Balance electrochemical gradient
  • if H+ levels are high, more of it will return to the filtrate and visa versa, sparing the other ion
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24
Q

Acidosis will cause what effect on K+ in the collecting duct?

A

Increased H+ secretion will cause increased K+ reabsorption (to maintain electrochemical gradient)
Hyperkalemia

25
Q

Alkalosis will cause what effect on K+ in the collecting duct?

A

Decreased H+ secretion will cause decreased K+ reabsorption (to maintain electrochemical gradient)
Hypokalemia

26
Q

Hyperkalemia will cause what effect on H+ in the collecting duct?

A

Increased K+ secretion will cause increased H+ reabsorption. (to maintain electrochemical gradient)
- acidosis

27
Q

Abnormally high aldosterone secretion (hyperaldosteronism) causes:

A

Hypokalemia

metabolic alkalosis

28
Q

Abnormally lo2 aldosterone secretion (Addison’s disease) causes:

A

Hyperkalemia

metabolic acidosis

29
Q

Why is normal urine slightly acidic?

A

Most bicarbonate is absorbed from the filtrate, H+ is excreted into it

30
Q

How is H+ concentrated into the urine?

Which is the predominant effect??

A 
- How is H+ concentrated into the urine?
Na+ / H+ antiport (proximal tubules)
H+ ATPase pumps (distal tubules)
- Which is the predominant effect??
H+ ATPase
31
Q

Why can bicarbonate not be directly absorbed

A

The nephron tubule cells are impermeable to bicarbonate

32
Q

How is bicarbonate absorbed from the filtrate?

A

Bicarbonate and H+ -> Carbonic acid H2CO3 -> Carbonic anhydrase -> CO2 + H20 -> CO2 diffuses into tubular epithelium -> Carbonic ahydrase -> H2CO3 -> H+ + HC03- -> H+ excreted through Na+/H+ exchanger

33
Q

Where is the majority of bicarbonate absorbed?

A

Proximal tubules 90%

34
Q

In a person with alkalosis how will bicarbonate absorption be affected?

A

Less H+ will result in less CO2 formation by carbonic anhydrase and more bicarbonate will be excreted.

35
Q

Kidney’s compensation for acidosis

  • Write the reaction performed by the proximal tubules to compensate for acidosis.
  • Explain how it compensates
A
  • Write the reaction performed by the proximal tubules to compensate for acidosis:
    Glutamine -> 2HCO3- + 2NH3
  • Explain how it compensates:
    Increased HCO3- to buffer blood. NH3 buffer H+ in the filtrate, allowing more to be excreted
36
Q

Respiratory compensation for acidosis (respiratory or :

- Define:

A
  • Define:

Chemoreceptors in medulla oblongata detect high pH -> Increased respiration -> CO2 is blown off -> less H+ free in blood

37
Q

What all buffers H+ in the filtrate?

A

NH3

Phosphates

38
Q

List the types of diuretics:

A 
Loop diuretics
Thiazides
Carbonic anhydrase inhibitors
osmotic diuretics
Potassium-sparing diuretics
39
Q

What type of diuretic is the most powerful?

A

Loop diuretics

40
Q

Loop diuretics:

  • Work by:
  • One example:
A
  • Work by:
    Stopping Na+ reabsorption in ascending limb -> renal medulla is less concentrated -> Less water can be pulled into it in the collecting duct
  • One example:
    Lasix
41
Q

Thiazide diuretics:

  • Work by:
  • One example:
A
  • Work by:
    Inhibiting Na+ transport in the initial segment of the distal tubule -> reduced osmotic gradient for water reabsorption
  • One Example:
    Hydrochlorothiazide
42
Q

Carbonic anhydrase inhibitors:

  • Work by:
  • One example:
  • Altitude use:
A
  • Work by:
    Stop reabsorption of bicarbonate -> stops water from coming back with bicarbonate
  • One example:
    Acetazolamide
  • Altitude use:
    Produce metabolic acidosis (because of low bicarbonate) -> hyperventilation to compensate -> treats altitude sickness
43
Q

Osmotic Diuretics:

  • Work by:
  • One example:
A
  • Work by:
    Are not transported from filtrate -> pull water in by osmosis
  • One example:
    Mannitol
44
Q

What naturally occurring substances can cause osmotic acidosis:

A 
Glucose (if past 190 mg/ml)
Ketone bodies (during ketoacidosis)
45
Q
  • Which diuretics can cause hypokalemia?
  • Why?
  • How is this dealt with?
A 
- Which diuretics can cause hypokalemia?
Loop diuretics
Thiazide diuretics
- Why?
Both inhibit Na+ excretion prior to the collecting duct -> Aldosterone upregulates as Na+ is lost -> Na+/K+ exchanger -> more K+ in urine
- How is this dealt with?
K+ supplement pills
46
Q

Potassium Sparring diuretics:

- Work by:

A
  • Work by:
    Competitive antagonist of aldosterone, results in more Na+ excretion and less k+ excretion and loss of water through osmosis from Na+
47
Q

Which two diuretics are often combined to spare potassium while having a large diuretic effect?

A

Potassium sparing diuretics and thiazonide diuretics (hydrochlorothiazide)

48
Q

Urinary albumin excretion rate:

  • Define:
  • Microalbuminuria is diagnosed at what quantity of albumin:
A
  • Define:
    Measure urinary albuminin
  • Microalbuminuria:
    30 - 300 mg protein per day
49
Q

Often the first sign of renal damage is?

A

microalbuminuria?

50
Q

Proteinuria:

- Define:

A
  • Define:

> 300 mg of protein per day

51
Q 
- Define:
Condition with high protein excretion
- level of protein excretion:
> 3.5 g of protein per day
- Symptoms?
Systemic edema due to lowered oncotic pressure
A

Nephrotic syndrome:

  • Define:
  • level of protein excretion:
  • Symptoms?
52
Q
  • Define:
    Drop in kidney’s ability to excrete everything over a few hours or days
  • Why does it occur?
    Inflammation of kidneys, atherosclerosis, reduced blood flow to kidneys, some drugs
A

Acute Renal Failure:

  • Define:
  • Why does it occur?
53
Q
  • Cause:
    Antigen antibody complexes from streptococcal infection enter systemic circulation
    Antibody made against the basement membrane
  • Can result in:
    Renal Insufficiency
A

Glomerulonephritis:

  • Cause:
  • Can result in:
54
Q 
- Define:
Inadequate filtration by kidney
- Secondary resulting conditions:
All from failure to clear something
Hypertension (from failure to clear ions), acidosis, hyperkalemia, high urea
A

Renal insufficiency:

  • Define:
  • Secondary resulting conditions:
55
Q
  • Define:
    Infection of the kidney’s
  • Can cause:
    Renal insufficiency
A

Pyelonephritis:

  • Define:
  • Can cause:
56
Q

Accumulation of all your metabolic waste

A

Uremia:

57
Q
  • Define:
    Diffuse blood across a semipermeable membrane so toxins can enter the dialysate
  • Frequency:
    Three times a week, for a few hours each time
A

Hemodialysis:

  • Define:
  • Frequency:
58
Q

How do you keep the good things in blood from entering the dialysate?

A

They are already in the dialysate. Glucose and some salts will have no concentration difference so they will be no net diffusion.

59
Q 
- Define:
Dialysis fluid is introduced to peritoneal cavity, waste accumulates into it, it is drained.
- Frequency:
Several times a day
- Hazards:
Infection from catheter in peritoneum
A

Continuous Ambulatory Peritoneal Dialysis:

  • Define:
  • Frequency:
  • Hazards:

ADV. Human Phys (51 decks)

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