Kidney Regulation

Question 1

2.4 mmEq/L

Answer 1

Serum Calcium

TIGHTLY regulated by PTH in the distal tubule

Question 2

1200 mOsm/L

Answer 2

MAX urine Osmolarity

Maximum concentrating ability

Question 3

Osmotic Diuretics

Answer 3

Mannitol, Urea, Glucose, Sucrose

Proximal Tubule - Inhibit 1st half Na+ transporters by saturating Tm

Question 4

Na+ Channel Antagonists

Answer 4

Directly block ENaC channels in late distal tubule and cortical collecting duct

Amiloride, Triamterene

Question 5

500-600 mOsm/day

Answer 5

Obligatory solute loss

Generally the quantity we consume each day. Except holy crap Americans eat 4x that amount…

Question 6

Exercise

Answer 6

Hyperkalemia

Question 7

Acetazolamide

Answer 7

Carbonic Anhydrase Inhibitor

Proximal Tubule - inhibits reabsorption of HCO3- and H+ secretion

Question 8

Pre-Renal Failure

Answer 8

Generally secreting LESS sodium

BUN/Cr >20
Urine Osmolarity >500
Urinary Na < 20

BUN increases in pre-renal failure because urea gets reabsorbed with the Na+ retention

Question 9

10 mmHg

Answer 9

A good value for Peritubular capillaries

Question 10

Cell Lysis

Answer 10

Hyperkalemia

Question 11

Write GFR equation (2 of them)

Answer 11

GFR = Cr Clearance

GFR = Kf * Capillary Equation

Question 12

Hypoaldosteronism

Addison’s

Answer 12

Decreased K+ Secretion

i.e. Hyperkalemia, also decreased BP

Question 13

ADH Inhibitors

Answer 13

Alcohol, Clonidine, Haloperidol

Lose Water

Question 14

Insulin Deficiency

Answer 14

Hyperkalemia

K+ can’t move into cells along with glucose

Question 15

ADH Agonists

Answer 15

Morphine, Nicotine, Cyclophosphamide
Nausea, Hypoxia

Retain Water

Question 16

Iso-Osmotic Volume Expansion

Answer 16

Drinking isotonic NaCl

Increase ECF volume, no other changes

Question 17

200 mg/dL

Answer 17

When you begin seeing glucose in the urine

Transport max is usually higher, like 380 mg/dL

Question 18

Hyperaldosteronism

Conn’s Syndrome

Answer 18

Increased K+ Secretion

i.e. Hypokalemia, also increased BP

Question 19

Hyperosmotic Volume Contraction

Answer 19

Loss of ECF water volume

Sweating, Fever, Diabetes

Question 20

Sympathetic Agonists

Answer 20

Hypokalemia

Question 21

Insulin

Answer 21

Hypokalemia

K+ moves into cells with Glucose

Question 22

180 L

Answer 22

Amount kidneys filter each day

Question 23

Hypo-Osmotic Volume Contraction

Answer 23

Adrenal Insufficiency - Decreased Aldosterone

Loss of NaCl
Kidneys excrete more NaCl than H2O
Decreased ECF volume
Increased ICF volume

Hematocrit increases because it occupies a greater % now that plasma has gone down

Question 24

Inhibitors of Na/K ATPase

Answer 24

Hyperkalemia

Digitalis - results in reduced intracellular K+ and allows it to move out of the cells

Question 25

Thiazide Diuretics

Answer 25

Na/Cl Cotransporter Early Distal Tubule Can be used to aid in the passage of kidney stones because promotes Ca2+ reabsorption and removes it from urinary tract

Question 26

Loop Diuretics

Answer 26

NKCC2 transporter Thick Ascending Limb - inhibit reabsorption of cations Furosemide, Bumetanide

Question 27

50 mOsm/L

Answer 27

Minimum urine Osmolarity The most dilute your urine can get

Question 28

Alkalosis

Answer 28

HYPOkalemia Exchange of intracellular H+ (to compensate for alkalosis) for extracellular K+ Acetazolamide - prevents alkalosis by inhibiting reabsorption of HCO3 and secretion of H+

Question 29

Aldosterone Antagonists

Answer 29

Late Distal Tubule + Cortical Collecting Duct Spironolaction, Eplerenone Lead to HYPERkalemia

Question 30

HYPOosmolarity

Answer 30

Hypokalemia H2O flows into the cell and K+ follows

Question 31

B-Adrenergic ANTAGONISTS (sympathetic)

Answer 31

Hyperkalemia

Question 32

60 mmHg

Answer 32

A good marker for GFR ``` Above = increased GFR Below = decreased GFR ```

Question 33

Aldosterone Antagonists

Answer 33

Hyperkalemia

Question 34

Acidosis

Answer 34

Hyperkalemia | - Exchange of extracellular H+ (which is high) for intracellular K+ on the basolateral membrane

Question 35

Specific Gravity

Answer 35

1. 01 = LOW, Hydrated | 1. 03 = HIGH, Dehydrated

Question 36

Hyperosmotic Volume Expansion

Answer 36

HIGH NaCl intake into ECF Increased ECF Volume Edema (swollen salt hands)

Question 37

Hypo-Osmotic Volume Expansion

Answer 37

SIADH Inappropriate retention of water in ECF ICF Volume goes up

Question 38

High Plasma Creatinine

Answer 38

Tells me there is kidney damage because Cr isn't being cleared properly

Question 39

Hypoaldosteronism

Answer 39

Decreased K+ Secretion | i.e. hyperkalemia

Question 40

Iso-Osmotic Volume Contraction

Answer 40

Diarrhea Decreased ECF volume, no other changes

Question 41

Hyperosmolarity

Answer 41

Hyperkalemia | H2O flows out of the cell and K+ follows

Question 42

500-600 mOsm/day

Answer 42

Obligatory solute loss Generally the quantity we consume each day. Except holy crap Americans eat 4x that amount...

Question 43

Intrinsic Renal Failure | Acute Tubular Necrosis

Answer 43

Generally secreting MORE sodium BUN/Cr 10-15 Urine Osmolarity < 350 Urinary Na > 40 Cells in the urine - These values can sometimes be seen if someone is using diuretics

Question 44

0.5 L/day

Answer 44

Minimum urine volume If you're not excreting 0.5 L per day, you may go into electrolyte imbalance

Question 45

Metabolic Alkalosis effect on Ca2+

Answer 45

Retention of Ca2+

Question 46

Metabolic Acidosis effect on Ca2+

Answer 46

Increased excretion of Ca2+

Question 47

Increased Plasma Phosphate on Ca2+

Answer 47

Retention of Ca2+

Question 48

Decreased Plasma Phosphate on Ca2+

Answer 48

Increased excretion of Ca2+

Question 49

Renal Tubular Osteomalacia

Answer 49

Consequence of acidosis and hypercalciuria | Increased excretion of Ca2+