Midterm 2 Flashcards

Learn the topics of "Blood Pressure 2", "Vascular Function" and "Reactive Oxygen Species"

1
Q

Long term mechanisms of blood pressure control depends mostly on _____ function through _____ control

A

kidney, hormonal

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2
Q

What is the name of the hormone system responsible for controlling kidney function and blood pressure?

A

Renin-angiotensin-aldosterone system

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3
Q

ADH

A

antidiuretic hormone (also called arginine vasopressin)

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4
Q

_____ and ____ regulate sodium and water retention affecting blood volume and thereby blood pressure

A

Aldosterone, ADH

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5
Q

Secretory function of the adrenal gland is regulated by _____ _____ _____ activity and _____ factors

A

sympathetic nervous system, humoral

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6
Q

Adrenal gland is important in the secretion of:

A

Cortisol- energy metabolism
Epinephrine- stress, exercise
Aldosterone- blood volume, blood pressure regulation

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7
Q

Which part of the nephron contains baroreceptors?

A

Afferent arteriole

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8
Q

The functional unit of the kidney

A

Nephron

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9
Q

Approximately how many nephrons are in a singular kidney?

A

1.5 million

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10
Q

Branched high pressure capillaries located in the Bowman’s capsule

A

Glomerulus

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11
Q

The high pressure in the glomerulus…

A

forces things (H2O, Na+, glucose) out of the blood

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12
Q

Exits the glomerulus and forms new capillaries that wrap around the PCT, Loop of Henle, and DCT

A

Efferent arteriole

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13
Q

PCT

A

Proximal convoluted tubule

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14
Q

DCT

A

Distal convolutes tubule

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15
Q

Ions, water, vitamins, glucose are reabsorbed in which areas of the nephron?

A

Proximal convoluted tubule, Loop of Henle, distal convoluted tubule, and the collecting duct

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16
Q

If H2O filtration rate (GFR) > H2O reabsorption then…

A

Urine output increases, blood volume decreases, blood pressure decreases

Decreased VR = Decreased CVP = Decreased EDV/ESV = Decreased MAP

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17
Q

Macula densa

A

Specialized cells lining the wall of the distal convoluted tubule that monitor flow through the distal convoluted tubule and the concentration of sodium ions

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18
Q

Regulates the release of renin from the juxtaglomerular cells

A

Macula densa

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19
Q

What hormone does the liver constitutively secrete into the blood?

A

Angiotensinogen

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20
Q

What is the rate limiting enzyme in the renin-angiotensin-aldosterone system (RAAS)?

A

Renin- it is required to cleave angiotensinogen to form Angiotensin I

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21
Q

How is Angiotensin I converted to Angiotensin II?

A

Angiotensin converting enzyme (ACE)

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22
Q

Endothelial cells contain _____ _____ _____; primarily the lungs

A

Angiotensin converting enzyme (ACE)

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23
Q

Angiotensin II interacts with what four structures?

A

Arterioles and veins, the adrenal cortex,collecting ducts in the kidney, and the posterior pituitary gland

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24
Q

True or false: Ag II induces vasoconstriction via vascular smooth muscle cells

A

True

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25
Q

Angiotensin II binds to _____ _____ _____ Receptors on the vascular smooth muscle cells, _____ _____ _____ receptors belong to the Gq protein coupled receptor family and act through the _____ _____ ______ pathway and _____ _____ pathway

A

Angiotensin Type 1 (AT1), angiotensin type I (AT1), phospholipase C-inositol triphosphate (IP3), rho kinase

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26
Q

Increased Angiotensin II stimulates the secretion of _____ from the _____ _____ to the blood

A

aldosterone, adrenal cortex

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27
Q

Aldosterone increases the rate of _____ reabsorption in the _____ _____ ______ and collecting duct

A

sodium (Na+), distal convoluted tubule

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28
Q

Aldosterone also increases the rate of _____ reabsorption by the direct activation of Na+/H+ exchangers and Na+ channels

A

sodium (Na+)

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29
Q

Increased reabsorption of _____ leads to increased reabsorption of _____ and thus increases venous return and mean arterial pressure

A

sodium (Na+), water (H2O)

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30
Q

Angiotensin II stimulates the secretion of _____ _____ from the _____ pituitary gland

A

antidiuretic hormone, posterior

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31
Q

Diuretic

A

Increases urine output

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32
Q

How does antidiuretic hormone regulate blood pressure?

