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Board Review: Physiology > Chapter 5: Renal and Acid-Base Physiology > Flashcards

Chapter 5: Renal and Acid-Base Physiology Flashcards

1
Q

Total Body Water (TBW)

A

60% of body weight

High in newborns and adult males.

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2
Q

ICF

A

2/3 of TBW

Mg++ and K+ are major cations
Anions are Protein and Organic Phosphates

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3
Q

ECF

A

1/3 of TBW

Interstitial Fluid (3/4 of ECF) and PLasma (1/4 of ECF).. Ultrafiltrate of Plasma with little protein.

Cation: Na+
Anion: Cl- and HCO3-

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4
Q

TBW marker

A

H30, D2O and Atnipyrene

( distributes throughout body compartments)

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5
Q

ECF Marker

A

Mannitol, Inulin and Sulfate

goes into plasma and interstitial fluid

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6
Q

Plasma Marker

A

Evans blue, RISA

(binds albumin and cannot leave plasma fluid)

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7
Q

Equation for Volume

A

Volume = g/(g/ml) aka grams/Conentration

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8
Q

How can you calculate Interstitial Fluid ?

A

Interstitial = ECF (Mannitol, Innulin or sulphate) - Plasma (Evans Blue and Risa

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9
Q

How can you calculate Intracellular Fluid (ICF)

A

TBW (H30, D20) - ECF (Mannitol, Innulin)

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10
Q

What happens to ICF and ECF when you add an Isotonic fluid to a system ?

A

ECF will expand with no change in the osmolarity

ISOOSMOTIC VOLUME EXPANSION

Decreased hematocrit

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11
Q

What kind of fluid is lost in diarrhea ?

A

Isotonic Fluid

Leads to a decrease in the ECF only (Osmolarity is unchanged )

Increased Hematocrit

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12
Q

Hyperosmotic Fluid Expansion (Intake of excessive NaCL soulution)

A

Fluid will move from the ICF into the ECF expanding the ECF and decreasing the ICF
Hematocrit will decrease due to expanded ECF

Osmolarity of Both will be increased

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13
Q

Hyperosmotic Fluid Loss (sweating excessively)

A

ICF and ECF will become smaller (initially ECF then ICF )

Osmolarity of both will Increased.
Hematocrit does not increase despite ECF Fluid loss because fluid volume is lost from inside the RBC’s as well.

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14
Q

Hypoosmotic Fluid Expansion (SIADH)

A

Both the ECF and ICF will increase

Osmolarity Decreases

Hematocrit is unchanged since more water will go into the RBC’s expanding them.

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15
Q

Hypoosmotic Volume Contraction (Loss of NaCL. Adrenocortical insufficiency)

A

ECF osmolarity decreases leading to fluid shift into the ICF

ICF expands while ECF contracts

Osmolarity of Both Decreases

Hematocrit will increase due to loss of H20 from the ECF

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16
Q

Clearance

A

The amount of blood that can be cleared of solute per unit time ( mL/min)

C= UV/P

U= Urine Concentration (mg/mL)
V= Urine Volume TIme (ml/min)
P= Plasma Concentration (mg/mL)
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17
Q

Renal Blood Flow (25% of CO) Is directly proportional to …

A

The difference in pressure between Renal Artery and Renal Vein

Inversely proportional to Renal Resistance

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18
Q

What leads to Renal Arteriole vasoconstriction and decreased RBF ?

A 
Sympathetic NS
Angiotensin II (Dilates the EFFERENT arteriole leading to Increased GFR)
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19
Q

What leads to vasodilation of renal arterioles ?

A

Prostaglandins E2, I2 , Bradykinin, NO and DOPAMINE.

–> Increased Renal Blood Flow

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20
Q

What is the range of Renal blood pressures that renal blood flood is held constant due to Autoregulation ?

