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JD RENAL > Phys & Pharm > Flashcards

Phys & Pharm Flashcards

1
Q

name one osmotic diuretic

A

mannitol

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2
Q

name one carbonic anhydrase inhibitor

A

acetazolamide/diamox

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3
Q

where does CAI act in nephron?

A

PCT

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4
Q

two uses for CAI?

A

glaucoma - reduce intraocular P

reduce CSF P

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5
Q

name four loop diuretics

A

furosemide
torsemide
bumetanide
ethacrynic acid (rarely used)

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6
Q

where in the nephron do loop diuretics work?

A

TAL LOH -

- blocks the NKCC channel

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7
Q

name four thiazide diuretics

A

HCTZ
chlorthalidone
indapamide
metolazone

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8
Q

where in the nephron do thiazide diuretics work?

A

DCT (on the NaCl reabsorption symporter)

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9
Q

name two K+-Sparing Diuretics that are Na Channel blockers

A

triamterene

amiloride

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10
Q

name two K+-Sparing Diuretics that are Aldosterone Receptor Antagonists

A

spironolactone

eplerenone

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11
Q

name two Vasopressin agonists

A

pitressin

desmopressin

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12
Q

name two Vasopressin receptor antagonists

A

conivaptan

tolvaptan

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13
Q

RAAS BLOCKADE

name ADH receptor blockers

A

-vaptams

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14
Q

RAAS BLOCKADE

two facts about ADH receptor blockers

A

1 - these stop CD water excretion

2 - hyponatremia treatment only! (no role in HTN treatment)

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15
Q

RAAS BLOCKADE

name two aldosterone blockers and what action do they take?

A

spironolactone/aldactone
epleronone

  • no sodium retention, no K= excretion!
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16
Q

RAAS BLOCKADE

name one renin inhibitor

17
Q

RAAS BLOCKADE

ACE-inhibitors

18
Q

RAAS BLOCKADE

Ang II Receptor Blockers (ARBs)

19
Q

K+ concentration

  • INSIDE cell
  • OUTSIDE cell
A

K+ concentration

  • INSIDE cell: ~140
  • OUTSIDE cell: ~4
20
Q

Na+ concentration

  • INSIDE cell
  • OUTSIDE cell
A

Na+ concentration

  • INSIDE cell: 14
  • OUTSIDE cell: ~140
21
Q

Ca+2 concentration

  • INSIDE cell
  • OUTSIDE cell
A

Ca+2 concentration

  • INSIDE cell: 0.1
  • OUTSIDE cell: 1.2
22
Q

ions highest inside the cell?

A

K+ 140
Mg+2 20
HPO4-3 11
proteins 4

(think bananas, Mg, phosphate, protein)

23
Q

ions highest outside cell?

A

Na+ 140
Ca+2 1.2
Cl- 110
HCO3- 28.3

(think salt, milk, and bicarb)

24
Q

in normal kidneys, what is true of osmolarity of renal tubular fluid that flows through early DT in region of macula densa?

A

HYPOTONIC compared with plasma

has just passed through diluting segment in which ions have passed out, and osmolarity decreases to ~100 mOsm

25
Q

what causes a great decrease in GFR in a person with normal kidneys?

A

a 50% decrease in the efferent arteriolar resistance

26
Q

what changes would be observed for a pt with high levels of plasma aldosterone (Conn’s syndrome)?

A 
plasma K+ concentration - down
plasma pH - up
plasma renin concentration - down
urine K+ excretion - no change
urine Na+ excretion - no change
27
Q

three weeks after pt ingests toxin that causes sustained impairment of proximal tubular NaCl reabsorption - what changes observed in GFR, AA resistance, and sodium excretion?

A

GFR rate - goes down
AA resistance - goes up
sodium excretion - no change, or goes up

28
Q

vasodilator drug causes 50% decrease in AA resistance, no change in arterial pressure. What changes would you find in RBF, GFR, and peritubular capillary hydrostatic P?

A

renal blood flow - increased
glomerular hydrostatic P - increased
GFR - increased

reducing AA resistance raises peritubular capillary hydrostatic P

29
Q

what change will increase peritubular capillary fluid reabsorption?

A

increasing efferent arteriolar (EA) resistance

30
Q

______ P in the ______arteriole and __________ capillaries = ___________of fluid

A

LOWER pressure in the EFFERENT arteriole and PERITUBULAR capillaries = REABSORPTION of fluid

31
Q

macular densa cells release _____ to ______AA

A

macula densa cells release ADENOSINE to CONSTRICT AA

32
Q

four values that shift K+ out of cells

A

hyperosmolarity
exercise
cell lysis (rhabdo)
acidosis

33
Q

four values that shift K+ INTO cells

A

insulin
beta agonists
aldosterone
alkalosis

34
Q

what effect does high luminal Na+ have on K+ secretion in late DCT/CCD (principal cells)?

A

increased Na+ –> more + lumen, then also, less Na+ is coming into the cell –> less K+ coming into cell

also, stops K+ secretion

35
Q

what effect does high luminal HCO3- have on K+ secretion in late DCT/CCD (principal cells)?

A

lumen potential will be more - and pull more K+ outside the cell

36
Q

what factors alter/perturb K+ (in other words, increase K+ secretion/excretion)?

A

high distal flow rate
increased sodium intake (greater flow rate –> Na+ drags water –> greater Na+-K+-ATPase moving K+out)
chronic alkalosis
acute and chronic acidosis

JD RENAL (3 decks)

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