Principles of Physiology and Pharmacology Flashcards
Which is the myelinating cell-type in the PNS?
Schwann cell
What does excitation-contraction coupling start with?
Propagation of APs along sarcolemma
Concerning body fluids and osmolality, select the incorrect statement
a) Plasma osmolality is 290mosmol/kg H2O
b) Isotonic saline has 150mmol/L of NaCl
c) 500ml of water containing 20mmol of CaCl2 has an osmolarity of 80mosmol/kg H2O
d) Normal blood has a haematocrit of 0.47 in adult males
500ml of water containing 20mmol of CaCl2 has an osmolarity of 80mosmol/kg H2O
Renal clearance values…
a) For insulin are a measure of GFR
b) Greater than the GFR indicates tubular secretion
c) Less than GFR are always indicative of tubular reabsorption
d) Can be measured non-invasively
Greater than the GFR indicates tubular secretion
How long is a cardiac action potential?
200 to 400 milliseconds
What type of Ca channels are found at the T-tubule membrane?
L-type/Dihydropyridine (DHP) receptors
What cells does omeprazole act on?
Parietal cells
Where are components of Herring bodies synthesised?
Preoptic and paraventricular nuclei of hypothalamus
What is the terminal cisternae?
The area where the sarcoplasmic reticulum on the myofibrils meet
What is nebulin?
Actin-binding protein that extends from Z band along length of actin filament
Acts as template to regulate actin length
What is titin?
Protein than extends Z-line to M-line
Anchors myosin to maintain central position in sarcomere
What are the 3 functional stages of the sarcomere?
Resting Stage
Contracting Stage
Stretched Stage
What type of contraction is present in the contracting stage of the sarcomere?
Concentric contraction
What type of contraction is present in the stretched stage of the sarcomere?
Eccentric contraction
What complex on tropomyosin blocks the head of actin?
Troponin
What does Calcium bind to when released into the sarcoplasm?
Troponin complex (Troponin C)
How many stages are there to muscle contraction and what they called?
5 stages Attachment Release Bending Force Generation Reattachment
How does muscle relax?
Calcium AT into sarcoplasmic reticulum to remove from cytosol
Stops binding to troponin
What are the 3 types of muscle fibres?
Slow twitch - oxidative type 1
Fast twitch - oxidative, glycolytic type 2A
Fast twitch - glycolytic type 2B
What is the length-tension relationship in a muscle?
Tension a muscle can generate related no of cross bridges formed between thick and thin filaments
What percentage of our body weight is water and what is it made up of?
60% water (42L) 40% of water - intracellular space (28L) (3.5L of which is blood cells) 15% is interstitial space (10.5L) 5% is plasma space (3.5L)
What is the water content of lean tissue?
0.7L/kg
How to calculate interstitial space?
Interstitial space = ECS - plasma volume
How to calculate intracellular space?
Intracellular space = TBW - ECS
How would you measure plasma volume?
What does the substance have to be like?
Something that can’t cross capillaries
Evans Blue, labelled Inulin, Albumin
How would you measure extracellular space?
What does the substance have to be like?
Something that doesn’t enter cell easily
Na-24, Sucrose
How would you measure total body weight?
What does the substance have to be like?
Something that distributes with all water
H2O-8
What is the difference between osmolarity and osmolality?
Osmolarity - 1 osmole p/litre
Osmolality - 1 osmole p/kg
What causes crystalloid osmotic pressure?
Due to small diffusable ions (e.g. Na, Cl, K in body fluid)
What causes oncotic osmotic pressure?
Proteins that can’t cross cell membranes and displace water molecules
What is the main ion in plasma and what does it control?
Sodium, Blood volume
What is the main ion in intracellular fluid and what does it control?
Potassium, Cell volume
What are the 3 plasma proteins and what do they do?
Albumin - oncotic osmotic pressure, buffering of pH,
Alpha, beta, gamma globulins - haemostasis, transport, immune system
Fibringon - haemostasis
What is the lifespan of RBC?
120 days
What percentage of leucocytes is lymphocytes and what do they do?
20-40%
Produce immunoglobins
What percentage of leucocytes is monocytes and what do they do?
2-8%
Form macrophages
What makes up granulocytes in leucocytes and what does each do?
Neutrophils - 50-70%, phagocytosis, chemotactic
Eosinophils - 1-4%, phagocytosis, allergy
Basophils - ~0.5%, release His + heparin
What are platelets?
Fragments of megakaryocytes
What are the 3 types of negative feedback?
Neuronal
Endocrinal
Local
What is normalization?
Change in variable being regulated is compared against a set-point
Causes a response that tends to move variables back to the set point
What is amplification?
Change in variable triggers a response that causes further change in that variable
Where are the neuronal integrating centres for physiological control located?
Midbrain and Brain-stem
What are the endocrine organs (8)?
Hypothalamus Pituitary Thyroid Parathyroid Adrenal cortex + medulla Pancreas Testes Ovaries
What are the releasing hormones of the hypothalamus?
GHRH - Growth Hormone Releasing Hormone
CRH - Corticotrophin Releasing Hormone
TRH - Thyrotrophin Releasing Hormone
GnRH - Gonadotrophin Releasing Hormone
What are the inhibiting hormones of the hypothalamus?