A

80-200 mmHg

Autoregulation: Myogenic Mechanism and Tubuloglomerular feedback

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21
Q

Tubuloglomerular feedback

A

Increased RBF leads to increased fluid being brought to the macula densa. Macula densa senses this and cause constriction of the AFFERENT arteriole to lower GFR and maintain proper blood flow.

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22
Q

Renal Plasma Flow

A

Amount of plasma that come through the kidney (measured by the clearance of PAH , a substance that is filtered and secreted only)

RPF = C(PAH) = UV/ P

U= Urine Concentration of PAH
V= Urine Flow Rate
P= Plasma Concentration of PAH
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23
Q

Renal Blood Flow

A

Amount of blood to come through the kidney over a set time

RBF = RPF/ (1-hematocrit)

1- hematocrit = Proportion of plasma in blood.

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24
Q

GFR

A

Calculated by clearance of INULIN ( Filtered not secreted or reabsorbed)

GFR = UV/P

U=Urine Concentration of Inulin
V= Urine flow Rate
P = plasma concentration of Inulin

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25
Q

What is the relationship between Decreasing GFR and BUN ?

A

BUN increases as GFR decreases

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26
Q

Pre-reanal azotemia

A

BUN:Creatinine of >20:1

Post renal : > 15

Primar Azotemia : <15

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27
Q

Filtration Fraction

A

Fraction of RPF that is filtered

FF = GFR/ RPF

Normally .2 !

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28
Q

Increased Filtration Fraction

A

Lead to increased [protein] of peritubular capillary blood –> Increased reabsorption in proximal tubule

Opposite is true of Decreased FF

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29
Q

Starling Forces For GFR

A

GFR = Kf ( Pc + Oi) - (Pi + Oc)

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30
Q

Glomerular Capilllary Hyrodstatic Pressure

A

Increased by dilation of Afferent or Constriction of Efferent .. Increasing this leads to increased GFR (all others held same)

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31
Q

Glomerular Capillary Oncotic Pressure

A

Increases along the capillary ( primary driving force is plasma proteins)

Increases in this decreases GFR and net filtration pressure

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32
Q

Bomans space Oncotic pressure

A

Essentially is zero

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33
Q

Bowmans Space Hydrostatic pressure

A

resists filtration, increases in this pressure leads to decreased GFR

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34
Q

Filtered Load

A

GFR x [Plasma] (g/min)

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35
Q

Excretion Rate

A

=Urine Flow (V) x [U]

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36
Q

Reabsorption Rate

A

FIltered Load - Excretion Rate

Less in blood than was filtered)

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37
Q

Secretion Rate

A

Excretion Rate - Filtered Load (More in urine than was filtered)

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38
Q

What is responsible for Glucose reabsorption in the proximal tubule

A

Na/Glucose co transport.

If plasma glucose is over 350 , you will see glucose in the blood (less than 250 all glucose is reabsorbed)

Splay is in between

Note: in the early proximal tubule, nearly all Glucose, HCO3 and Amino acids have been reabsorbed

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39
Q

What has higher clearance : A substance that is filtered and secreted or a Substance that is filtered ?

A

Filtered and secreted

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40
Q

In which conditions will The HA form of a weak acid be more prevalent than the A- form ?

A

At acidic pH

No reason to lose H+ to the solution

If it were basic solution, the A- would predominate since it would be easier to donate H+

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41
Q

In which conditions will The BH+ form of a weak base be more prevalent than the B form ?

A

In acidic environments. More readily accepts the B

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42
Q

Where is Reabsorption of Na+ the greatest along the nephron ?

A

Proximal Tubule
Reabsorbs 2/3’s of the filtered Na and H20

Done in Isoosmotic fashion so that reabsorption of Na is proportional to reabsorption of water.

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43
Q

What drives the Reabsorption of Na in the early prox tubule ?

A

Na/K+ pump on the basolateral side ** (sodium into the blood, K+ into the cell)

On the lumina side : Na/Glucose symport and Na+/H+ anti port

Note: Na/H+ antiport is due to activity of Carbonic ANhydrase. Carbonic Anhydrase inhibitors work as diuretics by blocking this (Acetozolamide, give this for Altitude sickness also to treat Respiratory Alkalosis)

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44
Q

How is Na+ reabsorbed in the Late Proximal Tubule ?

