Exam 2: Lecture 33 Flashcards

1
Q

What is the most important function of the kidneys?

A

Reabsorption of sodium

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2
Q

Which compartment (ICF/ECF) does sodium control the volume of?

A

ECF

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3
Q

If the daily Na+ balance is positive, what is the effect on the blood pressure?

A

Increase BP

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4
Q

If the daily Na+ balance is negative, what is the effect on the blood pressure?

A

Decrease BP

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5
Q

Define Na+ content.

A

Absolute amount (g or Kg Na+)

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6
Q

Define Na+ concentration.

A

Amount of Na+ and volume of H2O

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7
Q

Where does most of the Na+ reabsorption occur in the nephron?

A

In the Proximal convoluted tubule

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8
Q

Which part of the nephron is about 25% of filtered Na+ is reabsorbed?

A

In the thick ascending limb

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9
Q

Which structure(s) is responsible for fine tuning the amount of Na excreted in urine?

A

Distal tubule and collecting ducts

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10
Q

What solutes is Na reabsorbed with in the early PCT?

A

Bicarbonate, glucose, and AA’s

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11
Q

What solutes is Na reabsorbed with in the late PCT?

A

Cl

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12
Q

What does it mean that the reabsorption of filtered Na+ in the PCT is isosmotic?

A

Na+ and water are reabsorbed together

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13
Q

On the luminal membrane of the early PCT what is the one counter-transporter mechanism used for Na+ reabsorption?

A

H+/Na+ co-transporter

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14
Q

The H+/Na+ co-transporter also contributes to reabsorption of what?

A

Bicarbonate

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15
Q

By the mid-PCT, how much filtered glucose and aa’s are reabsorbed?

A

100%

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16
Q

What is cystinosis?

A

accumulation of aa cystine within cells

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17
Q

What values would you use to diagnose Fanconi syndrome?

A

High glucose, aa, and phosphates in urine

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18
Q

The fluid entering the late PCT is high in (Cl/Na)?

A

Cl

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19
Q

What force drives NaCl absorption in the late PCT?

A

High tubular fluid Cl concentration

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20
Q

What two exchangers are used for late PCT Na+ reabsorption through the cellular route?

A

Na+/H+ exchanger
Cl-/formate exchanger

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21
Q

How is Na+ reabsorbed in the late PCT through the paracellular route?

A

Through tight junctions - Cl diffuses, followed by Na+

22
Q

Folute reabsorption is ___________ event, water follows ____________.

A

Primary, passively

23
Q

Isosmotic fluid between cells is pulled into the capillary by what pressure?

A

Increased oncotic pressure of capillaries

24
Q

During isosmotic reabsorption of Na and water in the PCT, what is the relationship between the solute and water?

A

They are reabsorbed coupled and proportional to eachother.

25
Q

What is the major regulatory mechanism in PCT to ensure that a constant fraction of filtered load is reabsorbed?

A

Glomerulotubular balance

26
Q

What is the mechanism of glomerulotubular balance?

A

If filtration fraction increases, the oncotic pressure in peritubular capillaries increases - reabsorption increases

27
Q

How does the volume expansion in the ECF affect fractional reabsorption in PCT?

A

Decreases reabsorption

28
Q

How does the volume contraction in the ECF affect fractional reabsorption in PCT?

A

Increases reabsorption

29
Q

If the ECF volume decreases what system is activated to try and offset this?

A

RAAS is activated

30
Q

In what area of the PCT is Na+ mostly reabsorbed with Cl-?

A

Late PCT

31
Q

The thin descending limb is permeable to what?

A

Reabsorption of water and secretion of small salutes

32
Q

In the thin descending limb, water moves (in/out) and small solutes move (in/out)

A

out, in

33
Q

Thin ascending limb is permeable to _________________ but impermeable to ______________________.

A

reabsorption of NaCl; reabsorption of water

34
Q

The thick ascending limb reabsorbs about how much Na+?

A

25%

35
Q

T/F: In the thick ascending limb, the more Na+ delivered the more is reasbsorbed.

A

True - this is called load dependent

36
Q

That transporter is used in the TAL for Na+ reabsorption?

A

Na+/2Cl/K+ co-transporter

37
Q

What are of the Loop of Henle is the target for many loop diuretics such as furosemide?

A

Thick ascending limb

38
Q

How does furosemide work on the TAL cell?

A

Blocks Na+ reabsorption by binding to the Cl- portion of co-transporter

39
Q

What two structures of the nephron are combined to form the terminal nephron?

A

Distal tubule and collecting ducts

40
Q

Is there reabsorption of water in the distal tubule?

A

No - the DT is impermeable to reabsorption of water

41
Q

Which type of drug inhibits the co-transporter on the early DT?

A

Thiazide diuretics

42
Q

What are the two main cell types in the late DT and collecting duct?

A
  • principal cells
  • alpha-intercalated cells
43
Q

What occurs in principle cells?

A

Na reabsorption and K secretion

44
Q

What occurs in alpha-intercalated cells?

A

K reabsorption and H secretion

45
Q

About how much filtered Na+ is reabsorbed in the terminal nephron?

A

3% - fine tuning of final Na+ excretion

46
Q

Which cells is the Na+ reabsorption hormonally regulated?

A

Principe cells of late DT and CD

47
Q

What is the effect of aldosterone on Na+ reabsorption in the principal cells of late DT and CD?

A

Increases Na+ reabsorption - increase the number of Na channels and activity of Na/K ATPase

48
Q

How does the K+ sparing diuretic spironolactone inhibit Na reabsorption?

A

Inhibits aldosterone effects

49
Q

What is the effect on the renal system of SNS activity on baroreceptors responding to a decrease in BP?

A

Causes vasoconstriction of afferent arterioles

50
Q

What is the renal effects of an increase in ANP?

A

Vasodilation of afferent arterioles, vasoconstriction of efferent: Increase GFR, decrease Na reabsorption