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Patho: Kidney Packet four > Kidney: Secretion > Flashcards

Kidney: Secretion Flashcards

1
Q

the transfer of materials from the blood into tubular fluid

A

Tubular secretion

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2
Q

The secretion of ___ helps control blood pH

A

H+

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3
Q

Most secretion occurs in the ____ tubule with some in the more distal nephron

A

proximal

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4
Q

Endogenous substances (Prostaglandins) and exogenous diuretics (furosemide and bumetanide; thiazides) are delivered to sensitive distal sites after being secreted by the _____ _____

A

proximal tubules

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5
Q

Some organic molecules are not filtered to a great extent because they are extensively but reversibly bound to _____ ______

A

plasma proteins

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6
Q

As the blood flows out of the glomerulus past the proximal tubules, the free fraction of these organic ions in peritubular plasma are secreted into the filtrate via _____ (anions) and ____ (cations), reducing the concentration of free organic ion in the plasma and thereby causing most of the ion bound to plasma proteins to be “_______”

A

OATs
OCTs
unloaded

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7
Q

are two major classes of secretory transporters in the kidney

A

Organic anion transporters (OATs) and organic cation transporters (OCTs)

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8
Q

The transporters, ____, _____, and ____ in the renal basolateral membrane transport a large variety of endogenous and therapeutic compounds from the blood into the cells of the proximal tubules

A

OAT1, OAT3, and OCT2

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9
Q

Organic Ion Transporters in the renal epithelium are critical in _____ and _______ of xenobiotics from the systemic circulation, and therefore are major determinants of drug response and sensitivity

A

detoxification and elimination

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10
Q

Organic Ion Transporters control the exposure of renal cells to _____ drugs and environmental ____ and thus determine a patients susceptibility to drug-induced nephrotoxicity

A

nephrotoxic

toxins

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11
Q

Many medications or their metabolites exist as organic anions at physiological pH, and are transported by the multi-specific _____ _____ ____ of the kidney, liver, and choroid plexus

A

organic anion transporters (OAT)

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12
Q

the renal proximal tubule secretes clinically important pharmaceuticals such as

A

antibiotics
probenecid
loop and thiazide diuretics
angiotensin converting enzyme (ACE) inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), and methotrexate, among others

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13
Q

the renal proximal tubule also transports various endogenous compounds, including

A 
cyclic nucleotides
prostaglandins
folate
neurotransmitter-metabolites
hormone-conjugates
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14
Q

genetic variants in ____ are likely significant contributors to intersubject variability in drug response

A

OATs

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15
Q

Which of the following is an example of facilitated simple diffusion?

A

K channels

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16
Q

Which of the following is an example of primary active transport?

A

Na/K ATPase pump

H+ ATPase pump

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17
Q

Which of the following is an example of secondary active transport?

A

SGLUT1
Na/ H+ antiporter
Na+/amino acid symporter

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18
Q

Which of the following is an example of tertiary active transport?

A

OAT1

OAT3

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19
Q

Organic anion (OA) entry across the _______ membrane of the proximal tubule occurs through an antiporter (___ or ____) in exchange for dicarboxylate (especially, alpha-ketoglutarate, an intermediate in the Krebs cycle).

A

basolateral

OAT1 or OAT3

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20
Q

_________ is maintained at high intracellular concentrations by a Na-dicarboxylate cotransporter, which is driven by the trans-membrane Na gradient generated by the Na/K ATPase pump

A

alpha-ketoglutarate

21
Q

OA secreted into the lumen by ____

A

OAT4

22
Q

OAT3 gene expressed mainly in ______

A

Kidney

23
Q

OAT4 is expressed in the ____ and ____

A

placenta and kidney

24
Q

OATP8 is expressed in the _____ _____

A

fetal liver

25
Q

_______ are critical for transport of many endogenous small organic cations and are critical for elimination of a wide array of drugs and environmental toxins.

