Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Renal > Lecture 13: TBL Ca Phosphate Acid Base > Flashcards

Lecture 13: TBL Ca Phosphate Acid Base Flashcards

1
Q

List the major inputs and outputs of calcium and phosphate to and from plasma

A

Inputs =
GI absorption
Bone restoration

Outputs =
Urinary excretion
Bone mineralization (deposition)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List the 3 main hormones involved in the regulation of Ca and phosphate, identifying their major site of synthesis

A

PTH = parathyroid glands

Calcitriol = kidneys

FGF23 = bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the effects of PTH on Ca and Pi

A

Absorption = n/a

Excretion:
Ca = inc. reabsorption in DCT + dec. excretion

Pi = dec. reabsorption in PT + inc. excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe effect of calcitriol on Ca and Pi

A

Excretion = n/a

Absorption = inc. absorption of calcium and phosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe effects of FGF23 on Ca and Pi

A

Absorption = n/a

Excretion = dec. phosphate reabsorption in PT = inc. excretion

No effect on calcium!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are calcitropic hormones?

A

PTH + calcitriol

Direct relationship with calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are phosphaturic hormones?

A

PTH and FGF23

Both have indirect relationship with phosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What do each hormone effect?

A

PTH = urinary excretion

calcitriol = GI absorption

FGF23 = urinary excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a pneumonic for PTH?

A

PTH

Protects plasma calcium
THwarts phosphate rich diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is PTH’s effect on calcium and phosphate?

A

Inc. calcium

Dec. phosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a pneumonic for calcitriol?

A

Calcitriol rhymes with skeletal

Provides calcium and phosphate for bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What effects does calcitriol have on calcium and phosphate?

A

Inc. calcium

Inc. phosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a pneumonic for FGF23?

A

ForGet ‘Fosphate’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What effect does FGF23 have on calcium and phosphate?

A

Calcium = n/a

Dec. phosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What effects does PTH have on urinary excretion of calcium and phosphate?

A

Inc. Ca reabsorption in DCT = dec. excretion

Dec. phosphate reabsorption in PT = inc. excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What effect does FGF23 have on phosphate excretion?

A

Dec. phosphate reabsorption in PT = inc. excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the form of calcium that gets regulated??

A

Ionized!

Does NOT include calcium bound to albumin or complexed with anions

18
Q

What is the indirect effect of phosphate on PTH secretion?

A 
Inc. phosphate 
=
Dec. ionized calcium
=
Inc. PTH secretion
19
Q

Explain limitations of using plasma Ca concentration measured by clinical labs when discussing regulation of calcium and phosphate

A

Clinical labs measure TOTAL plasma calcium = can be misleading!

Inc. phosphate = dec. ionized Ca (but the total Ca would be unchanged)

Total plasma calcium can change even if ionized Ca remains constant
(Ex: if [albumin] changes)

20
Q

What is the effect of inc. ionized calcium on PTH, calcitriol, FGF23 secretion?

A

PTH = dec.

Calcitriol = dec.

FGF23 = n/a

21
Q

What is the effect of inc. phosphate on secretion of PTH, calcitriol and FGF23?

A

PTH = inc.

Calcitriol = dec.

FGF23 = inc.

22
Q

What is the effect of dec. plasma calcium on

Calcitriol
Ca IN (GI absorption)
Ca OUT (excretion)
Pi IN (GI absorption)
Pi OUT (excretion)
A

Dec. plasma Ca =

Inc. calcitriol

Inc. Ca absorption
No change excretion

Inc. Pi absorption
No change excretion

23
Q

What is the effect of dec. plasma calcium on

PTH
Ca IN (GI absorption)
Ca OUT (excretion)
Pi IN (GI absorption)
Pi OUT (excretion)
A

