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AU2017 Physio Exam 3 > Lecture 10- Renal- Ion and Water balance > Flashcards

Lecture 10- Renal- Ion and Water balance Flashcards

1
Q

after filtration, tubular fluid is subject to reabsorption or secretion. these processes involve transport of substances across the tubular epithelial cells in a nephron. there are 2 modes of transport, what are they?

A

transcellular- molecules move through tubular cells

paracellular- molecules move between tubular cells

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2
Q

… diffusion requires a specific membrane protein and they can be 3 different types

A

uniporter
symporter
antiporter

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3
Q

… transport is against the gradient and is coupled with ATP

A

active

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4
Q

sodium can be reabsorbed in all but this segment of the nephron

A

thin descending limb of loop of henle

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5
Q

you get pretty much 100% of reabsorption of glucose and amino acids in the ….

A

proximal tubule

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6
Q

there is a about 65% (2/3) reabsorption of Na in the ….

A

proximal tubule

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7
Q

about … % of Na is reabsorbed in the thin ascending limb

A

7

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8
Q

about …% of Na is reabsorbed in the thick ascending limb

A

20

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9
Q

about … % of Na is reabsorbed in the distal convoluted tubules

A

5

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10
Q

about …% of Na is reabsorbed in the collecting ducts

A

2-3

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11
Q

4 ways sodium is reabsorbed in the proximal tubule

A
  1. symporters with glucose
  2. active transport on basal side to keep intracellular sodium low
  3. moves with water and other solutes paracellularly
  4. Na/H antiporter which is indirectly associated with bicarb reabsorption
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12
Q

are drugs freely filtered?

A

no, they are too big, must be secreted in the proximal tubule

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13
Q

the proximal tubule has …. for organic cations and anions (drugs)

A

transporters

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14
Q

drugs are commonly bound to …. so they are not filtered at the glomerulus and must be secreted in order for them to be excreted in the urine

A

plasma proteins

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15
Q

in the loop of henle, … of filtered NaCL and … of water is reabsorbed

A

25%

15%

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16
Q

the descending thin limb is … to salt but … to water

A

impermeable

permable

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17
Q

the ascending thin limb is … to salt but …. to water

A

permeable

impermeable

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18
Q

reabsorption in the thin descending and ascending limbs is ….

A

passive

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19
Q

in the ascending limb, fluid becomes … due to …. symporter in apical membrane and …. in basolateral membrane

A

diluted

Na/K/2Cl

Na/K ATPase

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20
Q

fluid leaving the loop is… but the renal … mechanism has established an … gradient required for formation of hyperosmotic urine.

A

hypoosmotic
countercurrent
osmotic

21
Q

concentration of the tubular fluid will occur in the …. if …. is present

A

collecting duct

ADH (vasopressin)

22
Q

the initial segment of the distal tubule reabsorbs about …% of filtered NaCl via a …. symporter in apical membrane and … in basolateral membrane

A

Na/Cl

Na/K ATPase

23
Q

sodium reabsorption in the latter half of the distal tubule and collecting duct is …

A

similar

24
Q

there are 2 types of cells in the collecting duct and late distal tubule

A

principal cells that have epithelial sodium channels (ENaC) that reabsorb Na and secrete K

intercalated cells involved with acid-base balance; can also reabsorb K

25
Q

ADH (vasopressin) is released from the …

A

posterior pituitary

26
Q

ADH increases the … of the late distal tubuler and the collecting duct to water by increasing…. into the apical membrane (basolateral membrane is freely permable to water)

A

permeability

aquaporins

27
Q

the release os ADH is stimulated by changes in …. of body fluids and changes in …

A

osmolality

blood volume/pressure

28
Q

ADH responds to an osmolality above a set point of …mOsm/kg H2O

A

275-290

29
Q

…. baroreceptors in the LA and Pulm vessels respond to a … in blood volume and this stimulates ADH secretion

A

low pressure

decrease

30
Q

… baroreceptors in aortic arch and carotid sinus respond to a …. in blood pressure and this stimulates ADH secretion

A

high pressure

decrease

31
Q

ADH also increases permeability of medullary collecting duct to…

A

urea

32
Q

if ADH is low, solutes are reabsorbed in distal tubule and collecting duct but no water reabsorption so urine is as dilute as …

A

50 mOsm/kg H2O

33
Q

if ADH is high, water is reabsorbed as passes through collecting duct and urine can be concentrated up to …

A

1200 mOsm/kg H2O

34
Q

the renin-angiotensin-aldosterone system stimulates events that increase reabsorption of …. to combat volume…

A

Na and water

contraction (low BV)

35
Q

renin converts…

A

angiotensinogen to angiotensin I

36
Q

Angiotensin I is converted to angiotensin II by ….

A

angiotensinogen converting enzyme (ACE)

37
Q

what are the 4 effects of angiotensin II?

A

vasoconstriction

stimulate release of ADH

increase sympathetic activity

stimulate aldosterone secretion

38
Q

renin is released in response to a drop in …., decreased …. delivery to the macular densa or … input to the juxtaglomerular cells

A

perfusion pressure

NaCl

sympathetic

39
Q

aldosterone from the … acts to increase …. reabsorption in the distal tubule and collecting duct by increasing …

A

adrenal cortex

NaCl

transport protein synthesis

40
Q

… are hormones that are secreted when the heart dilates (during volume expansion)

A

natriuretic peptides

41
Q

atrial natriuretic peptide is from the …

brain natriuretic peptide is from the …

A

atria

ventricles

42
Q

are aldosterone’s effects immediate?

A

no

43
Q

4 effects of natriuretic peptides

A

vasodilation of afferent arterioles

vasoconstriction of efferent arterioles

inhibition of renin/aldosterone

inhibition of ADH secretion

44
Q

net effect of natriuretic peptides is to increase secretion of … and …

A

NaCl and water

45
Q

the main location where we see a decrease in Na reabsorption due to natriuretic hormones is in the ….

A

proximal tubules

46
Q

hypokalemia will …. membrane voltage

A

hyperpolarize

47
Q

hyperkalemia will … membrane voltage

A

depolarize

48
Q

ingested K+ is … shifted into cells and this is mediated by … , … and …

A

fast

insulin, epi, aldosterone

49
Q

kidneys typically excrete …% of ingested K+

A

90-95%

AU2017 Physio Exam 3 (12 decks)

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