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Year 1: 09. CPR Exam 2 > Lecture 15: Renal Physiology Part 3 > Flashcards

Lecture 15: Renal Physiology Part 3 Flashcards

1
Q

What is a diuretic?

A

Agent that increases urine volume

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2
Q

What is a natriuetic?

A

Increase in renal sodium excretion

-also increases water excretion

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3
Q

What is reabsorbed in the proximal tubule?

A 
Sodium Bicarbonate
Sodium Chloride
Glucose (almost all)
Amino Acids (almost all) 
Potassium
Organic Solutes
Urea
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4
Q

How is potassium reabsorbed in the proximal tubule?

A

Paracellular pathway (between cells)

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5
Q

How is water reabsorbed in the proximal tubule?

A

Passively

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6
Q

What promotes the reabsorption of sodium bicarbonate?

A

Na+/H+ exchanger (NHE3)

-luminal membrane of proximal tubule epithelial cell

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7
Q

How is sodium reabsorbed into the capillaries?

A

Na+/K+ ATPase on basolateral membrane of proximal convoluted tubule

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8
Q

Where are diuretics delivered to?

A

Luminal side of tubule (apical) where they act

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9
Q

What do carbonic anhydrase inhibitors do?

A

Inhibit carbonic anhydrase

  • decrease in H+ formation inside PCT
  • decrease in Na+/H+ transport
  • Increase in urine pH
  • Decrease in body pH
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10
Q

What is reabsorbed from the thin descending limb of the loop of Henle?

A

Water

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11
Q

What is reabsorbed from the thick ascending limb of the loop of Henle?

A 
Sodium
Potassium
Chloride
Magnesium
Calcium
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12
Q

How is sodium reabsorbed in the thick ascending limb of the loop of Henle?

A

Na+/K+/2Cl- Cotransporter

-establishes ion concentration gradient

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13
Q

How are magnesium and calcium reabsorbed in the thick ascending limb of the loop of Henle?

A

Diffusion of potassium back into tubular lumen drives reabsorption of cations via paracellular pathway

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14
Q

What do loop diuretics do?

A

Inhibit Na+/K+/2Cl- cotransporter in thick ascending limb of the loop of Henle

  • decreased intracellular concentration of potassium, sodium, and chloride in thick ascending limb
  • decreased reabsorption of calcium and magnesium
  • increased diuresis
  • Decrease in urine pH
  • Increase in body pH
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15
Q

What is reabsorbed in the distal convoluted tubule?

A

Sodium chloride

Calcium

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16
Q

How is sodium reabsorbed in the distal convoluted tubule?

A

Thiazide sensitive Na+/Cl- cotransporter (NCC)

-found on apical side of DCT

17
Q

How is calcium reabsorbed in the distal convoluted tubule?

A

Passively

-regulated by parathyroid hormone

18
Q

What do thiazide diuretics do?

A

Inhibit Na+/Cl- cotransporter (NCC)

  • Increased luminal sodium and calcium concentration
  • Increased diuresis
  • Decrease in urine pH
  • Increase in body pH
19
Q

What is reabsorbed from the collecting duct?

A

Sodium chloride

20
Q

What is secreted into the collect duct?

A

Potassium

Hydrogen

21
Q

What role does aldosterone play at collecting duct?

A

Increases expression of ENaC to increase sodium reabsorption and promote potassium secretion
-also causes retention of water

22
Q

What role does vasopressin play at collecting duct?

A

1) Increases water permeability: Inserts aquaporin-2 on apical membrane of principal cells on collecting duct to promote water reabsorption
2) Increase urea permeability in IMCD
3) Increases activity of Na+/K+/2Cl- Cotransporter in thick ascending limb

23
Q

What do K+ sparing diuretics do?

A

Inhibition of aldosterone receptor

  • decreased ENaC: more sodium excreted and less potassium excreted
  • Increase in urine pH
  • Decrease in body pH
24
Q

What stimulates sodium reabsorption?

A

Low sodium levels
Severe diarrhea
Angiotensin II
Aldosterone

25
Q

What stimulates sodium secretion?

A

Increased ECF sodium levels

Increased tubular flow rate

26
Q

What stimulates potassium reabsorption?

A

Low potassium levels

Severe diarrhea

27
Q

What stimulates potassium secretion?

A

Increased ECF potassium levels
Aldosterone
Increased tubular flow rate
Sodium delivery to cortical collecting duct

28
Q

During anti-diuresis, where is urea concentrated?

A

Inner medullary collecting duct

-promotes a passive reabsorption down its concentration gradient to interstitium to loop of henle

Year 1: 09. CPR Exam 2 (24 decks)

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