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PSIO 259 > Fluid and Electrolyte Balance > Flashcards

Fluid and Electrolyte Balance Flashcards

1
Q

Kidneys regulate:

A
  • solute and water content, which also determines volume

- acid-base balance

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2
Q

Composition is also affected by…

A

exchange between different compartments of body

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3
Q

Name some of the components of body.

A
  • cells
  • connective tissue
  • gastrointestinal tract
  • sweating
  • respiration
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4
Q

To maintain homeostasis, what comes in the body must eventually be:

A

used or excreted

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5
Q

Water intake + metabolically produced =

A

water output + water used

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6
Q

Name 2 ways to intake water.

A
  • gastrointestinal tract

- metabolism

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7
Q

Name 4 ways of water output.

A
  • insensible loss
  • sweating
  • gastrointestinal tract
  • kidneys
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8
Q

What is normovolemia?

A

normal blood volume

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9
Q

What is hypervolemia?

A

high blood volume due to positive water balance

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10
Q

What is hypovolemia?

A

low blood volume due to negative water balance

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11
Q

balance:

A

input + production = utilization + output

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12
Q

In the proximal tubule, ___% of filtered water is reabsorbed.

A

70%

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13
Q

the primary solute in the proximal tubules is

A

sodium

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14
Q

What is actively transported across the basolateral membrane and establishes gradient in the proximal tubule?

A

Na+

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15
Q

What is reabsorbed in the distal tubules and collecting ducts?

A

most remaining water

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16
Q

Water reabsorption in the distal tubules and collecting ducts are regulated by:

A
  • ADH (vasopressin)

- indirectly through aldosterone

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17
Q

Describe osmosis.

A
  • Water diffuses down the concentration gradient
  • Water moves from area of low solute concentration to area of high solute concentration
  • Water reabsorption follows solute reabsorption
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18
Q

Osmolarity of body fluids =

A

300 mOsm (milliosmoles of solute per liter of plasma)

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19
Q

No osmotic force for:

A

water to move between fluid compartments

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20
Q

Kidneys compensate for changes in osmolarity of extracellular fluid by…

A

regulating water reabsorption

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21
Q

Water reabsorption is a ____ process, and is based on ____ _____.

A
  • passive

- osmotic gradient

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22
Q

Principal cells deal with:

A
  • water

- electrolytes

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23
Q

Intercalated cells deal with:

A

acid-base balance

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24
Q

Osmolarity of interstitial fluid of renal medulla varies with _____.

A

depth

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25
Q

Lower osmolarity near _____.

A

cortex

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26
Q

Greater osmolarity near _____.

A

renal pelvis

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27
Q

_____ is critical to water reabsorption.

A

gradient

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28
Q

Fluid in proximal tubule = ____ mOsm

A

300 mOsm

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29
Q

Describe fluid in descending limb.

A
  • osmolarity increases as it descends
  • osmolarity = interstitial fluid
  • osmolarity > descending limb
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30
Q

Describe fluid in ascending limb.

A
  • osmolarity decreases as it ascends
  • osmolarity < interstitial fluid
  • osmolarity < descending limb
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31
Q

Urea is generated by _____.

A

liver

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32
Q

Urea eliminates ______.

A

nitrogen

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33
Q

Urea is _____ water soluble.

A

extremely

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34
Q

Urea requires:

A

urea transporters

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35
Q

Describe facilitated diffusion of urea.

A
  • collecting duct to capillaries

- makes up 40% of gradient

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36
Q

Transport of urea through UTA from filtrate to peritubular fluid approximately ___% of the osmolarity of the gradient.

A

40%

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37
Q

What is the vasa recta?

A
  • straight vessels-capillaries

- prevents diffusion of water and solutes from dissipating the medullary osmotic gradient

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38
Q

Describe the descending limb of vasa recta.

A
  • 300 mOsm

- as it descends, water leaves capillaries by osmosis and solutes enter by diffusion

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39
Q

Describe the ascending limb of vasa recta.

