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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
What is Conn's disease
primary hyperaldosteronism | aldosterone secreting tumor in adreanl cortex
26
what is the net result of Conn's disease on K
hypokalemia because K secretion is inappropriately stimulated
27
What is Addison's disease
destruction of adrenals-- no secretion of aldosterone
28
what is the net result of addison's disease on K
hyperkalemia due to decreased K secretion in the collecting duct
29
When do we usually give loop diuretics
when patient is volume overloaded
30
What condition will cause osmotic diuresis without drugs
DM hyperlgycemia
31
what effect do osmotic diuretics have on nephron
work proximally and inhibit water and Na reabsorption so very concentrated urine. however downstream will absorb Na and thus lose K
32
What are carbonic anhydrase inhibitors used for
since they inhibit NaHCO3- reabsorption could cause metabolic acidosis used for altitude sickness
33
how do loop diuretics work
block Na K Cl cotransporter by competing for Cl
34
what is the result of loop diuretics
lessen water reabsorption in descending limb and medullary collecting duct
35
where do thiazed diuretics have their affect
DCT and inhibit Na Cl co transport
36
what is the result of thiazide diuretics
increase Na and Cl excretion as well as K
37
Where do K sparring diuretics have their effect
collecting duct inhibit Na reabsoprtion and K secretion
38
what are examples of potassium sparring diuretics
amiloride, triamterene, spironolactone (Aldosterone antagonist)
39
What is the role of EC Ca
dampen AP by blockin Na Channels | needed for neuromuscular transmission
40
low EC Ca can cause what
hypocalcemic tetany
41
which form of Ca is biologically active
free plasma 45% is bound to protein
42
What effect does high H+ levels have on Ca
compete for binding to proteins
43
acidemia would change Ca levels how | alkalosis?
increase free Ca | alkalosis would decrease free Ca
44
What organs determine EC Ca levels
GI tract kidneys bone
45
where is most Ca reabsorped
PT and TAL
46
How does Ca reabsorb in the PT in TAL
transcellular and paracellular
47
how does Ca reabsorb in the DT
transcellular only
48
what effects do loop diuretics have on Ca
decrease the paracellular reabsorption movement
49
What does Ca rely on for transcellular transport
Vit D dependend Ca bidning protein on tubular lumen side and a Ca ATPase and Ca/Na exchanger on basolateral side
50
where in the nephron is control of Ca levels regulated
in TAL and DT
51
what stimulates reaboprtion of Ca in nephron
PTH and Vit D and calcitonin
52
a decrease in plasma Ca stimulates what hormone
PTH
53
What other ion increases when trying to increase EC Ca levels
phosphate because when breaking down bone phosphate is also released
54
Where does most of phosphate get reabsorbed
in the PT and then some in DT
55
What does PTH inhibit
reabsorption of phosphate
56
hwo does phosphate get reabsorbed
Na/Pi co transport on tubular side | Pi/ weak acid tranport on basolateral side
57
the kinetics of phosphate reaboprtion can be describe how
saturable
58
What does PTH do to the Tm of phosphate
this is its maximum saturation for reabsorption so it decreases the Tm at any level
59
which forms is Mg found in plasma
majority is free Mg 20% complexed with inorganic small organic anions 20% bound to plasma proteins
60
where is majoirty of MG reabsorbed in nephron
TAL via paracellular
61
what affect do loop diuretics have on Mg reabsorption
decrease it

renal final (6 decks)

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