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Nephrology > Electrolytes > Flashcards

Electrolytes Flashcards

1
Q

Fractional excretion of a substance is the _

A

Fractional excretion of a substance is the percentage of the filtered load that gets excreted in the urine
* Ex: fractional excretion of Na is 1% because 99% of the filtered sodium is reabsorbed while only 1% is excreted in the urine

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2
Q

If a substance has a fraction excretion over 100% that means _

A

If a substance has a fraction excretion over 100% that means it is secreted in excess of filtration

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3
Q

Conditions that disrupt reabsorption such as diuretic use and kidney disease will _ the FE

A

Conditions that disrupt reabsorption such as diuretic use and kidney disease will increase the FE
* More of the solutes will end up excreted in the urine

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4
Q

Extrarenal fluid loss like diarrhea or shock (decreased renal blood flow) will _ the FE

A

Extrarenal fluid loss like diarrhea or shock (decreased renal blood flow) will decrease the FE

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5
Q

Paracellular transport involves water and solutes passing _

A

Paracellular transport involves water and solutes passing between renal tubular epithelial cells
* Must pass through thetight junctions (zonula occludens) which are selective to certain solutes but not others

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6
Q

The transport maximum is the _

A

The transport maximum is the maximum rate at which a solute can be reabsorbed and occurs when all transport proteins are saturated

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7
Q

The primary goal of the proximal tubule is _

A

The primary goal of the proximal tubule is massive reabsorption of filtered sodium, chloride, water, potassium, calcium, magnesium, phosphate, bicarbonate, glucose, and amino acids

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8
Q

The main purpose of the loop of henle is to _

A

The main purpose of the loop of henle is to concentrate the urine by creating a concentration gradient from the cortex to the inner medulla
* As water flows down the collecting duct, it can be reabsorbed as it flows past the increasingly concentrated interstitium

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9
Q

The Na+/glucose cotransporter gets saturated at _ mg/dL

A

The Na+/glucose cotransporter gets saturated at 200 mg/dL this is when glucose spills over into the urine
* Tm is ~350 mg/min
* Renal threshold is a concentration, transport maximum is a rate

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10
Q

Bicarbonate is reabsorbed as _ and _ on the apical side of the PCT

A

Bicarbonate is reabsorbed as H2O and CO2 on the apical side of the PCT

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11
Q

Bicarbonate is reabsorbed as _ and _ on the basolateral side of the PCT

A

Bicarbonate is reabsorbed as HCO3- and Na+ on the basolateral side of the PCT

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12
Q

Parathyroid hormone acts on the _ transporter in the PCT by (stimulating/blocking it)

A

Parathyroid hormone acts on the Na+/PO4 cotransporter in the PCT by blocking it
* Decreases the reabsorption of PO4 and Na+
* Causes phosphate to get excreted

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13
Q

Angiotensin II stimulates the activity of _ transporter in the PCT

A

Angiotensin II stimulates the activity of Na+/H+ exchanger in the PCT

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14
Q

What is the effect of Ang II’s stimulation on the PCT?

A

Increase in Na/H exchanger causes:
* Increase in Na+ reabsorption
* Increase in HCO3- reabsorption
* Increase in H2O reabsorption

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15
Q

Fanconi syndrome causes a metabolic (acidosis/alkalosis)

A

Fanconi syndrome causes a metabolic acidosis
* We can’t reabsorb HCO3- in the PCT

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16
Q

Fanconi syndrome can also cause _ serum phosphate and _ serum potassium

A

Fanconi syndrome can also cause low serum phosphate and low serum potassium

17
Q

The reabsorption of water in the thin descending loop of henle is (active/passive)

A

The reabsorption of water in the thin descending loop of henle is passive
* Driven by medullary hypertonicity

18
Q

The thick ascending loop of henle actively reabsorbs _

A

The thick ascending loop of henle actively reabsorbs Na, Cl, K
* Also allows the passive reabsorption of Mg and Ca

19
Q

Bartter syndrome is a reabsorption defect of the _ channel

A

Bartter syndrome is a reabsorption defect of the NKCC
* Autosomal recessive

20
Q

Explain why Bartter’s and loop diuretics can both cause a metabolic alkalosis

A

Both block the NKCC channel in the thick ascending loop –>
Leaves more Na+ in the tubule reaching the CD –>
Aldosterone tries to reabsorb Na+ at the expense of H+ which gets secreted

21
Q

Most nephron disorders are autosomal recessive; the exception is _

A

Most nephron disorders are autosomal recessive; the exception is Liddle syndrome

22
Q

The site of the lowest tubular osmolarity is the _

A

The site of the lowest tubular osmolarity is DCT
* Impermeable to H2O but Na, Cl, Mg, and Ca can get reabsorbed

23
Q

What effect does PTH have on the DCT?

A

PTH stimulates the Ca2+/Na+ exchanger in the DCT
* Increases Ca2+ reabsorption

24
Q

_ syndrome is a defect of the Na/Cl cotransporter in the DCT

A

Gitelman syndrome is a defect of the Na/Cl cotransporter in the DCT

25
Q

Mg2+ and Ca2+ move through the DCT (transcellularly/ paracellularly)

A

Mg2+ and Ca2+ move through the DCT transcellularly

26
Q

The function of the collecting duct is to reabsorb _

A

The function of the collecting duct is to reabsorb Na+ , H2O, and urea

27
Q

The collecting duct also functions to secrete _

A

The collecting duct also functions to secrete K+ and H+

28
Q

The primary site of Na+ reabsorption in the CD is in the _ cell

A

The primary site of Na+ reabsorption in the CD is in the principal cell

29
Q

The primary site of acid secretion and bicarb reabsorption in the CD is in the _ cell

A

The primary site of acid secretion and bicarb reabsorption in the CD is in the alpha intercalated cell

30
Q

The primary site of bicarb secretion and acid reabsorption in the CD is in the _ cell

A

The primary site of bicarb secretion and acid reabsorption in the CD is in the beta intercalated cell

31
Q

Liddle syndrome is a _ mutation

A

Liddle syndrome is a gain of function mutation in ENaC
* Causes an increase in Na+ reabsorption
* Causes metabolic alkalosis, hypertension, hypokalemia

32
Q

Syndrome of apparent mineralocorticoid excess is a loss of function mutation of _ enzyme

A

Syndrome of apparent mineralocorticoid excess is a loss of function mutation of 11B-HSD
* Can’t convert cortisol –> cortisone
* Increases cortisol and decreases aldosterone
* Cortisol still causes the same effects as aldosterone because it can bind to aldosterone’s receptors

33
Q

ADH binds to _ receptors, causes a release of vesicles, and adds aquaporin channels to apical membrane

A

ADH binds to V2 receptors, causes a release of vesicles, and adds aquaporin channels to apical membrane

Nephrology (16 decks)

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