A
  • 325 mOsm
  • water moves into plasma and solutes move into interstitial fluid
  • osmolarity is higher due to the lack of urea transporters
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40
Q

____% of water reabsorbed in PCT and is ____ regulated.

A
  • 70%

- not regulated

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41
Q

____% of water reabsorbed in DCT and is regulated by ____.

A
  • 20%

- ADH

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42
Q

___% of water is reabsorbed in collecting ducts and is regulated by ____.

A
  • 10%

- ADH

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43
Q

Water reabsorption is dependent on:

A
  • gradient
  • permeability
  • length of Loop of Henle
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44
Q

How is water reabsorption dependent on gradient?

A

dependent on osmotic gradient established by countercurrent multiplier

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45
Q

How is water reabsorption dependent on permeability?

A
  • dependent on epithelium permeability to water

- water permeability dependent on water channels

46
Q

Aquaporin-3 is present in:

A

basolateral membrane always

47
Q

Aquaporin-2 is present in:

A

apical membrane only when ADH present in blood

48
Q

What happens when the membrane of late distal tubule and collecting duct is impermeable to water?

A
  • water cannot leave the tubules
  • no water reabsorption
  • more water is excreted in urine
49
Q

ADH stimulates:

A

the insertion of water channels (aquaporin-2) into apical membrane

50
Q

Water is reabsorbed by _____.

A

osmosis

51
Q

Maximum urine concentration is _____ mOsm.

A

1400 mOsm

52
Q

Maximum amount of water reabsorbed depends on:

A

length of loop of Henle

53
Q

Describe the regulation of ADH secretion.

A
  • Posterior pituitary (hypothalamus)
  • Osmoreceptors in the brain
  • Baroreceptors detecting BV/BP
  • ↓ baroreceptor activity = ↑ ADH secretion
54
Q

What is hypernatremia?

A

high plasma sodium

55
Q

What is hyponatremia?

A

low plasma socium

56
Q

What is the primary solute in ECF?

A

sodium

57
Q

Sodium is critical for:

A
  • normal osmotic pressure

- to function of excitable cells

58
Q

Na+ is _____ filtered.

A

freely

59
Q

Na+ is reabsorbed (___%) in:

A
  • 70%

- PCT, DCT, and collecting ducts

60
Q

There is ____ secretion of Na+.

A

no

61
Q

What regulates Na+ absorption?

A
  • aldosterone

- ANP

62
Q

What type of reabsorption does Na+ use?

A
  • active

- Na+/K+ pump drives reabsortpion

63
Q

Describe how aldosterone increases sodium reabsorption.

A
  • Steroid hormone secreted from adrenal cortex
  • Acts on principal cells of distal tubules and collecting ducts
  • Increases number of Na+/K+ pumps on basolateral membrane
  • Increases number of open Na+ and K+ channels on apical membrane
64
Q

What secretes renin?

A

granular cells of juxtaglomerular apparatus

65
Q

Capillary walls contain:

A
  • angiotensin-converting enzyme (ACE)

- especially in lungs

66
Q

Liver secretes:

A

angiotensinogen

67
Q

Angiotensinogen is converted by renin into ______.

A

angiotensin I

68
Q

Angiotensin I is converted by ACE into ______.

A

angiotensin II

69
Q

Angiotensin II stimulates:

A

aldosterone production

70
Q

The above system is called:

A

renin-angiotensin-aldosterone system (RAAS)

71
Q

What acts as stimuli for renin release?

A
  • Decreased pressure in afferent arteriole
  • Renal sympathetic nerve activity
  • Decreases in Na+ and Cl– in distal tubule filtrate
72
Q

Relationship between hormones have a ______ outcome.

A

similar

73
Q

What does ANP stand for?

A

atrial natriuretic peptide

74
Q

ANP opposes _____.

A

aldosterone

75
Q

ANP is secreted by:

A

atrial cells in response to distension of atrial wall

76
Q

ANP increases ____.