A

With Cl- ( Na/Cl- Symport)

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45
Q

How does ECF volume contraction affect tubular reabsorption ?

A

Increases it since ECF (Plasma and Interstitial fluid) decreases lead to increased plasma protein concentration and great Capillar oncotic pressures.

Opposite is true of ECF Expansion

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46
Q

How much of Na+ is reabsorbed in the Thick Ascending Loop of Henle ?

A

25% of filtered

NCCK Transporter

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47
Q

What diuretic class works on he NCCK transporter /

A

Loop Diuretics

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48
Q

What is different about the TALH and the Proximal tubule ?

A

Unlike in the Proximal Tubule, the TALH is impermeable to H20, so when The NCCK reabsorb ions, H20 cannot follow leading to a dilution of the Tubule osmolarity (

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49
Q

How much of Na+ is reabsorbed in the Distal Convoluted Tubule and Collecting duct ?

A

8%

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50
Q

Like in the Late Proximal Tubule, how is Na+ reabsorbed in the Early Distal Convoluted Tubule ?

A

with Cl- (Na/Cl- Symport

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51
Q

What diuretics work on the Na/Cl- Symport in the Early Distal Convoluted tubule ?

A

Thiazide Diuretics

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52
Q

Is the Early Distal Tubule permeable to H20 ?

A

NOPE (Just like the TALH)

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53
Q

What are the two types of cells important to ion regulation found in the Late Distal Convoluted Tubule/Collecting Ducts ?

A

Principal Cells

a-Interaclated cells

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54
Q

Pricinple Cells

A

Reabsorb Na+ and H20 , Secrete K+

Aldosterone mediates the function of Principle Cells !!!!! (Increases Na+ reabs and K+ secretion)… ENAC channels are placed on the lumenal side of Principal Cells and allow for the Movement of Na+ into the cell. Aldosterone also stimulates the activation of Na/K pump

Gradient is maintained by Basolateral Na/K+ Pump ( Na into blood, K+ into cell –> increased K+ which leave cell via lumenal K+ channel into urine)

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55
Q

Effect of Acidosis on K+ secretion

A

Acidosis leads to decreased K+ secretion

(H+ enters principal cell, this somehow causes K+ to leave the cell on basolateral side

H+/K+ anti-port ?

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56
Q

Effect of Alkalosis on K+ secretion

A

Alkalosis leads to increased K+ Secretion

(H+ does not enter principal cell, this somehow causes K+ to leave the cell on lumenal side due to increased [K+]

57
Q

What is the effect of Thiazide and loop diuretics on K+ Secretion ?

A

They increase the secretion of K+ by increasing flow rate in distal tubule and thus diluting the K+ concentration–> K+ moving from principle cell into the lumen. –> Hypokalemia

Loops: Inhibit NCCK (more fluid retained, dilutes K+ concentration)

Thiazides: Inhibit Na Cl transporter.

58
Q

How do the Potassium Sparring Diurectics (Spironolactone, Amilioride, Triamitrine) work ?

A

Directly inhibiting Principal Cell Secretion of K

Spironolactone is an inhibitor of Aldosterone (given in patients with Conn Snydrome, can lead to Hyperkalemia and Man tits)

59
Q

What is the effect of increased luminal ANIONS on K+ secretion ?

A

Increases it ( more anions = more need for cations to come into the lumen to balance charges)

60
Q

Where is most Urea reabsorbed ?

A

Proximal Tubule (50%)

The nephron is impermeable at all other places along the path except at the Medullary Collecting Ducts (NOT CORTICAL COLLECTING DUCT)–> medullary gradient

60
Q

Where is most Urea reabsorbed ?

