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CRRAB II > Loop of Henle (Muster) - W2 > Flashcards

Loop of Henle (Muster) - W2 Flashcards

1
Q

thin descending limb

A

permeable to water, not solutes

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2
Q

thin ascending limb

A

begins solute reabsorption, not permeable to water

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3
Q

How much sodium is reabsorbed in the thick ascending limb?

A

25%

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4
Q

What are the transporters on the luminal side of the thick ascending limb?

A
  • NKCC2 - brings in Na, 2Cl, K+
  • ROMK - K+ recycling into lumen
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5
Q

what are the transporters on the basolateral side of the thick ascending limb?

A
  • K+ and Cl- symporter
  • Cl- and K+ recycling
  • 2K/3Na pump
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6
Q

How are calcium and magnesum reabsorbed in the thick ascending limb?

How much of each is reabsorbed?

A
  • move paracellularly - driven by higher + charge in lumen.
  • 20% calcium
  • 50-60% magnesium
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7
Q

What 2 things can upregulate NKCC2?

A
  • Angiotensin II
  • Vasopressin
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8
Q

What are the genetic mutations in the thick ascending limb- what syndrome can this cause?

A
  • Bartter syndrome
    • depends on which genetic mutation for if it presents early or later in life
    • causes growth and mental issues
    • volume depletion
    • low blood pressure
    • hypokalemia
    • metabolic acidosis
    • hypercalciuria
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9
Q

What is a drug that blocks the NK2Cl channel?

A

lasix

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10
Q

What are the channels on the luminal side of the distal convoluted tubule?

A
  • Na+/Cl- symporter = NCC channel
  • TRPV5 - brings in calcium
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11
Q

What are the channels on the basolateral side of the distal convoluted tubule?

A
  • Cl-
  • K+/Cl- symporter
  • K+ recycling
  • Na+ in/Ca2+ out antiporter
  • ATPase
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12
Q

How much of each is absorbed in the distal convoluted tubule?

sodium

calcium

magnesium

A

Sodium = 5%

Calcium = 7-10%

Magnesium = 10%

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13
Q

What is the disease that results if the NaCL transporter in the distal convoluted tubule doesn’t work?

Symptoms?

A
  • Gitleman Syndrome
    • ​normal bp
    • metabolic acidosis
    • HYPOcalciuria
    • HYPOmagnesemia
    • HYPOkalemia
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14
Q

What drug can manipulate the Na-Cl channel?

A

hydrochlorothiazide

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15
Q

Describe the principle cell of the collecting duct?

A
  • Principle cell
    • salt, chloride reabsorption
    • potassium exceretion
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16
Q

Describe the intercalated cell of collecting duct

A
  • Intercalated cell
    • H+ and HCO3- excretion
    • K+ reabsorption
17
Q

How much Na is reabsorbed in the collecting duct?

A
  • 0 to 5%
18
Q

What are the luminal transporters on the principle cell of the collecting duct?

A
  • ENAC - reabsorbs Na+
  • ROMK - lets K+ into lumen
19
Q

What are the basolateral transporters on the principle cell of the collecting duct.

A
  • K+ recycling channel
  • ATPase
  • aldosterone can bind to SRE
20
Q

What are the effects of aldosterone binding?

A
  • Sodium reabsorption
  • K+ excretion
21
Q

What does the sympathetic nervous system control?

What is it triggered by?

A
  • Stimulates sodium uptake in proximal tubule
    • increases Na-K ATPase
    • Increases Na-H antiporter
  • Controls afferent/efferent tone
    • REDUCES renal blood flow and GFR
  • Hypovolemia, Angiotensin II
22
Q

What are the 3 primary signaling pathways that stimulate renin release?

A
  • sympathetic input - NE triggers renin
  • decreased stretch in afferent arterole
  • decreased chloride delivery to macula densa
23
Q

What 5 things does angiotensin II do?

A
  1. systemic vasoconstrictor
  2. proximal tubule reabsorption of sodium and stimulates ENAC
  3. stimulates salt appetite, thirst in CNS
  4. stimualtes aldosterone
  5. increases sympathetic activity
24
Q

How does the amount of salt affect:

Creatinine clearance & sodium excretion

Plasma renin activity

Plasma Aldosterone

A
  • clearance = lower salt = lower clearance
    • more salt = higher clearance
  • renin
    • lower salt = more renin
  • Plasma aldosterone
    • ​low salt = more aldosterone

CRRAB II (26 decks)

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