18 K+ and more!:) Flashcards

1
Q

What is the intracellular concentration of K+?

A

140mM

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2
Q

What is the extracellular concentration of K+/

A

4mM

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3
Q

How can any adverse affects of increased extracellular K+ be avoided?

A

buffering by uptake into cells

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4
Q

What 6 things might cause hyperkalaemia?

A
CKD 5
crush injuries
blood transfusion
cytotoxic drugs
insulin deficiency
over use of K+ sparing diuretics
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5
Q

Why might blood transfusion cause hyperkalaemia?

A

red cells leak some K+ into the plasma during storage

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6
Q

Why might giving glucose treat hyperkalaemia?

A

stimulates insulin release

insulin stimulates Na+/K+ ATPase
cells uptake K+

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7
Q

Name 3 causes of hypokalaemia

A
diarrhoea
furosemide (along with most diuretics)
insulin overdose
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8
Q

what might you do if someone is have significant furosemide-induced hypokalaemia?

A

decrease the concentration of furosemide and increase concentration of K+ sparing diuretic

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9
Q

name a K+ sparing diuretic

A

sprinolactone

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10
Q

What is the main dangerous consequence of hypo or hyperkalaemia?

A

dysrhythmia

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11
Q

How might you treat hypokalaemia?

A

give IV K+ if acute

give orally if chronic

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12
Q

How is K+ exchanged in the TAL?

A

through NKCC cotransporter

much of the K+ cycles back into the filtrate here though

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13
Q

How is K+ exchanged in the DCT and CD?

A

apical membrane K+ channel (ROMK) (aldosterone)

A Ca2+ activatead K+ channel (flow rate dependent)

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14
Q

What is aldosterone secretion sensitive to?

A

AngII

K+

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15
Q

What is the main hormone for regulating bodily K+?

A

aldosterone

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16
Q

What proportion of total Ca2+ is filtered by the glomerulus?

A

10% total

20% free

17
Q

what happens to filtered calcium in the PCT?

A

moves transcellularly

proportional to H2O movement

18
Q

What happens to filtered calcium in the TAL?

A

absorbed

driven by + potential in the lumen of the TAL

19
Q

Why is there a positive potential in the TAL lumen?

A

MKCC is electrically neutral
apical K+ recycling makes the filtrate +

this drives the reabsorption of Ca2+

20
Q

How does ascending to high altitudes affect red cell production?

A

it increases it

21
Q

where is EPO made?

A

renal mesangial cells

22
Q

What is another name for mesangial cells?

A

peritubular fibroblasts

23
Q

What stimulates transcription of EPO?

A

hypoxia-inducible factors (HIF-2)

24
Q

What is HIF-alpha degradation enhanced by?

25
How does iron affect EPO?
low iron causes EPO production
26
How is EPO regulated?
EPOR binds and internalises EPO
27
how does renal failure lead to anaemia? what is the exception to this?
falls in EPO production polycystic kidney disease
28
How does polycystic kidney disease not cause anaemia?
sufficient renal parenchyma to prevent loss of EPO production
29
What EPO analogue is used clinically?
Darbepoietin alpha
30
Can EPO be found in urine
yes, a little bit as it is 34kDa
31
What is the other name for vitamin D?
cholecalciferol
32
How is vitamin D metabolised?
converted to 25-hydroxycholecalciferol in the liver converted to 1,25-hydroxycholecalciferol by the kidney
33
What are the actions of 1,25-VitD?
increase Ca2+ and phosphate absorption in the ileum | decrease Ca2+ and phosphate excretion