A

Polyspecific organic cation transporters (OCTs)

26
Q

OCT1 is expressed in the _____

A

liver

27
Q

OCT2 is expressed in the ____

A

Kidney

28
Q

In humans, about ___% of daily uric acid disposal occurs via the kidneys

A

70

29
Q

urate is secreted and in unusual circumstances the rate of excretion may exceed the rate of _____

A

filtration

30
Q

High blood levels of uric acid are associated with ____ and urate kidney ____

A

gout

stones

31
Q

Urate crystal formation occurs best at ____ temperatures and tends to form most often in the hands and feet

A

lower

32
Q

~90% of filtered ____ is reabsorbed

~10% is excreted in the urine

A

urate

33
Q

filtered urate is both reabsorbed and secreted exclusively in the ______ tubule. Reabsorption occurs in S1 and S3. Secretion occurs in ____

A

proximal

S2

34
Q

Substances That Decrease

Urate Excretion

A 
Lactate 
Acetoacetate
ß-Hydroxybutyrate 
Nicotinate 
Pyrazinamide (tuberculostatic)
35
Q

Substances That Increase

Urate Excretion

A 
Orotate 
Probenecid* 
Sulfinpyrazone* 
Benzbromarone*
Losartan (antihypertensive drug) 
Tienilic acid (diuretic)*
36
Q

______ is a uricosuric drug that increases uric acid excretion in the urine possibly by competing for OAT mediated reabsorption in the PCT

It is primarily used in treating gout and hyperuricemia

A

Probenecid

37
Q

_________ competitively inhibits the renal excretion of some drugs {examples: penicillin, oseltamivir (Tamiflu)}, thereby increasing their plasma concentration and prolonging their effects

A

Probenecid

38
Q

Urate reabsorption is a _____ active transport process

A

tertiary

39
Q

Uricosuric drugs such as ______ and _____ act like orotate to compete with urate for transport through the urate/anion exchanger decreasing the reabsorption of urate

A

benzbromarone

probenecid

40
Q

an ATP-dependent efflux pump with broad substrate specificity

A

P-glycoprotein (ABCB1)

41
Q

_____ transports a broad spectrum of substrates across the cell membrane including psychotropic drugs
Mediates Digoxin uptake

A

ABCB1

42
Q

Mediates the transport of compounds out of the brain across the blood-brain barrier and prevents the entry into the central nervous system of compounds such as ivermectin

A

ABCB1 transport

43
Q

Effects the distribution and bioavailability of drugs and mediates the removal of toxic metabolites and xenobiotics from cells into urine, bile and the intestinal lumen

A

P-glycoprotein

44
Q

______ intestinal expression of P-glycoprotein can reduce the absorption of drugs that are substrates for P-glycoprotein, thereby ______ the bioavailability which results in therapeutic plasma concentrations not being attained

A

Increased

reducing

45
Q

Over-expression of ____ results in active cellular transport of anti-neoplastics and multidrug resistance

A

P-gp

46
Q

supratherapeutic plasma concentrations and drug toxicity may result because of _____ P-glycoprotein expression or drug-drug interactions inhibiting PG activity

A

decreased

47
Q

The two key genes of interest for warfarin response, which only explain about 15-30% of the variability in drug dose required to achieve the desired therapeutic response in different patients

A

cytochrome P450 2C9 gene, CYP2C9, and the vitamin K epoxide reductase complex 1 gene, VKORC1

48
Q

Aldosterone acts on the ____ and ____

A

DCT & CD

49
Q

______ medications are secreted more when urine is basic because _____ donate a proton and become negatively charged (anions) in basic fluids
____ medications are secreted more when urine is acidic because ____ receive a proton and become positively charged (cations) in acidic fluids
______ molecules are less likely to be reabsorbed

A

Acid
Acid

Basic
bases

Charged

Patho: Kidney Packet four (1 decks)

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