Phys & Pharm

Question 1

name one osmotic diuretic

Answer 1

mannitol

Question 2

name one carbonic anhydrase inhibitor

Answer 2

acetazolamide/diamox

Question 3

where does CAI act in nephron?

Answer 3

PCT

Question 4

two uses for CAI?

Answer 4

glaucoma - reduce intraocular P

reduce CSF P

Question 5

name four loop diuretics

Answer 5

furosemide
torsemide
bumetanide
ethacrynic acid (rarely used)

Question 6

where in the nephron do loop diuretics work?

Answer 6

TAL LOH -

- blocks the NKCC channel

Question 7

name four thiazide diuretics

Answer 7

HCTZ
chlorthalidone
indapamide
metolazone

Question 8

where in the nephron do thiazide diuretics work?

Answer 8

DCT (on the NaCl reabsorption symporter)

Question 9

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

Answer 9

triamterene

amiloride

Question 10

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

Answer 10

spironolactone

eplerenone

Question 11

name two Vasopressin agonists

Answer 11

pitressin

desmopressin

Question 12

name two Vasopressin receptor antagonists

Answer 12

conivaptan

tolvaptan

Question 13

RAAS BLOCKADE

name ADH receptor blockers

Answer 13

-vaptams

Question 14

RAAS BLOCKADE

two facts about ADH receptor blockers

Answer 14

1 - these stop CD water excretion

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

Question 15

RAAS BLOCKADE

name two aldosterone blockers and what action do they take?

Answer 15

spironolactone/aldactone
epleronone

• no sodium retention, no K= excretion!

Question 16

RAAS BLOCKADE

name one renin inhibitor

Answer 16

aliskerin

Question 17

RAAS BLOCKADE

ACE-inhibitors

Answer 17

• prils

Question 18

RAAS BLOCKADE

Ang II Receptor Blockers (ARBs)

Answer 18

-sartans

Question 19

K+ concentration

• INSIDE cell
• OUTSIDE cell

Answer 19

K+ concentration

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

Question 20

Na+ concentration

• INSIDE cell
• OUTSIDE cell

Answer 20

Na+ concentration

• INSIDE cell: 14
• OUTSIDE cell: ~140

Question 21

Ca+2 concentration

• INSIDE cell
• OUTSIDE cell

Answer 21

Ca+2 concentration

• INSIDE cell: 0.1
• OUTSIDE cell: 1.2

Question 22

ions highest inside the cell?

Answer 22

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

(think bananas, Mg, phosphate, protein)

Question 23

ions highest outside cell?

Answer 23

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

(think salt, milk, and bicarb)

Question 24

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

Answer 24

HYPOTONIC compared with plasma

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

Question 25

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

Answer 25

a 50% decrease in the efferent arteriolar resistance

Question 26

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

Answer 26

``` plasma K+ concentration - down plasma pH - up plasma renin concentration - down urine K+ excretion - no change urine Na+ excretion - no change ```

Question 27

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?

Answer 27

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

Question 28

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?

Answer 28

renal blood flow - increased glomerular hydrostatic P - increased GFR - increased reducing AA resistance raises peritubular capillary hydrostatic P

Question 29

what change will increase peritubular capillary fluid reabsorption?

Answer 29

increasing efferent arteriolar (EA) resistance

Question 30

______ P in the ______arteriole and __________ capillaries = ___________of fluid

Answer 30

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

Question 31

macular densa cells release _____ to ______AA

Answer 31

macula densa cells release ADENOSINE to CONSTRICT AA

Question 32

four values that shift K+ out of cells

Answer 32

hyperosmolarity exercise cell lysis (rhabdo) acidosis

Question 33

four values that shift K+ INTO cells

Answer 33

insulin beta agonists aldosterone alkalosis

Question 34

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

Answer 34

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

Question 35

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

Answer 35

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

Question 36

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

Answer 36

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