kidneys 2

Question 1

what order does plasma go through kidney?

Answer 1

bowmanns capsule, proximal tubule, loop of henle, distal tubule, collecting duct

Question 2

what is filtered in glomerular filtration?

Answer 2

blood plasma (20% removed)

permits H20 and small molecules
restricts blood cells and proteins

Question 3

what does ultrafiltrate consist of?

Answer 3

protein free plasma
(1% protein filtered- albumin)
conc of Na in bowmanns capsule is same that is in plasma

Question 4

what is difference between trancellular and paracellular transport ?

Answer 4

transcellular is through cell (requires membrane transport proteins)
paracellular is between cells

Question 5

what does proximal tubules reabsorb?

Answer 5

70% filtrate
70% H2O and NA
~100% glucose and amino acids
90% HCO3- (bicarbonate)

Question 6

give transport proteins on apical side

Answer 6

SGLT1, SGLT2, NaPiII

NHE3?

Question 7

what happened in NaPiII knockout mice?

Answer 7

less phosphate in serum (less reabsorbed) (more in urine)

low phsophate = less dense bone

Question 8

what is apical and basolateral ?

Answer 8

apical is lumen of tubules, baslateral is peritubular capillaries

Question 9

what is SGLT1 and SGLT2 structure?

Answer 9

1-664 aa (14 TMD)
2-672 aa

(glocose and sodium reabsorbtion)

Question 10

what happens in familial renal glycosuria?

Answer 10

increase in urinary glucose
normal plasma glucose
(due to 21 mutations in SGLT2)

Question 11

what happens in NHE3 knockout mice ?

Answer 11

lower plasma HCO3-
plasma PH decreases (more acidic)
BP decreases

(inhibition of H+ secretion ) causes inhibitions of Na and Hco3- transport

Question 12

what does loop henle do?

Answer 12

regulates urine conc
reabsorbs Na+, Cl-, and H2O
reabsorbs Ca2+ and Mg2+

site of action of loop diuretics

Question 13

what are structures of loop diuretics and what do they do?

Answer 13

thin descending limb (reabs of H2O)
thin ascending limb (reabs of Na+, Cl-)+ urea (not permeable to water)
thick ascending limb (reabs Na+ Cl-) (extremely impermeable to H2O)

Question 14

what are thick ascending limb carriers?

Answer 14

NKCC2, ROMK (apical)

CLCK with Barttin (basolateral)

Question 15

what is bartters syndrome?

Answer 15

genetic inheritance - recessive 
slat wasting and polyuria 
hypotension
hypokalaemia
higher PH
hypercaluciuria

Question 16

what is mutated in bartters syndrome?

Answer 16

barttin mutated (CLCK doesnt work) 
this causes increased cellular Cl-, NKCC2 diesnt work

Question 17

what happens in ROMK mouse ?

Answer 17

polyuria, salt wasting, BUT plasma PH lower than n bartters (acidosis) little/no diff in K+ (no hypokalaemia)

Question 18

what does early distal tubule do?

Answer 18

reabsorb Na+ and Cl-
Reabsorption Mg2+
is sensitiv to thiazide diuretics

Question 19

what are carriers on early DT?

Answer 19

apical - NCC + Mg

basolateral - CLCK, an barttin (+na k pump)

Question 20

what is gitelmans syndrome?

Answer 20

inherited - recessive, 
salt wasting + polyuria 
hypotension 
hypokalaemia 
higher PH
hypocalciura
(same as battins expect hypocalciuria)

Question 21

what causes gitelmans?

Answer 21

loss of function mutation in NCC (less Na and H2O reabsorbed)

Question 22

what can chlorothiazide do?

Answer 22

can be used to treat high blood pressure
similar syptom to gitelmans
acts on DT

Question 23

what does late DT , connecting tubules and collecting duct do?

Answer 23

concentrated urine
rabsorption of Na and H2O
secretion of K+ and H+

Question 24

what are cells types in LDT and CCD?

Answer 24

principle - Na+ and H2O reabsorption.
K+ and H+ secretion

intercalated- alpha and beta
H+ secrestion and reabsorption
HCO3- reabsorption and secretion

Question 25

what do alpha and beta intercalated cells do?

Answer 25

alpha - H+ secretion and HCO3- reabsorption

beta - HCO3- secretion and Cl and H+ reabsorption

Question 26

what does medullary CD do?

Answer 26

low Na+ permeability

high H2O and urea permeability in prescence of vasopressin

Question 27

what is rhabdomyolysis

Answer 27

release myoglobin from damaged muscle - can cause tubule damage