A

GFR

77
Q

An increase of GFR results in:

A
  • dilation of afferent arteriole
  • constriction of efferent arteriole
  • relaxes mesangial cells
  • decreases Na+ reabsorption by closing Na+ channels in apical membrane (increased Na+ excretion)
  • decreases sympathetic activity to the kidney inhibits renin secretion
  • washes out the medullary osmotic gradient (increased BF through vasa recta)
78
Q

What is hyperkalemia?

A

high plasma potassium

79
Q

What is hypokalemia?

A

low plasma potassium

80
Q

Potassium is crucial for:

A

function of excitable cells

81
Q

Glomerulus is _____ filtered.

A

freely

82
Q

Potassium in PCT is:

A

reabsorbed

83
Q

Potassium in DCT & collecting ducts are:

A

reabsorbed and secreted (regulated)

84
Q

What regulates secretion of potassium?

A
  • aldosterone
  • K+ in plasma directly stimulates aldosterone release
  • as K+ increases, more aldosterone is released
85
Q

___% of filtered calcium is reabsorbed.

A

99%

86
Q

70% of filtered calcium is reabsorbed in _____.

A

PCT

87
Q

19-20% of filtered calcium is reabsorbed in _______.

A

the loop of Henle (ascending limb)

88
Q

9-10% is reabsorbed in _____.

A

DCT

89
Q

Reabsorption in _____ and _____ is regulated (hormones).

A
  • loop of Henle

- DCT

90
Q

Blood calcium is bound to:

A

carrier proteins

91
Q

Ca2+ + protein =

A

Ca-protein

92
Q

Blood calcium is ____ in plasma.

A

free

93
Q

Free calcium:

A

freely filtered at glomerulus

94
Q

What is hypercalcemia?

A

high plasma calcium

95
Q

What is hypocalcemia?

A

low plasma calcium

96
Q

Why is calcium balance critical?

A
  • triggers exocytosis
  • triggers secretion
  • triggers muscle contraction
  • increases contractility of cardiac and smooth muscle
97
Q

Parathyroid hormone (PTH) is released from:

A

parathyroid glands

98
Q

What is the stimulus to release PTH?

A

decreased Ca2+ in plasma

99
Q

What does PTH do?

A
  • Increases Ca2+ reabsorption by kidneys
  • Stimulates activation of 1,25-dihydroxycholecalciferol in kidneys
  • Stimulates resorption of bone
  • Stimulates small increase in calcium absorption
  • Overall effect: increased blood calcium
100
Q

What is 1,25-(OH2)D3) or Cacitriol?

A

activated vitamin D3

101
Q

What produces vitamin D3?

A

skin/sunlight

102
Q

What converts vitamin D3 to inactive form?

A

liver

103
Q

Low plasma Ca2+ detected by PTH in ______.

A

kidneys

104
Q

PTH activates:

A

1,25-(OH2)D3) or Cacitriol

105
Q

1,25-(OH2)D3) or Cacitriol does what?

A
  • increased Ca2+ absorption in digestive tract

- Ca2+ reabsorption in kidneys

106
Q

What is the opposing hormone to PTH?

A

calcitonin

107
Q

Calcitonin is secreted by:

A

thyroid gland

108
Q

Calcitonin is triggered by:

A

high plasma [Ca2+]

109
Q

What actions does calcitonin have at target cells?

A
  • increases bone formation

- decreases Ca2+ reabsorption by kidneys

110
Q

Describe the physiological response to hemorrhage.

A
  • decrease in blood volume = decrease in MAP
  • neural control of heart and vasculature (baroreceptor reflex)
  • hormonal control of blood volume (ADH, RAAS)
111
Q

Why is exercise in the heat problematic?

A
  • excessive sweating (loss of fluid and electrolytes)
  • hypohydration or dehydration leads to reduction in aerobic performance by 7-60% (>2% of body mass)
  • renal tubule damage (excess metabolites/acids)
112
Q

Describe acclimatization.

A
  • better ability to reabsorb electrolytes
  • enhanced norepinephrine (NE) spillover increases erythropoiesis (replaces lost RBCs in urine and through hemolysis (muscle contraction/impact damage))

PSIO 259 (22 decks)

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