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PT 509 Physiology > Metabolism/Urinary > Flashcards

Metabolism/Urinary Flashcards

1
Q

Main goal of Adenosine Triphosphate?

A

Make ATP

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2
Q

CHO metabolism: main forms

A

Glucose
Fructose
Galactose

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3
Q

CHO is transported into…

A

Cytoplasm

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4
Q

What is the most important and common carrier?

A

GLUT

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5
Q

Rate of CHO utilization is controlled by…

A

Insulin secretion

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6
Q

Glycolysis

A 
Split glucose to 2 molecules of pyruvic acid
10 chemical reactions
Net: 2 ATP, 2 NADH
Input: glucose
Output: pyruvate
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7
Q

Glycolysis compared to Electron Transport

A

Many more ATP w/ ETC

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8
Q

CHO: Pyruvic Acid/Krebs Cycle

A

Conversion to Acetyl Co-A (2)
No ATP
H+ formation (4)
Mitochondrial matrix

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9
Q

CHO: Citric Acid Cycle

A

Acetyl Co-A (2) to CO2 & H+

2 ATP formed (1/Acetyl Co-A), spine twice

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10
Q

CHO: Oxidative Phosphorylation

A

90% of total ATP formed via oxidation of H+ from glucose degradation
Mitochondria

Chemiosmotic mechanism

  • ETC
  • ATP synthase
  • Transfer ATP to cytoplasm

32 ATP

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11
Q

ETC

A

most ATP

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12
Q

Lipid Metabolism

A

TG, Phospholipids, Cholesterol
TG to FA & glycerol
Glycerol to glycolysis

FAs enter mitochondria to Acetyl Co-A (Beta Oxidation)

Acetyl Co-A to Citric Acid Cycle

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13
Q

Protein Metabolism

A

Deamination - removal of amino groups from AAs, releases ammonia NH3
Conversion into urea (liver), excreted by kidneys
Kept acids undergo oxidation (Transamination)
Enters CAC
Produces slightly less ATP than glucose
Gluconeogenesis, Ketogenesis

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14
Q

ATP production levels

A

Protein

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15
Q

Developmental Physiology: Prenatal

A

Urine excretion - 2nd tri

Amniotic

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16
Q

Developmental Physiology: Infancy

A

Other kidney functions

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17
Q

Functional unit of kidneys?

A

Nephron

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18
Q

Male vs female: urethra

A

males have prostrate gland that can back up bladder, impact the kidneys if severe

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19
Q

Macula Densa

A

sensitive to NaCal
Vasodilation in afferent arterioles
renin release method of fluid balance
blood pressure regulation

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20
Q

Filtration* most time on

A

1) Filtration*
2) Resorption*
3) Secretion
4) Execretion

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21
Q

Bowman’s capsule

A

where glomerular filtration takes place

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22
Q

Last opportunity for filtration

A

Peritubular capillaries

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23
Q

Urinary excretion

A

Excretion = Filtration - Reabsorption + Secretion

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24
Q

Renal Handling

A

Filtration only: Creatinine
Filtration, partial reabsorption: NaCl
Filtration, complete reabsorption: AA/glucose, water
Filtration/secretion: acids/bases

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25
Q

glomerular filtration (GFR)

A

125 ml/min = 180 liters/day
60 times/day

Composition is about the same as plasma, except for large proteins

26
Q

Filtration fraction (GFR/Renal plasma flow)

A

0.2 (20% plasma filtered)

27
Q

Glomerular Capillary Filtration Barrier

A

Loops

28
Q

Determinants of GFR

A

Hydrostatic pressure
Bowman’s capsule pressure
Oncotic pressure

29
Q

Glomerular Injury in DM

A

Capillaries swell, impairs the filtration system
Filled with blood/glucose/inflammed
Can’t filter properly

30
Q

RBF

A

High blood flow needed for high GFR
22% CO goes to kidneys
O2 and nutrients to fuel kidneys
O2 consumption related to sodium resorption

31
Q

Autoregulation

A

Macala densa
in the distal tubule near arterioles
If NaCl low dilates (increases everything) Efferent
If NaCl high constricts (decreases everything) Afferent