A

It moves aquaporins to the apical surface of the plasma membrane in order to increase water reabsorption and therefore increase blood volume

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33
Q

What class of hormones opposes the renin-angiotensin-aldosterone system?

A

Natriuretic hormones (e.g. arterial natriuretic peptide, ANP, which is released from the atria in response to stretching in the atrial walls)

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34
Q

Arterial natriuretic peptide acts by inhibiting the secretion of _____ from the adrenal cortex

A

aldosterone

35
Q

Inhibition of aldosterone secretion leads to…

A

less sodium (Na+) reabsorption and therefore less water reabsorption

36
Q

Arterial natriuretic peptide acts by inhibiting the secretion of _____ from the posterior pituitary gland

A

antidiuretic hormone (ADH)

37
Q

Arterial natriuretic peptide acts on the vascular _____ _____ of veins and arterioles by increasing the concentration of _____

A

smooth muscle, cGMP (results in venodilation and vasoconstriction)

38
Q

Arterial natriuretic peptide acts by inhibiting the secretion of _____ from the juxtaglomerular cells

A

renin (reduces Ag II)

39
Q

What is a reactive oxygen species (ROS)?

A

Highly reactive compounds formed in every cell. There is a basal level of ROS production at rest which can increase in times of stress. They contain at least one O2 (ROS) or one nitrogen (NOS).

40
Q

What is a free radical?

A

These compounds fall under the ROS category and contain at least one unpaired electron (e.g. O2-, superoxide)

41
Q

NOX

A

NADPH oxidase- a protein complex that produces primarily superoxide. NADPH + O2 –(NOX)–> NADP+ + H+ + O2-

42
Q

eNOS

A

Endothelial nitric oxide synthase- a transmembrane protein that produces nitric oxide from L-arginine

43
Q

ONOO-

A

Peroxynitrite- a ROS formed from superoxide and nitric oxide

44
Q

Complex I, II, III and PMF all have the potential to form _____

A

superoxide

45
Q

Enzymatic antioxidants

A

Superoxide Dismutase (MnSOD or CuZnSOD) and catalase

46
Q

Non-enzymatic antioxidants

A

alpha-tocopherol (vitamin E), ascorbate (vitamin C), retinol (vitamin A), and glutathione (GSH)

47
Q

ROS-mediated _____-_____ modifications of proteins is an important means of controlling protein _____

A

post- translational

48
Q

ROS affects the _____ _____ of a protein which will alter the activity for better or for worse

A

3D structure

49
Q

A protein with two thiol groups can form sulfenic acid by the addition of _____ _____

A

hydrogen peroxide

50
Q

Sulfenic acid can form an intramolecular disulfide bond, an intermolecular disulfide bond, s-glutathiolation or sulfinic acid

A

Intramolecular disulfide bond- water dehydrates
Intermolecular disulfide bond- another molecule with a thiol group interacts with R-SOH group
Sulfinic acid- hydrogen peroxide interacts with the R-SOH group (R-O2H formed)
S-glutathiolation- glutathione adds SH and removes OH to form water

51
Q

Optimal ROS production occurs during…

A

moderate stress like exercise

52
Q

Oxidative stress

A

ROS production too great

53
Q

In S1 hypertension systolic BP = _____ and diastolic BP = _____

A

130-139, 80-89

54
Q

In S2 hypertension systolic BP = _____ and diastolic BP = _____

A

> 140, >90

55
Q

Primary hypertension

A
  • also known as essential hypertension or idiopathic hypertension
  • bp increases without identifiable cause
  • most common (>95% of cases)
  • contributing factors are genetic, environmental and behavioural
56
Q

Secondary hypertension

A
  • elevated bp with an unidentifiable cause

- usually renal, endocrine or drugs treating other diseases/conditions

57
Q

Why does the probability of developing hypertension increase as we age>

A

Due to stiffening of the large arteries

58
Q

______ are more likely to develop hypertension before the age of 55

A

Men

59
Q

The intersalt study looked at _____ and found a relationship between developing it and _____ consumption

A

hypertension, salt

60
Q

Hypertension due to increased salt consumption is the result of…

A

vasoconstriction due to increased Ca2+ due to activation of NCX (sodium-calcium exchanger) Ca2+ binding CM (calmodulin) and then Ca-CM (calcium-calmodulin) binding MLCK (myosin light-chain kinase)

61
Q

What consequences are there for a reduction in eNOS activity?

