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URN Biweekly 2 > Disorders of K+ Metabolism- Bessette > Flashcards

Disorders of K+ Metabolism- Bessette Flashcards

1
Q

_____ is found intracellular and mainly in muscles

A

K+

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2
Q

2 mechanisms of K+ balance:

A

transcellular shifts
regulation from kidneys and intestines

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3
Q

freely filtered and then reabsorbed in PCT and loop of henle

A

K+

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4
Q

distal delivery of Na+ and water, and MR activity determine what

A

K+ secretion

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5
Q

65-70% K+ reabsorbed here

A

PCT

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6
Q

driven by concentration gradient initiated by Na+ and H2O

A

K+ reabsorption in PCT

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7
Q

2 transporters of TAL that K+ is involved in

A

NKCC2
ROMK

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8
Q

fine tuning of K+ homeostasis starts here

A

early DCT

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9
Q

what 2 transporters of early DCT provide basis of transport for Na+, Cl-, Ca2+, and Mg2+ into and out of lumen

A

NCC
Na+/K+ ATPase

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10
Q

increased plasma [K+] does what to NCC activity

A

decreases it

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11
Q

decreased plasma [K+] does what to NCC activity

A

increases it

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12
Q

these cells reabsorb Na+ (ENaC) and water and secrete K+ through ROMK

A

principal cells

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13
Q

these cells secrete H+ and reabsorb K+ and HCO3-

A

alpha intercalating cells (respond to acidosis)

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14
Q

if lumen [K+] is high, what happens to K+

A

more will be reabsorbed

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15
Q

if intracellular [K+] is high, what happens

A

more K+ secretion and decreased absorption

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16
Q

ENaC brings Na+ in, more - on lumen side, what happens to K+

A

secreted into lumen

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17
Q

more water flow, more flush out, more ______ goes out

A

K+

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18
Q

why can a patient on ARBs experience hyperkalemia

A

aldosterone not binding to MR; less K+ being secreted through ROMK

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19
Q

RAAS disruption can cause what to K+

A

hyperkalemia

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20
Q

binds MR; increases # of ENaC channels
increases ROMK channels
activates Na+/K+ ATPase

A

Aldosterone

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21
Q

secrete HCO3- and K+; H+ reabsorption

A

beta intercalated cells (responding to alkalosis)

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22
Q

secrete H+; reabsorb HCO3- and K+

A

alpha intercalated cells (in response to acidosis)

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23
Q

what happens in a low K+ diet

A

body wants to secrete less of K+
(more reabsorption of K+)

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24
Q

in a high K+ diet what happens

A

intercalated cells increase K+ secretion
aldosterone increased; more K+ secretion (principal cells)

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25
Q

ability of the kidney to stimulate NaCl retention w/ minimal K+ secretion during hypovolemia

A

aldosterone paradox

26
Q

ability of kidney to maximize K+ secretion without Na+ retention in hyperkalemia

A

aldosterone paradox

27
Q

what happens at alpha intercalated cells in response to acidosis

A

H+ secreted; HCO3- and K+ reabsorbed

28
Q

what happens at beta intercalated cells during alkalosis

A

secrete HCO3- and K+ and reabsorb H+

29
Q

what controls extra-renal K+ homeostasis

A

insulin and catecholamines

30
Q

what does insulin do to K+

A

stimulates Na+/K+ ATPase and puts K+ into cell

31
Q

what happens in patient after K+ containing meal who has uncontrolled diabetes type 1 and doesn’t have insulin

A

increase in extracellular K+ (hyperkalemia) b/c no insulin to bring it into cell

32
Q

____-adrenergic receptors impair cellular entry of K+ into cells

A

alpha

33
Q

____-adrenergic receptors promote cellular entry of K+ into cells

A

beta

34
Q

beta 2 adrenergic receptor agonist

A

Albuterol

35
Q

_____ released during exercise limits amount of K+ in interstitial space

A

catecholamines

36
Q

_____ moves K+ to interstitial space in skeletal muscle

A

exercise

37
Q

______when [H+] in blood decreases; H+ leaves cell into blood and K+ enters cell

A

alkalemia

38
Q

_____when [H+] in blood increases; H+ moves into cell and K+ leaves cell into blood

A

acidemia

39
Q

mineral acidosis of skeletal muscle causes what to happen to K+

A

increase in serum [K+]

40
Q

organic acidosis of skeletal muscle causes what to happen to K+

A

no change in serum [K+]

41
Q

hyper-osmolarity of ECF space causes what to happen to water and K+

A

water flows into space and brings K+ with it; cell shrinkage (movement out of cell into ECF space)

42
Q

patient with this disease has a hard time handling K+

A

chronic kidney disease

43
Q

increase in K+ intake=_______ bp

A

lower bp

44
Q

K+ deficiency (less ROMK channels); more ____ reabsorption and higher bp

A

Na+

45
Q

all interrupt RAAS and lead to less K+ secretion (causing hyperkalemia)

A

ACEIs/ARBs and NSAIDs

46
Q

these 2 things lead to hypokalemia (deals with aldosterone—hint)

A

primary and secondary aldosteronism

47
Q

K+ loss or low intake or intracellular shift of K+

A

hypokalemia

48
Q

3 main causes of hypokalemia

A

cellular shifts
GI loss
urinary K wasting

49
Q

alkalosis
insulin
beta agonist
hyperaldosteronism

A

lead to hypokalemia

50
Q

vomiting and diarrhea lead to what

A

hypokalemia

51
Q

diuretics
Bartter syndrome
Gitelman syndrome

A

lead to hypokalemia

52
Q

weakness, fatigue, confusion, alkalosis

A

hypokalemia

53
Q

high U wave on ECG

A

hypokalemia

54
Q

3 main causes of hyperkalemia

A

cellular shifts
increased intake
less K+ excretion

55
Q

extra renal metabolic acidosis causes what to happen to K+

A

H+ from blood into cell and K+ out of cell into blood (hyperkalemia)

56
Q

muscle twitches, cramps, abd cramping

A

hyperkalemia

57
Q

peaked T wave on ECG

P wave flattening

PR elongation

Wide QRS’s

A

hyperkalemia

58
Q

seen in patients with leukocytosis or thrombocytosis; falsely elevated K+ in serum

A

pseudohyperkalemia

59
Q

elevates serum K+ but no plasma K+ (pseudohyperkalemia)

A

thrombocytosis

60
Q

insulin
aldosterone
dietary restriction

A

treat hyperkalemia

61
Q

CKD increases RAAS (and vice versa CKD can lead to HTN and HTN can lead to CKD) and what happens to K+

A

more aldosterone and more K+ secretion

62
Q

how does diabetic nephropathy lead to hyperkalemia

A

no/dysfunctional insulin unable to bring K+ into cells; and also damage to kidney function being able to secrete K+; and hyperglycemia causes water and K+ to flow into blood

URN Biweekly 2 (15 decks)

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