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GIR Test 4 > B4-087 Renal Physiology VI > Flashcards

B4-087 Renal Physiology VI Flashcards

1
Q

when sodium is reabsorbed, […] is secreted

A

potassium

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2
Q

activates the proton pumps

hormone

A

aldosterone

hyperaldosterone = metabolic alkalosis

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3
Q

how does hypokalemia cause metabolic alkalosis?

A
  • potassium moves out
  • H+ moves in to maintain electrical neutrality –> raises blood pH
  • also: increased ammonia production
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4
Q
  • hypertension
  • hypokalemia
  • metabolic acidosis

w/ low renin and low aldosterone

A

Liddle’s syndrome

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5
Q

diuretic that targets ENac

A

triamterene

treatment for Liddles

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6
Q

why does hyperglycemia cause pseudohyponatremia?

A
  • water is driven by glucose out of cells into ECF
  • cause volume expansion
  • dilutes sodium in ECF
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7
Q

when sodium goes down, […] goes down

A

chloride

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8
Q

why is plasma K+ high in acidosis?

A

acidosis causes K+ to move from cell to ECF in exchange for H+

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9
Q

all the glucose is reabsorbed in the

A

proximal tubule

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10
Q

glucose is secreted in urine when

A

surpasses point of saturation

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11
Q

why does acidosis cause hypercalciuria?

A

acidosis triggers osteoclasts –> high bone turnover –> hypercalciuria –> nephrolithiasis

causes generalize reduction in bone density

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12
Q

how does acidosis cause kidney stones?

A

hypercalciuria + increased citrate reabsorption

low citrate and high urine pH precipitate stones

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13
Q

treatment of distal renal tubular acidosis

A
  • restore pH with bicarb and sodium citrate
  • KCl supplement therapy
  • vitamin D/Ca++ for ricketts
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14
Q

produced by mutations that cause hyperactivation of ENac

A

liddle’s

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15
Q
  • high blood pressure
  • low renin
  • low aldosterone
A

Liddle’s

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16
Q

what causes pseudohyponatremia in hyperglycemia?

A

high glucose in plasma pulls water into the ECF, dilutes sodium

17
Q

metabolic acidosis from renal tubular acidosis type 1 (distal) can be differed from type 2 (proximal) via…?

A

bicarbonate excretion in urine

18
Q

bicarbonate release in urine is […] in proximal RTA and […] in distal RTA

A

increased in proximal
decreased in distal

19
Q

what favors calcium precipitation in the renal ultrafiltrate?

A

decrease in citrate in urine
and high pH of urine

20
Q

how would SIADH affect:
blood pressure:
plasma renin:
aldosterone:
serum Mg2+:
urine Ca2+:

A

blood pressure: –/increased
plasma renin: low
aldosterone: low
serum Mg2+: –
urine Ca2+: –

21
Q

how would primary hyperaldosteronism affect:
blood pressure:
plasma renin:
aldosterone:
serum Mg2+:
urine Ca2+:

A

blood pressure: high
plasma renin: low
aldosterone: high
serum Mg2+: –
urine Ca2+: –

22
Q

how would Bartter syndrome effect:
blood pressure:
plasma renin:
aldosterone:
serum Mg2+:
urine Ca2+:

A

blood pressure: –
plasma renin: high
aldosterone: high
serum Mg2+: –
urine Ca2+: high

23
Q

how would Gitelman syndrome effect:
blood pressure:
plasma renin:
aldosterone:
serum Mg2+:
urine Ca2+:

A

blood pressure: –
plasma renin: high
aldosterone: high
serum Mg2+: low
urine Ca2+: low

24
Q

how would Liddle syndrome effect:
blood pressure:
plasma renin:
aldosterone:
serum Mg2+:
urine Ca2+:

A

blood pressure: high
plasma renin: low
aldosterone: low
serum Mg2+: –
urine Ca2+: –

25
Q

inability of a-intercalated cells to secrete H+ so no new HCO3 is generated causing metabolic acidosis

A

distal renal tubular acidosis (type I)

26
Q

in which type of RTA is urine pH > 5.5?

A

distal

type I

27
Q

causes of RTA type 1

distal

A
  • ampho B
  • analgesic nephropathy
  • congenital abnormalities
  • obstruction of urinary tract
  • autoimmune disease (SLE)
28
Q

which type of RTA carries an increased risk of kidney stones?

A

type I (distal) due to increased urine pH and high bone turnover

29
Q

defect in PCT bicarb reabsorption causing increased excretion of bicarb in urine

A

proximal RTA (type 2)

30
Q

proximal RTA (type II) is caused by

A

Fanconi
multiple myeloma
carbonic anhydrase inhibitors

31
Q

which type of RTA carries an increased risk of hypophosphatemic rickets?

A

proximal

type II

32
Q

due to hypoaldosteronism or aldosterone resistance

A

RTA type IV
hyperkalemic tubular acidosis

33
Q

hypekalemia causes decreased NH3 synthesis in PCT leading to decreased ammonium secretion

A

RTA type IV
hyperkalemic tubular acidosis

34
Q

RTA associated with hyperkalemia

A

RTA type IV
hyperkalemic tubular acidosis

35
Q

what can cause decreased aldosterone production?

A
  • diabetic hyporeninism
  • ACEs/ARBs
  • NSAIDs
  • heparin
  • cyclosporine

type IV RTA

36
Q

what can cause aldosterone resistance?

A
  • K+ sparing diuretics
  • nephropathy due to obstruction
  • bactrim

type IV RTA

GIR Test 4 (18 decks)

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