A

A decrease in nitric oxide production; decreased nitric oxide bioavailability. Nitric oxide is unable to activate guanylate cyclase which results in a decrease in cGMP and MLCP (myosin light-chain phosphatase) activity (i.e. VSMC tone increases)

62
Q

Renal artery stenosis

A

Narrowing of one of the renal arteries, most often caused by atherosclerosis or fibromuscular dysplasia.

63
Q

Renovascular disease

A

A progressive condition that causes narrowing or blockage of the renal arteries or veins.

64
Q

_____ plaque can form in the renal artery or smaller arteries from the renal artery

A

Atherosclerotic

65
Q

Creation of a _____ in the artery is the result of a build up atherosclerotic plaque

A

stenosis

66
Q

Downstream of a stenosis you would expect…

A

a substantial drop in blood pressure

67
Q

Why is there such a drop in blood pressure following a stenosis?

A

Vasodilation occurs in an attempt to maintain adequate blood flow

68
Q

In renal artery stenosis, a drop in blood pressure will be observed in the _____ _____ just downstream the renal artery and lead to low blood pressure being detected by the _____ _____ ______ and causing increased SNS activity to the juxtaglomerular cells and ultimately _____ release

A

afferent arteriole, afferent arteriole baroreceptors

69
Q

List the steps in renal artery stenosis

A

atherosclerotic plaque forms stenosis in renal artery, downstream bp is reduced, afferent arteriole baroreceptors activate SNS response to juxtaglomerular cells, juxtaglomerular cells release renin, renin cleaves angiotensinogen to form angiotensin I, angiotensin I is converted to angiotensin II by angiotensin converting enzyme

70
Q

List the effects in order of angiotensin II interacting with vascular smooth muscle

A

Angiotensin II binds angiotensin type 1 Gi coupled receptor, decrease in adenylate cyclase activity, decrease in cAMP concentration, decrease in protein kinase A activity, increased myosin light-chain kinase activity, and thus increased tension

71
Q

C57/BL6 is a genetically _____ mouse for the p47phox

A

normal

72
Q

p47phox-/- is has a gene for a subunit of _____ _____ knocked out

A

NADPH oxidase

73
Q

p47phox-/- mice had…

a) higher superoxide production than C57/BL6 mice
b) lower superoxide production than C57/BL6 mice
c) identical superoxide production to C57/BL6 mice

A

b)

74
Q

What class of diuretics is typically used in the initial stages of treating hypertension?

A

Thiazides

75
Q

A chemical inhibiter of the Na+/Cl- symporter of the distal convoluted tubule of the nephron

A

Hydrochlorothiazide

76
Q

What are the two classes of renin-angiotensin-aldosterone system (RAAS) inhibiting drugs?

A

Angiotensin converting enzyme (ACE) inhibitors, and angiotensin type 1 receptor (AT1R) blockers

77
Q

AT1 Receptor Blockers work by…

A

preventing angiotensin II from binding to AT1 receptors, reducing intracellular signalling and preventing the depletion of NO bioactivity

78
Q

Beta Blockers

A

B-adrenergic receptor blockers- blocks norepinephrine (NE) from binding to B-adrenergic receptors

79
Q

What effect do beta blockers have on the circulatory system?

A

Decrease inotropy = increase in end-systolic volume = decrease stroke volume = decrease in cardiac output = decrease in systolic blood pressure = decrease in mean arterial pressure

80
Q

What effect do beta blockers have when they bind the B-adrenergic receptors of the sinoatrial node?

A

Decreased heart rate = decreased cardiac output = decrease in systolic blood pressure = decrease in mean arterial pressure

81
Q

In Ca2+ channel blockers what two channels are targeted?

A

Dihydropyridine receptors (DHPRs), and L-type channels

82
Q

What effect does decreased Ca2+ entry into the cell during depolarization have?

A

Ventricular cardiomyocytes: decreased inotropy in left ventricle (increased end-systolic volume = decreased stroke volume = decreased cardiac output)
Sinoatrial nodal cells: negative chronotropic effect (decreases heart rate)

83
Q

What effect does a Ca2+ channel blocker (CCB) have on vascular smooth muscle?

A

Decreases calcium entry = decreases Ca-CM = decreases MLCK activity
Results in vasodilation, thus decrease in TPR (MAP = CO X TPR)