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Physiology > Chapter 29: Renal Regulation Of K, Ca, PO, Mg > Flashcards

Chapter 29: Renal Regulation Of K, Ca, PO, Mg Flashcards

0
Q

Ions controlled by an overflow mechanism

A

Potassium

Phosphate

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1
Q

ECF Potassium concentration

A

4.2mEq/L

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2
Q

Hormones that increase potassium uptake into cells

A

Insulin
Aldosterone
Epinephrine

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3
Q

Acid-base abnormality causing a decrease potassium concentration in the ECF or Hypokalemia

A

Alkalosis

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4
Q

Effect of increased H ion concentration on K

A

Reduces activity of Na-K ATPase pump –> Increases K on ECF

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5
Q

Potassium abnormality caused by Cellular lysis, strenuous exercise and intake of B-adrenergic blockers

A

Hyperkalemia

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6
Q

How does increased ECF osmolarity increase K in the ECF

A

Osmosis out of cells –> cellular dehydration –> increased K concentration in cells –> K diffusion out of the cells

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7
Q

Most important sites for regulating K excretion

A

Principal cells of the late distal tubules and cortical collecting tubules

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8
Q

Intercalated cells of the late distal tubules and cortical collecting tubules contain what transporter which aids in potassium reabsorption

A

H-K ATPase in the luminal membrane

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9
Q

3 mechanisms that raises K secretion during increased ECF K concentration

A
  • stimulation of Na-K ATPase pump
  • diffusion of K from increased gradient
  • stimulation of aldosterone secretion
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10
Q

Effect of Addison’s disease in K concentration in the blood

A

Hyperkalemia

Addison’s dse –> dec aldosterone –> dec K secretion –> hyperkalemia

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11
Q

Chronic Acidosis leads to what potassium abnormality

A

Hypokalemia

Chronic acidosis decreases NaCl and Water reabsorption in the proximal tubules –> increasing distal volume delivery –> overrides inhibitory effect oh inc H on Na-K ATPase pump –> K secretion

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12
Q

ECF Ca ion concentration

A

2.4 mEq/L

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13
Q

50% of Ca is in what form, which has biologic activity at cell membranes

A

Ionized form

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14
Q

Effect of alkalosis in the binding of Ca and plasma proteins

A

More Ca is bound to plasma proteins in alkalosis –> prone to hypocalcemic tetany

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15
Q

Large share of Ca excretion occurs in

A

Feces

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16
Q

Percentage of Ca deposition in the bone

A

99%

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17
Q

Effect of PTH

A

Increases Bone resorption –> increase Ca levels in ECF

18
Q

Calcium is filtered, reabsorbed and secreted in the kidneys. True or False

A

False. Only filtered and reabsorbed; not secreted

19
Q

Most of calcium reabsorption occurs through which transport pathway in the proximal tubule

A

Paracellular pathway

20
Q

Transport mechanism for Ca as it exits the cell across the basolateral membrane from the proximal tubule

A

Primary active transport (Ca-ATPase)

Secondary active transport (Na-Ca counter transport)

21
Q

50% of Ca reabsorption in the thick ascending limb occurs through the paracellular route by passive diffusion and 50% through the transcellular pathway which is stimulated by what hormone?

A

PTH

22
Q

PTH, Vitamin D and Calcitonin stimulates ca reabsorption in which tubular segments?

A

Thick ascending limb

Distal tubule

23
Q

Reabsorption of Ca in which segment parallels Na and water reabsorption and is independent of PTH

A

Proximal tubule

24
Q

Effect of acidosis on Ca reabsorption

A

Increased

25
Q

Threshold of phosphate in the ECF

A

0.8 mM/L

26
Q

Proximal tubule reabsorbs 75-80% of filtered Phosphate occurring through which pathway and transporter in luminal membrane?

A

Transcellular pathway through the Na-PO4 con-transporter

27
Q

Effect of PTH on Phosphate and Ca reabsorption

A

Decreased PO4 reabsorption

Increased Ca reabsorption

28
Q

Ions stored in the bones

A

Ca
PO4
Mg

29
Q

Total plasma Mg concentration

A

1.8 mEq/L

30
Q

Free ionized concentration of Mg

A

0.8 meq/L

31
Q

In disturbances of kidney function which are not too severe, Na balance may be achieved mainly by systemic adjustments. True / False

A

False. Mainly by intrarenal adjustments with minimal changes in ECF volume

32
Q

Severe perturbations of the kidney exhausts intrarenal compensations so that systemic adjustments must be invoked. True / False

A

True

33
Q

If kidneys become greatly vasodilated and GFR increases, NaCl delivery to the tubules leads to two intrarenal compensations. What are these?

A
  • glomerulotubular balance

- macula densa feedback

34
Q

Refers to the effect of increased BP to raise urinary volume excretion

A

Pressure diuresis

35
Q

Effect of increased Na excretion that occurs with increased BP

A

Pressure natriuresis

36
Q

Chronic increases in BP suppresses the release of which hormone, which enhances the effectiveness of pressure natriuresis

A

Renin

37
Q

Trace the basic renal-body fluid feedback mechanism

A

Increase fluid intake ➡️ fluid accumulation in ECF ➡️ inc blood volume ➡️ inc mean circulatory filling pressure ➡️ inc venous return ➡️ inc cardiac output ➡️ inc arterial pressure ➡️ pressure diuresis to inc urine output

38
Q

Blood volume and ECF volume are controlled simultaneously. True / False

A

True. Ingested fluid initially goes into the blood but rapidly becomes distributed between interstitial spaces and plasma

39
Q

Neither a decrease nor an increase in circulating angiotensin II has a large effect on ECF volume or blood volume as long as HF or KF does not occur. True or False

A

True

40
Q

Excess ADH secretion causes only small increases in ECF volume and large increases in Na concentration. True or False

A

False. Only small increases in ECF due to pressure diuresis and large decreases in Na concentration because of ECF dilution

41
Q

Action of ANP

A

Increased salt and water excretion d/t increase GFR and decrease Na reabsorption by the collecting ducts

42
Q

Conditions that cause large increases in blood volume and ECF volume

A
  • heart diseases

- increased capacity for circulation (pregnancy, varicosities)

43
Q

Conditions that cause large increases in ECF volume but with normal blood volume

A

Nephrotic syndrome

Liver cirrhosis

Physiology (8 decks)

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