A

Proximal Tubule (50%)

The nephron is impermeable at all other places along the path except at the Medullary Collecting Ducts (NOT CORTICAL COLLECTING DUCT)–> medullary gradient

61
Q

How is flow linked to urea reabsorption and secretion ?

A

At low flow, urea absorption is high ! at high flow reabsorption is minimal

61
Q

How is flow linked to urea reabsorption and secretion ?

A

At low flow, urea absorption is high ! at high flow reabsorption is minimal

62
Q

Where is most Phosphate reabsorbed along the nephron ?

A

In the proximal tubule (85%) via Na/Phosphate symport.

DISTAL PORTIONS OF THE NEPHRON ARE IMPERMEABLE TO PHOSPHATE… remaining 15% is excreted

62
Q

Where is most Phosphate reabsorbed along the nephron ?

A

In the proximal tubule (85%) via Na/Phosphate symport.

DISTAL PORTIONS OF THE NEPHRON ARE IMPERMEABLE TO PHOSPHATE… remaining 15% is excreted

63
Q

Where in the nephron will you find the greatest amount of Ca++ reabsorption and what is it coupled to ?

A

Proximal TUbule and TALH (90%)

Coupled to Na+ Transport (reabsorption)

63
Q

Where in the nephron will you find the greatest amount of Ca++ reabsorption and what is it coupled to ?

A

Proximal TUbule and TALH (90%)

Coupled to Na+ Transport (reabsorption)

64
Q

What is the effect of loop diuretics on Ca++ reabsorption ?

A

Loop Diuretics (Like furosemide) inhibit the NCCK transporter. This will cause a disruption of the Ca++ reabsorption since it is linked to Na+ reabsorption.

Can give Loop Diuretics to treat Hypercalcemia !

64
Q

What is the effect of loop diuretics on Ca++ reabsorption ?

A

Loop Diuretics (Like furosemide) inhibit the NCCK transporter. This will cause a disruption of the Ca++ reabsorption since it is linked to Na+ reabsorption.

Can give Loop Diuretics to treat Hypercalcemia !

65
Q

PTH

A

Activates Adenyl Cyclase in the distal tubule –> Ca++ reabsorption

65
Q

PTH

A

Activates Adenyl Cyclase in the distal tubule –> Ca++ reabsorption

66
Q

What diuretic can you give to help increased Ca++ reabsorption in the distal tubule ?

A

Thiazide diuretics.

66
Q

What diuretic can you give to help increased Ca++ reabsorption in the distal tubule ?

A

Thiazide diuretics.

67
Q

What is the effect of Mg++ on Ca++ reabsorption ?

A

In the TALH, Mg++ and Ca++ compete for reabsorption. Hypermagnesemia can lead to decreases Ca++ reabsorption and vis versa.

67
Q

What is the effect of Mg++ on Ca++ reabsorption ?

A

In the TALH, Mg++ and Ca++ compete for reabsorption. Hypermagnesemia can lead to decreases Ca++ reabsorption and vis versa.

68
Q

Circulating ADH will lead to the formation of what kind of urine ?

A

Hyperosmotic !

68
Q

Circulating ADH will lead to the formation of what kind of urine ?

A

Hyperosmotic !

69
Q

ADH causes the Medullary Collecting duct to be more permeable to …

A

UREA !

69
Q

ADH causes the Medullary Collecting duct to be more permeable to …

A

UREA !

70
Q

Corticopapillary Osmotic Gradient is mainly due to

A

NaCL and UREA.

70
Q

Corticopapillary Osmotic Gradient is mainly due to

A

NaCL and UREA.

71
Q

What blood vessels are responsible for the countercurrent multiplication in the LOH ?

A

Vasa Recta (equilibrate with the interstitial fluid of the papilla which has a large amount of NaCl and Urea)

71
Q

What blood vessels are responsible for the countercurrent multiplication in the LOH ?

A

Vasa Recta (equilibrate with the interstitial fluid of the papilla which has a large amount of NaCl and Urea)

72
Q

What is the TF/P value of the TALH ?