32
Q

Tubular Reabsorption

A 
Tubular lumen, peritubular capillaries
Transepithelial transport, 5 barriers
1) luminal cell membrane
2) cytosol
3) basolateral cell membrane
4) interstitial fluid
5) capillary wall

Proteins are too large

33
Q

Glucose Transport Maximum

A

Only filter so much glucose before the kidneys cannot keep up anymore

34
Q

Hormone: Aldosterone, effects

Adrenal cortex

A

Increase NaCl, H2O reabs

Increase K secr

35
Q

Hormone: Angiotensin II, effects

Liver

A

Increase NaCl, H2O reabs

Increase H secr

36
Q

Hormone: ADH, effects

Post pit

A

Increase H2O

AKA Vasopressin

37
Q

Hormone: ANP, effects

Heart

A

Decrease NaCl

38
Q

Hormone: PTH, effects

A

Decrease PO4, Ca++ reabs

39
Q

Reabsorbs NaCl, low BP

A

Aldosterone

Angiotensin II

40
Q

Reaborbs H2O, low BP

A

Aldosterone
Angiotensin II
ADH

41
Q

Angiotensin II

A

increases renal tubular sodium resorption

binds on cell receptor then uses pumps back into blood

42
Q

ANP (heart)

A 
chemoreceptors in heart
goal: decrease BP, SNS
output: urine
input: water
decreases NaCl
43
Q

Main things secreted?

A

Hydrogen, H

Potassium, K

44
Q

Waste Products

A

Urea
Uric acid
Creatinine
Bilirubin

45
Q

Short Term effects: Baroreceptor Reflex

A 
BP drops
in heart
SNS
vasoconstriction
increase arterial pressure
exercise, altitude
46
Q

Long term effects: Baroreceptors

A 
BP drops
changes vasoconstriction changes afferent/kidneys (system)
Glomerulus Bowman's
Decrease GFR/BP/urine volume
retaining NaCl, H2O
increases BP
47
Q

Uncontrolled BP.. long term leads too..

A

taxes out kidneys

48
Q

RAAS

A

main output: increase NaCl and H2O reabs

Angiotensinogen - liver
Renin - kidneys
ACE - lungs
A2 - adrenal cortex
Aldosterone - kidneys, adrenal cortex
49
Q

RAAS: A2 causes

A

Vasopressin (ADH)
Thirst
Arteriolar vasoconstriction

NaCl/H2O reabsorption

50
Q

Aging

A

Decrease blood flow to kidneys, nephrons, efficiency, volume, sodium regulation, bladder capacity

51
Q

DM 1: Pathogenesis

A

Autoimmune progressive

Destruction of beta cells

52
Q

Chronic Kidney Disease: CKD

A

half of kidney disease results from DM

53
Q

CKD

A

sugar in blood impairs vasculature

doesn’t allow normal nutrients to circulate properly

54
Q

CKD & DM: Pathogenesis

A

Abnormal byproducts, hyperglycemia

55
Q

DM neuropathy

A

vessels inflamed due to excess protein
leads to decrease urine output
increases in GFR first then when capsules die theres a decrease in GFR (RAAS)

56
Q

Consequences of CKD

A 
impaired immune
skin disorders
gastrointestinal
neurological
sexual dysfunction
57
Q

CKD Dx

A 
Blood GFR, creatinine levels
urine test for blood/protein/albumin/creatinine
imaging
biopsy
5 stages
1: >90
5:
58
Q

CKD, diminished

A

> 90 ml/min
normal or increase GFR
nocturia, decrease []

59
Q

CKD, insufficiency

A 
headaches
can't []
polyuria/olliguria
increase BUN/serum/creatinine
edema
GFR to 30 ml/min
mild anemia
increase BP
weak/fatigue
60
Q

CKD: Tx

A 
sodium restrictions
diuretics
dietary restrictions
avoid NASAIDS
sodium bicarbonate
phosphate binders
61
Q

CKD: Tx endstage

A

Dialysis

Kidney transplant

PT 509 Physiology (9 decks)

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