Dec. plasma Ca =

Inc. PTH

No change Ca absorption
Dec. Ca excretion

No change Pi absorption
Inc. Pi excretion

24
Q

What are the effects of inc. plasma phosphate on

Calcitriol
Ca IN (absorption)
Ca OUT (excretion)
Pi IN (absorption)
Pi OUT (excretion)
A

Inc. plasma phosphate =

Dec. calcitriol

Dec. Ca IN
No change Ca excretion

Dec. Pi IN
No change Pi OUT

25
Q

What is the effect of increased plasma phosphate on

PTH
Ca IN (absorption)
Ca OUT (excretion)
Pi IN (absorption)
Pi OUT (excretion)
A

Inc. plasma Pi =

Inc. PTH

No change Ca IN
Dec. Ca excretion

No change Pi IN
Inc. Pi excretion

26
Q

What is the effect of increased plasma phosphate on

FGF23
Ca IN (absorption)
Ca OUT (excretion)
Pi IN (absorption)
Pi OUT (excretion)
A

Inc. plasma Pi =

Inc. FGF23

No change Ca IN
No change Ca OUT

No change Pi IN
Inc. Pi excretion

27
Q

What are the effects of PTH on secretion of other hormones?

A

PTH helps the other hormones

Inc. calcitriol

Inc. FGF23

28
Q

What are the effects of calcitriol on secretion of other hormones?

A

calcitriol “calculates”: rejects help from PTH but needs FGF to avoid Pi overload

Dec. PTH

Inc. FGF23

29
Q

What are the effects of FGF23 on secretion of other hormones?

A

FGF23 forgets the other hormones

Dec. calcitriol

Dec. PTH

30
Q

Describe the two important roles of the kidney in the regulation of acid-base balance

A
  1. Reabsorption of filtered bicarbonate

2. Synthesis of new bicarbonate

31
Q

Explain why the kidney cannot eliminate the fixed metabolic acid load by excreting H+

(instead of making 70-100 mmol of new bicarbonate every day)

A

Kidney can ONLY excrete 0.04 mmol of H+ per day - NOT 70-100 mmol!!!

32
Q

List the 4 major acid-base disorders

A

Metabolic acidosis

Respiratory acidosis

Respiratory alkalosis

Metabolic alkalosis

33
Q

What is a normal level for P(CO2) in mmHg?

[HCO3] in mmol/liter?

A

P(CO2) = 40

[HCO3] = 24

34
Q

How do you determine type of acid-base disorder?

A

(1) look at pH
- if <7.38 = acidosis
- if >7.42 = alkalosis

(2) look at P(CO2)
Acidosis:
- if <40 mmHg = metabolic acidosis
- if >40 mmHg = respiratory acidosis

Alkalosis:

  • if <40 mmHg = respiratory alkalosis
  • if >40 mmHg = metabolic alkalosis
35
Q

What is the ‘rule’ to distinguish between acute vs. chronic respiratory acidosis?

A

If ACUTE:

Every 2 mmHg increase in P(CO2) = 0.01 unit dec. in pH

36
Q

What is the ‘rule’ to distinguish between acute vs. chronic respiratory alkalosis?

A

If ACUTE:

Every 1 mmHg dec. in P(CO2) = 0.01 unit inc. in pH

37
Q

Identify important causes of metabolic acidosis

A

Kidney disease

Uncontrolled DM

Anaerobic exercise

Methanol toxicity

CA inhibitors

K+-sparing diuretics

38
Q

Identify important causes of ACUTE respiratory acidosis

A

Acute opioid or barbiturate OD

39
Q

Identify important causes of CHRONIC respiratory acidosis

A

COPD

40
Q

Identify important causes of ACUTE respiratory ALKalosis

A

Acute hyperventilation due to anxiety

41
Q

Identify important causes of chronic respiratory ALKalosis

A

High altitude

For >48-72 hours

42
Q

Identify important causes of metabolic alkalosis

A

Vomiting

Hyperaldosteronism

Loop diuretics

Thiazides diuretics

Renal (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions