Lecture 12- Renal- Diuretics and Dialysis

Question 1

2 main indications for diuretics

Answer 1

HTN

CHF

Question 2

diuretics inhibit

Answer 2

water reabsorption

Question 3

in CHF, the heart is weakened so this decreases CO which decreases GFR which then causes an … of aldosterone which will … Na and H2O reabsorption leading to ….

Answer 3

increase

increase

increased ECV/ edema

Question 4

6 classes of diuretics

Answer 4

osmotic
CA inhibitors 
loop
thiazides
K+ sparing
aquaretics

Question 5

… diuretics retain water by increasing osmotic pressure; they act on water-permeable segments of the nephron (PT and descending LOH)

Answer 5

osmotic

Question 6

…. diuretics reduce Na reabsorption; proximal tubule is major site of action

Answer 6

CA inhibitors

Question 7

… diuretics act in the thick ascending limb to inhibit Na reabsorption via the Na/K/2Cl symporter

Answer 7

loop

Question 8

… diuretics block the NaCl symporter in the early distal tubule

Answer 8

thiazide

Question 9

… diuretics has 2 classes that both act in the late distal tubule and cortical collecting duct to inhibit sodium reabsorption AND potassium secretion

Answer 9

K+ sparing

Question 10

2 classes of K+ sparing diuretics?

Answer 10

aldosterone antagonists

ENaC blockers

Question 11

…. are ADH receptor anatagonists in the late distal tubules and collecting duct. water is eliminated without the loss of solutes

Answer 11

aquaretics

Question 12

mannitol is an example of …

Answer 12

an osmotic diuretic

Question 13

bumetanide, ethacrynic acid and furosemide are examples of

Answer 13

loop diuretics

Question 14

metolazone is an example of a

Answer 14

thiazide diuretic

Question 15

amiloride, spironolactone and triamterene are examples of

Answer 15

K+ sparing diuretics

Question 16

mannitol gains access to tubule by …. and are poorly reabsorbed

Answer 16

glomerular filtration

Question 17

CA inhibitors gain access to tubule via

Answer 17

secretion

Question 18

CA inhibitors reduce Na reabsorption by inhibiting CA, thus reducing the H+ available for the ….

Answer 18

Na/H antiporter

Question 19

most of the diuretic effect of CA inhibitors is in the PT where 1/3 of Na reabsorption relies on the ….

Answer 19

Na/H antiporter

Question 20

T/F CA inhibitors are extremely effective

Answer 20

false. downstream segments will increase Na reabsorption when tubular Na increases

Question 21

… are the most powerful diuretics

Answer 21

loop diuretics

Question 22

furosemide (lasix) is a … diuretic

Answer 22

loop

Question 23

where do loop diuretics work?

Answer 23

ascending loop

Question 24

loop diuretics are secreted into the

Answer 24

proximal tubule

Question 25

loop diuretics inhibit the …. symporter in the thick ascending limb which inhibits Na reabsorption and causes the urine leaving the loop to not be …. which means no …. is established in the medulla interstitium so water is not reabsorbed along collecting duct

Answer 25

Na/K/2Cl

dilute

osmotic gradient

Question 26

thiazide diuretics act in the

Answer 26

early distal tubule

Question 27

thiazide diuretics act in the … by blocking the

Answer 27

early distal tubule

NaCL transporter

Question 28

spironolactone is a common

Answer 28

aldosterone antagonist (K sparing diuretic)

Question 29

amiloride is a …

Answer 29

ENaC channel blocker (K sparing)

Question 30

aldosterone antagonists block aldosterones ability to increase…. in … cells

Answer 30

Na transporters

principal

Question 31

ENaC channel blockers block Na reabsorption across the … membrane

Answer 31

apical

Question 32

CA inhibitors cause metabolic…

Answer 32

acidosis

Question 33

loop and thiazide diuretics cause metabolic …

Answer 33

alkalosis

Question 34

K sparing diuretics cause metabolic …. because H+ secretion in distal tubule and cortical collecting duct is …

Answer 34

acidosis

inhibited

Question 35

except for …. all other diuretics alter calcium excretion

Answer 35

K sparing

Question 36

osmotic and CA inhibitors both act in proximal tubule and … reabsorption of calcium in this segment so … is increased

Answer 36

reduce

excretion

Question 37

… diuretics stimulate calcium reabsorption in the distal tubule and thus reduce excretion

Answer 37

thiazide