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Renal > 04b: Na Regulation > Flashcards

04b: Na Regulation Flashcards

1
Q

(X)% of Na is in bone and not available for ordinary metabolic processes. Of the available Na, most, (Y)%, is in (Z).

A 
X = 40;
Y = 90;
Z = ECF
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2
Q

Normal daily Na intake is about (X), but what’s the full range?

A

X = 100 mEq

Less than 1 mEq to over 400 mEq

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3
Q

Typical ICF:ECF volume ratio.

A

2:1

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4
Q

Major excretory pathway for Na is (X). How else, although in negligible amounts, is Na excreted?

A

X = renal excretion;

Sweat and stool

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5
Q

T/F: Regulation of body Na is primarily achieved by receptors that detect changes in osmolality.

A

False - detect changes in ECF volume/P (secondary to changes in Na content of ECF)

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6
Q

T/F: Increase in salt ingestion increases osmolality of ECF, but not ICF.

A

False - both (osmotic equilibration)

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7
Q

Following increased Na ingestion and compensatory mechanisms, a new steady state is reached. This includes (increased/decreased) volume by addition of (hypo/hyper/iso)-osmotic solution.

A

Increased;

Iso-osmotic

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8
Q

Effective Circulating Volume (ECV) is the (X) of blood that’s (Y). In other words, it’s a degree of filling of (Z).

A 
X = pressure
Y = perfusing the baroreceptors
Z = arterial system
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9
Q

T/F: In all circumstances, ECV changes in parallel with ECF volume.

A

False - may be independent in some cases (ex: CHF)

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10
Q

Major baroreceptors involved in sensing of Na content by monitoring (X) are in which location(s)?

A

X = ECV

  1. Carotid sinus and aortic arch
  2. Atria (cardiopulmonary receptors)
  3. Afferent arterioles in kidney
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11
Q

How do baroreceptors in carotid sinus/aorta respond to increase in ECV?

A

Reduce symp NS signaling

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12
Q

How do baroreceptors in Atria respond to increase in ECV?

A

Release ANP

and can also alter symp NS

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13
Q

How do baroreceptors in afferent arterioles respond to increase in ECV?

A

Reduce renin secretion from JG apparatus

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14
Q

List the two general methods for adjustment in Na excretion by kidneys.

A
  1. Filtered Na load (determined mainly by GFR)

2. Tubular Na reabsorption

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15
Q

T/F: Renal processing of Cl is usually coupled to Na, so Na excretion regulation applies equally to Cl.

A

True

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16
Q

What’s the equation that determines Na filtrated by kidney? The typical daily value is:

A

P(Na)GFR = (140)(180) = 25,200 mEq/day

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17
Q

Aside from the proximal tubule, list the tubules that “fine tune” Na reabsorption.

A

Distal convoluted tubule and collecting duct

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18
Q

Increase in body Na leads to (increase/decrease) GFR. Explain.

A

Increase;

Increase in ECF and plasma volume

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19
Q

Decreased Na/ECF (increases/decreases) sympathetic innervation of (aff/eff) arterioles, thus having which effect on GFR?

A

Increases (vasoconstriction);
Afferent;
Reduces GFR

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20
Q

(Increased/decreased) Na/ECF leads to release of (X), which leads to increased GFR by (vasodilation/vasoconstriction) of (aff/eff) arterioles.

A

Increased;
X = ANP and NO
Vasodilation of aff and vasoconstriction of eff

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21
Q

T/F: Changes in GFR are required to maintain Na balance.

A

False - tubular reabsorption can maintain GT balance

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22
Q

T/F: Tubular reabsorption, not GFR changes, is the main response to ECV fluctuations.

A

True

23
Q

Which transporters are responsible for Na (uphill/downhill) exit from basolateral membrane? Star the one that’s more important.

A

Uphill;

  1. Na/K ATPase*
  2. (3)HCO3/Na
24
Q

At the early proximal tubule, preferential mode of Na entry into tubular cells is via which transport method?

A

Co-transport with organic solutes;

and some H+ exchange

25
Q

At the late proximal tubule, which two (co-transporters/exchangers) are coupled?

A

Exchangers;

NaH and Cl-OH

26
Q

Cl reabsorption occurs in (early/late) proximal tubule and is (co-transported/exchanged) with (X).

A

Late ;
Exchanged;
X = OH

27
Q

(Passive/active) Na reabsorption takes place in TAL of loop of Henle.

A

Passive (paracellular)

28
Q

TAL Na reabsorption involves (cotransport/exchange) with (X).