A

less than 1 since solute is being reabsorbed but LOH is impermeable to H20 (dilutes out the tubular fluid)

72
Q

What is the TF/P value of the TALH ?

A

less than 1 since solute is being reabsorbed but LOH is impermeable to H20 (dilutes out the tubular fluid)

73
Q

Free Water Clearance (equation)

A

Estimate of the ability to concentrate or Dilute Urine

(in the presence of ADH, free water is absorbed and C(H20) is negative

In the absence of ADH free water is excreted and C(H20) is positive.

73
Q

Free Water Clearance (equation)

A

Estimate of the ability to concentrate or Dilute Urine

(in the presence of ADH, free water is absorbed and C(H20) is negative

In the absence of ADH free water is excreted and C(H20) is positive.

74
Q

Free Water Clearance (equation)

A

C(H20) = V - Cosm

V= Urine Flow rate (mL/min)

C= Osmolar Clearance ( [U]x V/ [P])

74
Q

Free Water Clearance (equation)

A

C(H20) = V - Cosm

V= Urine Flow rate (mL/min)

C= Osmolar Clearance ( [U]x V/ [P])

75
Q

What is the Free Water Clearance when urine is isoosmotic to plasma ?

A

0

If you work through the equation where Osmolar Clearance (Cosm) is ( [U]x V/ [P]). If [U] and [P] are the same then you are left with V = Cosm

C(H20) = V - Cosm , and since Cosm =V you get 0

75
Q

What is the Free Water Clearance when urine is isoosmotic to plasma ?

A

0

If you work through the equation where Osmolar Clearance (Cosm) is ( [U]x V/ [P]). If [U] and [P] are the same then you are left with V = Cosm

C(H20) = V - Cosm , and since Cosm =V you get 0

76
Q

What is the Free Water Clearance of Urine that is Hypoosmotic to plasma ?

A

C(H20) is greater than 0 (if you plug the numbers in and solve for Cosm you will see it is less than V .

LOW ADH

76
Q

What is the Free Water Clearance of Urine that is Hypoosmotic to plasma ?

A

C(H20) is greater than 0 (if you plug the numbers in and solve for Cosm you will see it is less than V .

LOW ADH

77
Q

What is the Free Water Clearance of Urine that is Hyperosmotic to plasma ?

A

C(H20) is negative since Cosm will be greater than V .

High ADH

77
Q

What is the Free Water Clearance of Urine that is Hyperosmotic to plasma ?

A

C(H20) is negative since Cosm will be greater than V .

High ADH

78
Q

What is the effect of PTH on Phosphate reabsorption in the kidney ?

A

Decreases it

78
Q

What is the effect of PTH on Phosphate reabsorption in the kidney ?

A

Decreases it

79
Q

What kind of G-protein is associated with the ADH V2 receptor ?

A

Gs… Leads to an increase in cAMP and the up regulation of aquaporin II

79
Q

What kind of G-protein is associated with the ADH V2 receptor ?

A

Gs… Leads to an increase in cAMP and the up regulation of aquaporin II

80
Q

What actions does Aldosterone have on the kidneys ?

A

Increases ENaC channels for Na+ Reabsorption

Stimuluates K+ secretion

Increases H+ secretion ( leading to metabolic alkalosis which causes further K+ Secretion)

80
Q

What actions does Aldosterone have on the kidneys ?

A

Increases ENaC channels for Na+ Reabsorption

Stimuluates K+ secretion

Increases H+ secretion ( leading to metabolic alkalosis which causes further K+ Secretion)

81
Q

Describe the Role of Atrial Naturetic Pepetide

A

Released in response to increased stretch in the atria.

Decreases Na+ reabsorption, increases GFR ( dilating the afferent arteriole via cGMP ? )

81
Q

Describe the Role of Atrial Naturetic Pepetide

A

Released in response to increased stretch in the atria.

Decreases Na+ reabsorption, increases GFR ( dilating the afferent arteriole via cGMP ? )

82
Q

What is the effect of Angiotensin II on the proximal tubule ?

