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renal final > K. Ca, Mg PO4 > Flashcards

K. Ca, Mg PO4 Flashcards

1
Q

what hormone promotes K secretion

A

aldosterone

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2
Q

what is the normal range of K

A

3.5-5

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3
Q

what can yo see on ECG with progressive hyperkalemia

A

high T wave
prolonged PR with high T wave
atrial standstill
ventricular fibrillation

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4
Q

what can you see on ECG with progressive hypokalemia

A

low T wave
Low T wave and high U wave
Low T wave, high U wave, low ST

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5
Q

What promotes K movement into cells from ECF

A

hyperkalemia
alkalemia
B adrenergic agnoists
Insulin

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6
Q

What promotes K movement out of cells into ECF

A 
hypokalemia
acidemia
hyperosmolarity
ischemia
alpha adrenergic agonists
heavy exercise
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7
Q

Where is majority of K reabsorbed

A

proximal tubule

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8
Q

where is the next are where K reabsorption takes place

A

TAL via Cl,K,Na cotransporter

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9
Q

where is physiological control of K concentration

A

in the collecting duct

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10
Q

what cells are responsible for control of K

A

the principal cells

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11
Q

how does dietary depletion compare in the nephron to dietary increased intake of K

A

depletion has reabsorption at all places in nephron

increased has secretion at DT and CCD

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12
Q

what is the main driving force for K secretion in collecting tubules

A

the Na/K ATPase on basolateral side increase K intracell and the tubular lumen is negative charged so goes down its gradient

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13
Q

What are the 5 factors that affect K secretion in collecting duct

A 
extracellular K
Na reabsorption (negative charge in lumen)
luminal fluid flow rate
Extracellular pH
aldosterone
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14
Q

what affect does an increase in ECF K concentration have on K secretion

A

increases

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15
Q

What affect does an increase in Na reabsoprtion have on K secretion

A

increases because negative lumen charge difference

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16
Q

what affect does increase luminal flow have on secretion of K

A

increased because dilutes rapidly what was previously secreted to allow for more

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17
Q

what does an decrease in EC pH have on K secretion

A

excrete H so take in K to keep electroneutral

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18
Q

what affect does inreased aldosterone have on K

A

stimulates K secretion

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19
Q

What do most diuretics that act on early parts of nephron do to K

A

cause an increase in K due to Na reabsorption so could lead to hypokalemia

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20
Q

What could a low Na diet change in K concentration

A

less Na delivery to DT so there would be less K secretion and could lead to hyperkalemia

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21
Q

Does Na amount delivery to DT have little or big affects on K secretion

A

huge effects

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22
Q

The more alkalotic the blood what happens with K

A

so want to retain H so will secrete more K

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23
Q

what hormone is released when senses hyperkalemia

A

aldosterone

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24
Q

how does aldosterone stimulate K secretion

A

more Na/K ATPase

Insertes K and Na channels on luminal side

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25
Q

What is Conn’s disease

A

primary hyperaldosteronism

aldosterone secreting tumor in adreanl cortex

26
Q

what is the net result of Conn’s disease on K

A

hypokalemia because K secretion is inappropriately stimulated

27
Q

What is Addison’s disease

A

destruction of adrenals– no secretion of aldosterone

28
Q

what is the net result of addison’s disease on K

A

hyperkalemia due to decreased K secretion in the collecting duct

29
Q

When do we usually give loop diuretics

A

when patient is volume overloaded

30
Q

What condition will cause osmotic diuresis without drugs

A

DM hyperlgycemia

31
Q

what effect do osmotic diuretics have on nephron

A

work proximally and inhibit water and Na reabsorption so very concentrated urine.
however downstream will absorb Na and thus lose K

32
Q

What are carbonic anhydrase inhibitors used for

A

since they inhibit NaHCO3- reabsorption could cause metabolic acidosis
used for altitude sickness

33
Q

how do loop diuretics work

A

block Na K Cl cotransporter by competing for Cl

34
Q

what is the result of loop diuretics

A

lessen water reabsorption in descending limb and medullary collecting duct

35
Q

where do thiazed diuretics have their affect

A

DCT and inhibit Na Cl co transport

36
Q

what is the result of thiazide diuretics

A

increase Na and Cl excretion as well as K

37
Q

Where do K sparring diuretics have their effect

A

collecting duct inhibit Na reabsoprtion and K secretion

38
Q

what are examples of potassium sparring diuretics

A

amiloride, triamterene, spironolactone (Aldosterone antagonist)

39
Q

What is the role of EC Ca

A

dampen AP by blockin Na Channels

needed for neuromuscular transmission

40
Q

low EC Ca can cause what

A

hypocalcemic tetany

41
Q

which form of Ca is biologically active

A

free plasma 45% is bound to protein

42
Q

What effect does high H+ levels have on Ca

A

compete for binding to proteins

43
Q

acidemia would change Ca levels how

alkalosis?

A

increase free Ca

alkalosis would decrease free Ca

44
Q

What organs determine EC Ca levels

A

GI tract
kidneys
bone

45
Q

where is most Ca reabsorped

A

PT and TAL

46
Q

How does Ca reabsorb in the PT in TAL

A

transcellular and paracellular

47
Q

how does Ca reabsorb in the DT

A

transcellular only

48
Q

what effects do loop diuretics have on Ca

A

decrease the paracellular reabsorption movement

49
Q

What does Ca rely on for transcellular transport

A

Vit D dependend Ca bidning protein on tubular lumen side and a Ca ATPase and Ca/Na exchanger on basolateral side

50
Q

where in the nephron is control of Ca levels regulated

A

in TAL and DT

51
Q

what stimulates reaboprtion of Ca in nephron

A

PTH and Vit D and calcitonin

52
Q

a decrease in plasma Ca stimulates what hormone

A

PTH

53
Q

What other ion increases when trying to increase EC Ca levels

A

phosphate because when breaking down bone phosphate is also released

54
Q

Where does most of phosphate get reabsorbed

A

in the PT and then some in DT

55
Q

What does PTH inhibit

A

reabsorption of phosphate

56
Q

hwo does phosphate get reabsorbed

A

Na/Pi co transport on tubular side

Pi/ weak acid tranport on basolateral side

57
Q

the kinetics of phosphate reaboprtion can be describe how

A

saturable

58
Q

What does PTH do to the Tm of phosphate

A

this is its maximum saturation for reabsorption so it decreases the Tm at any level

59
Q

which forms is Mg found in plasma

A

majority is free Mg
20% complexed with inorganic small organic anions
20% bound to plasma proteins

60
Q

where is majoirty of MG reabsorbed in nephron

A

TAL via paracellular

61
Q

what affect do loop diuretics have on Mg reabsorption

A

decrease it

renal final (6 decks)

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