A
  1. Co-transport
    X = K and (2) Cl
  2. H+ exchange
29
Q

In early distal tubule, Na reabsorption is (cotransported/exchanged) with (X).

A

Co-transported;

X = Cl

30
Q

Late distal tubule and collecting duct Na reabsorption via which transporter?

A

Epithelial Na channel

31
Q

Euvolemia is condition in which (X) is/are normal.

A

X = ECF volume and Na content

32
Q

List the four regulatory mechanisms that alter fraction of tubular Na reabsorbed proximally in response to ECF changes.

A
  1. Sympathetic nerves
  2. AII
  3. Starling forces in peritubular cap’s
  4. NO
33
Q

T/F: Sympathetic nerves directly innervate proximal tubule and inhibit Na reabsorption.

A

False - stimulate reabsorption (by stimulating Na-H exchanger)

34
Q

NO, stimulated by volume (expansion/contraction) will (stimulate/inhibit) Na reabsorption.

A

Expansion;

Inhibit

35
Q

List two regulatory mechanisms that alter fraction of tubular Na reabsorbed in TAL in response to ECF changes.

A
  1. ADH (stimulatory)

2. Prostanoids and NO (inhibitory)

36
Q

Prostanoids and (X) are released by (Y) cells in TAL and (increase/decrease) Na reabsorption.

A

X = NO
Y = tubular and medullary interstitial;
Decrease

37
Q

In euvolemic conditions, (X) is the primary regulatory of Na reabsorption by its effects on (proximal/distal) segments of nephron.

A

X = aldosterone

Distal

38
Q

Aldosterone is a(n) (X), released by (Y) cells of (Z).

A 
X = steroid hormone;
Y = glomerulosa
Z = adrenal cortex
39
Q

T/F: Plasma level of renin is rate-limiting factor in series of events leading to aldoesterone production.

A

True

40
Q

Angiotensinogen is produced by (X) and cleaved by (Y), produced by (Z).

A 
X = liver
Y = rening
Z = JG cells
41
Q

Aldosterone acts on (X) cells of distal nephron by binding (lumenal/basolateral) receptor. (Activation/inhibition) of this receptor leads to:

A

X = principal
CYTOPLASMIC
Activation;
Translocates to nucleus and regulates gene transcription

42
Q

Early effects of aldosterone on distal nephron involve (X), causing (increase/decrease) in Na reabsorption.

A

X = recruitment of apical Na channel and basolateral NaK ATPase

Increase

43
Q

Later effects of aldosterone on distal nephron involve (X), causing (increase/decrease) in Na reabsorption.

A

X = increased synthesis of Na transport proteins

Increase

44
Q

Secretion of renin by (X) cells involves process that’s activated by (Y), which is stimulated by (Z).

A 
X = JG
Y = protein kinase A
Z = cAMP
45
Q

High intracellular Ca has which effect on renin secretion? Explain.

A

Decrease;

Inhibits adenylate cyclase in JG cells, thus decreasing cAMP then PKA activity

46
Q

List three distinct inputs to JG cells that increase renin secretion in response to (low/high) ECF/Na volume.

A

Low;

  1. Symp nerve activity
  2. Low perfusion pressure
  3. Low NaCl delivery to macula densa
47
Q

Sympathetic nerve activity on JG cells: (X) NT binds (Y) receptor and (increases/decreases) (Z) activity.

A

X = NE
Y = beta-1 adrenergic
Increases;
Z = AC

48
Q

High perfusion pressure in (aff/eff) arteriole is sensed by intrarenal baroreceptors. This (increases/decreases) renin secretion by (increasing/decreasing) (X) of JG cells.

A

Aff;
Decreases;
Increasing;
X = intracellular Ca levels (inhibits AC)

49
Q

The volume of water reabsorbed by the descending limb (increases/decreases) with high ADH, aka (diuretic/antidiuretic) state.
This happens because:

A

Osmotic driving force (interstitial osmolality) is larger in antidiuresis (1200 mOsm);

NOT because ADH affects the permeability to water of this segment

50
Q

How does state of diuresis differ in case of ingesting large amounts of water versus taking diuretic?

A

Taking diuretic will increase both solute and water excretion; ingesting large amount of water will result in increased excretion of primarily water

51
Q

T/F: Addition of water to the body usually causes a permanent increase in ECF
volume.

A

False

52
Q

T/F: Addition of water to the body usually causes a permanent increase in BP.

A

False

53
Q

T/F: Most of water retained/reabsorbed is usually added to ICF.

A

True

Renal (8 decks)

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