A

Leads to an increased Na/H+ exchange (anti-port) and increases Na reabsorption

82
Q

What is the effect of Angiotensin II on the proximal tubule ?

A

Leads to an increased Na/H+ exchange (anti-port) and increases Na reabsorption

83
Q

What is the major ‘volatile’ acid produced in the body and what enzyme creates it ?

A

CO2

Carbonic Anhydrase .

83
Q

What is the major ‘volatile’ acid produced in the body and what enzyme creates it ?

A

CO2

Carbonic Anhydrase .

84
Q

What is the main extracellular buffer ?

A

HCO3 (pK of 6.1)

84
Q

What is the main extracellular buffer ?

A

HCO3 (pK of 6.1)

85
Q

List a minor extracellular buffer ?

A

Phosphate (pK of 6.8)

85
Q

List a minor extracellular buffer ?

A

Phosphate (pK of 6.8)

86
Q

List major intracellular buffers ?

A

Organic Phosphates

Proteins ( Hemoglobin and Deoxyhemoglobin)

86
Q

List major intracellular buffers ?

A

Organic Phosphates

Proteins ( Hemoglobin and Deoxyhemoglobin)

87
Q

Is there a net secretion of H+ in the proximal tubule when Na/H+ anti port leads to HCO3- reabsorption ?

A

NO!

The H+ will then bind with FILTERED HCO3 and dissociate to CO2 and H20 . So in essence only HCO3 is reabsorbed while H+ Is not secreted.

87
Q

Is there a net secretion of H+ in the proximal tubule when Na/H+ anti port leads to HCO3- reabsorption ?

A

NO!

The H+ will then bind with FILTERED HCO3 and dissociate to CO2 and H20 . So in essence only HCO3 is reabsorbed while H+ Is not secreted.

88
Q

What will the effect of increased PCO2 be on HCO3 reabsorption ?

A

Increased PCO2 leads to increased reabsorption of HCO3

PC02 will go into the tubular cell, be converted to HCO3 and H+ . HCo3 will be reabsorbed, H+ will go into the lumen and bind a filtered HCO3 leading, bruch border CA will lead to CO2 + H20 and the process starts again.

88
Q

What will the effect of increased PCO2 be on HCO3 reabsorption ?

A

Increased PCO2 leads to increased reabsorption of HCO3

PC02 will go into the tubular cell, be converted to HCO3 and H+ . HCo3 will be reabsorbed, H+ will go into the lumen and bind a filtered HCO3 leading, bruch border CA will lead to CO2 + H20 and the process starts again.

89
Q

What is the effect of ECF volume on HCO3 reabsorption ?

A 
Expansion = less reabsorption
Contraction= More Reabsorption

has to do with RPF. Will be increased with Expansion leading to less time for reabsorption.

89
Q

What is the effect of ECF volume on HCO3 reabsorption ?

A 
Expansion = less reabsorption
Contraction= More Reabsorption

has to do with RPF. Will be increased with Expansion leading to less time for reabsorption.

90
Q

How are fixes H+ ions excreted ?

A

As NH4+ or Titratable acids (H2P04)

THIS RESULTS IN NET SECRETION OF H+ AND NET REABSORPTION OF HCO3-

90
Q

How are fixes H+ ions excreted ?

A

As NH4+ or Titratable acids (H2P04)

THIS RESULTS IN NET SECRETION OF H+ AND NET REABSORPTION OF HCO3-

91
Q

Describe the Excretion of H+ as H2PO4

A

THIS RESULTS IN NET SECRETION OF H+ AND NET REABSORPTION OF HCO3-

91
Q

Describe the Excretion of H+ as H2PO4

A

THIS RESULTS IN NET SECRETION OF H+ AND NET REABSORPTION OF HCO3-

92
Q

What hormone increases the activity of the H+ ATPase that is responsible for moving H+ into the lumen where it combines with HPO4 ?

A

Aldosterone !!!

