fluid-electrolyte physiology

Question 1

4 ways to measure protein in urine

Answer 1

1. single urine [prot]
2. 24 hour clleciton
3. single urine protein/cr ratio
4. sinle urine albumin/Cr ratio

Question 2

what is urine [prot}

Answer 2

amount of protein in urine/urine vol.

Question 3

what is prob with measuring [prot.]

Answer 3

depends on dilution of urine

Question 4

what is adv. of 24hr collection

Answer 4

not dependant on fluid levels

Question 5

what is large amount of protenuria

Answer 5

> 3.5g per day

Question 6

what is a backup measure to assess [prot.]

Answer 6

also measure Cr and see if theres is a difference in the ratio

Question 7

what is path through the tubule

Answer 7

PCT>DLOH>ALOH>DCT>CCD>MCD

Question 8

why is so much water filtered if need to reabsorb

Answer 8

need to filter out all the dirty garbage

Question 9

how is Na taken out of tubule

Answer 9

Na/K ATPase take Na out of epithelium and this then diffiuses into epithelium from tubule

Question 10

3 main functions of proximal tubule

Answer 10

1. bulk reabsorb of Na (80%)
2. reabsorb other filtered “desirables” (H2O, Cl, glucose)
3. acid base balance (reabsorb HCO3-

Question 11

how is glucose reabsorbed with Na?

Answer 11

1. from tubule into epi cell via SGLT transported

2. from cell to cap. via GLUT2 transporter

Question 12

how is urea reabsorbed

Answer 12

as small [urea] becomes greater because Na and H2O are being reabsorbed there created a [c] gradient and the urea is reabsorbed too

Question 13

what is special about asc. LOH

Answer 13

water impermiable

Question 14

what does ALOH do?

Answer 14

reabsorbed Na (10%)

Question 15

how is Na reabsorbed in ALOH

Answer 15

1. Na/K ATPase pull Na into cap
2. Na,K,2Cl trasnporter pushes K back into tubule
3. high [K] creates a potential that pushes other cations back into cap

Question 16

what is consequence of ALOH action

Answer 16

low Na at end and so fluid is dilute

Question 17

3 functions of DCT

Answer 17

1. reabsorbes NaCl (5%)
2. impermeable to water
3. reabsorb Ca (via PTH)

Question 18

3 functions of Cort col duct

Answer 18

1. reabsorb Na (1-5%)
2. secrete K and H
3. reabsorb lots of H2O if ADH present

Question 19

how is H2O reabsorbed in CCT

Answer 19

1. Aldost. bind to cystolic receptor
2. enters nucleus and transcription changes
3. new proteins
4. inserts NaC channel in tubule wall
5. Na comes into cell
6. -ve charge left behind in tubule
7. push out K and H into tubule (urine) via charge

Question 20

what does MCT do?

Answer 20

1. water in if has ADH

2. small Na reabsorb

Question 21

how does ADH work

Answer 21

1. ADH binds to receptor on cell wall and uses cAMP messenger system to put aquaporin in tubule side of cell
2. water comes into cell and into cap.

Question 22

where is K absorbed

Answer 22

PCT - 65-70%
LOH - 30%
CCD - some can be excreted

Question 23

where is Ca absorbed

Answer 23

PCT - 65%
LOH - 25-30%
DCT - 5-10%

Question 24

what happens to glucose

Answer 24

1. filtered by glom

2. reabsorbed by PCT

Question 25

what are consequences of excess excretion of NA, K, H2O and H

Answer 25

Na- hypovolemia
K - hypokalemia
H20 - Hypernatrmia
H - metabolc alkalosis

Question 26

what are consequences of too little excretion of NA, K, H2O and H

Answer 26

Na- edema, hypertension
K - hyperkalemia
H20 - hyponatremia
H - metabolc acidosis

Question 27

what are 2 functions of bladder?

Answer 27

1. storage

2. voiding

Question 28

2 things that happen for bladder storage

Answer 28

1. detrusor relaxes

2. sphincters contract

Question 29

3 things that happen for voiding

Answer 29

1. bladder fills and sends signal
2. detrusor contracts
3. sphincters contract

Question 30

2 voiding probems

Answer 30

1. retention

2. incontinence

Question 31

2 issues that ifluence bladder problems

Answer 31

1. too little/much detrusor

2. too little/much sphincter