Remember, aldosteone increases H+ secretion which helps make the body alkalotic so that K+ is also excreted.

92
Q

What hormone increases the activity of the H+ ATPase that is responsible for moving H+ into the lumen where it combines with HPO4 ?

A

Aldosterone !!!

Remember, aldosteone increases H+ secretion which helps make the body alkalotic so that K+ is also excreted.

93
Q

How is NH3 synthesized ?

A

In the renal cells from Glutamine

93
Q

How is NH3 synthesized ?

A

In the renal cells from Glutamine

94
Q

What kind of breathing is seen with metabolic acidosis ?

A

Kussmaul (Deep rapid breathing.)… Respiratory compensation for metabolic acidosis

94
Q

What kind of breathing is seen with metabolic acidosis ?

A

Kussmaul (Deep rapid breathing.)… Respiratory compensation for metabolic acidosis

95
Q

Anion Gap

A

Na+ - (Cl- + HCO3-)

Gap represents unmeasured anions (phosphate, citrate, sulfate, protein)

Normal value of 12 mEq/L

95
Q

Anion Gap

A

Na+ - (Cl- + HCO3-)

Gap represents unmeasured anions (phosphate, citrate, sulfate, protein)

Normal value of 12 mEq/L

96
Q

What is the site of action for Carbonic Anhydrase inhibitors ? Main Action ?

A

Proximal tubule

Increase filtered HCO3 excretion (since H+ will not produced within the cell and secreted into the lumen, there is less H+ to bind HCO3 . Also, Carbonic ANhydrase in the brush border is inhibited so, you will not be able to make H20 and CO2 from lumenal H2C03.

Ex. Acetazolamide

96
Q

What is the site of action for Carbonic Anhydrase inhibitors ? Main Action ?

A

Proximal tubule

Increase filtered HCO3 excretion (since H+ will not produced within the cell and secreted into the lumen, there is less H+ to bind HCO3 . Also, Carbonic ANhydrase in the brush border is inhibited so, you will not be able to make H20 and CO2 from lumenal H2C03.

Ex. Acetazolamide

97
Q

What is the site of action for Loop diuretics ? Main Action ?

A

TALH at the NCCK

Increases the osmoarity of the tubular fluid leading to H20 reabsorption down the line.

Also, Ca++ will not be reabsorbed since Na+ reabsorption is nixed.

Also increases K+ excretion

Ex. Furosemide, Ethacrynic Acid

97
Q

What is the site of action for Loop diuretics ? Main Action ?

A

TALH at the NCCK

Increases the osmoarity of the tubular fluid leading to H20 reabsorption down the line.

Also, Ca++ will not be reabsorbed since Na+ reabsorption is nixed.

Also increases K+ excretion

Ex. Furosemide, Ethacrynic Acid

98
Q

What is the site of action for Thiazide Diuretics ? Main Action ?

A

Early Distal Convoluted Tubule, Na/Cl- Symport.

Main job is to increases excretion of Na and Cl-
Can help increase the reabsorption of Ca++
Also, increases K+ secretion

Ex. Hydrochlorothiazide, Chlorothiazide.

98
Q

What is the site of action for Thiazide Diuretics ? Main Action ?

A

Early Distal Convoluted Tubule, Na/Cl- Symport.

Main job is to increases excretion of Na and Cl-
Can help increase the reabsorption of Ca++
Also, increases K+ secretion

Ex. Hydrochlorothiazide, Chlorothiazide.

99
Q

What is the site of action for K+ Sparring Diuretics ? Main Action ?

A

Late distal tubule and collecting duct

Spironolactone : direct inhibitor of Aldosterone

AMilioride: act on the principal cells to increases Na+ secretion while preserving K+

99
Q

What is the site of action for K+ Sparring Diuretics ? Main Action ?

A

Late distal tubule and collecting duct

Spironolactone : direct inhibitor of Aldosterone

AMilioride: act on the principal cells to increases Na+ secretion while preserving K+

Board Review: Physiology (5 decks)

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