Somastostatin
Dopamine
What hormones are secreted by the posterior pituitary?
Neuroendocrine
Oxytocin
ADH - anti-diuretic hormone
What hormones are secreted by the anterior pituitary?
Endocrine GH - Growth hormone Prolactin FSH - Follicle Stimulating Hormone LH - Luteinizing Hormone TSH - Thyroid Stimulating Hormone ACTH - Adrenocorticotrophic Hormone
What are the types of hormones?
Peptides Polypeptides Glycopeptides AA derivatives Steroids
What hormones have tyrosine as a derivative?
Thyroxine T4 (in the thyroid) Adrenaline (adrenal medulla)
What hormones do the ovaries secrete?
Progesterone
Estrogens
What type of hormones do the testes secrete?
Androgens e.g testosterone
What hormones does the adrenal cortex secrete?
Glucocorticoids e.g. Cortisol
Mineralocortocoids e.g. Aldosterone
What hormones have their receptor location in the plasma membrane and mechanism of action?
Peptides, Proteins, Glycoproteins, Catecholamines
Secondary messengers to change enzyme activity
What hormones have their receptor location in the intracellular (cyto/nucleus) and mechanism of action?
Steroids, thyroid hormones
Alter gene transcription
What is a natural example of positive feedback?
Parturition - contraction of uterus to expel fetus
What are the 2 types of circulation?
Pulmonary circulation - in series with systemic
Systemic circulation - mostly parallel with each other
How to calculate cardiac output?
Cardiac Output = Stroke Volume x Heart Rate
What is laminar flow?
Viscous drag at sides of tube slows fluid
Fastest in centre
What is the Fahraeus-Lindquist effect?
Cells tend to become aligned in fast-moving fluid
Axial streaming
What is turbulence?
Partial narrowing of artery
What can turbulence trigger?
Can trigger production of reactive oxygen species
Induce proliferation and migration of vascular sm cells
In the left ventricle, what does the pressure oscillate between?
0-120 mmHg
In the right ventricle, what does the pressure oscillate between?
0-20 mmHg
How are electrical events in cells measured?
Intracellular - Electrode inside cell
Extracellular - Electrode outside cell
Patch Clamping - Electrode sealed to cell surface
What types of medical diagnostic tools use extracellular recordings?
ECG - Electrocardiogram
EMG - Electromyograph
EEG - Electroencephalogram
When a membrane is at rest, what ion is it more permeable to?
Potassium
What is the difference between permeability and conductance?
Permeability - ease with which an ion can enter a membrane, (no of open channels)
Conductance - measure of current that gets across cell membrane
How many subunits does a potassium channel have?
4
A transmembrane current can either be…?
Resistive - ion flows through channels
Capacitative - ion approaches 1 surface of membrane and another is expelled from other side
What is a consequence of demyelination?
Current dissipates over a distance
What are heart cells connected by?
Intercalated discs
What are MEPPs?
Sub Threshold Minature Endplate Potentials
small depolarisations of post-synaptic terminals caused by release of single vesicle into synaptic cleft
What response can MEPPs cause?
EPSP - Excitatory Post-Synaptic Potential
IPSP - Inhibitatory Post-Synaptic Potential
Between skeletal and cardiac muscle, which one is triad and which one is dyad?
Skeletal - Triad
Cardiac - Dyad
Why is a cardiac action potential longer than a skeletal?
Prevents tetany (involuntary contraction of muscle) Protects against re-entrant arrhythmias
What type of receptor is present on Ca release channels?
Ryanodine receptors
How is Ca removed from the sarcoplasm?
Via SERCA (sarco/endoplasmic Ca ATP-ase) Via sarcolemmal Na/Ca exchanger
What is the force-frequency effect (in heart)?
Increasing rate of cardiac contraction results in an increased tension development Gives treppe (staircase) effect on slow chart recorder
Do smooth muscle cells have striations?
No
What type of receptor does noradrenaline bind to and what does it activate?
Alpha 1 receptor
G-protein - activates phospholipase C - breakdown PIP2 (phosphatidyl inositol 4,5 biphosphate)
What receptor does adrenaline bind to?
Beta 1/2
What is unitary smooth muscle?
Not all cells have synaptic input
Excitation spreads through tissue by gap junctions
What is multi-unit smooth muscle?
Each smooth muscle cell has a synaptic input
Allows finer control of muscle
What g-protein is alpha-1 adrenergic receptor associated with and what does it stimulate?
Gq
IP3/Ca + DAG secondary messenger pathways to raise cellular [Ca]
What g-protein is alpha-2 adrenergic receptor associated with and what does it stimulate?
Gi
Inhibits adenylate cyclase to decrease cellular cAMP
What g-protein are beta adrenergic receptors associated with?
Gs
Where are each of the beta adrenergic receptors mainly located?
beta-1 - cardiac
beta-2 - vascular + airways
beta-3 - adipose, bladder
What non-adrenergic, non-cholinergic neurotransmitters can be released that promote vasoconstriction?
(Along with what NT?)
Neuropeptide Y
ATP
NA
What non-adrenergic, non-cholinergic neurotransmitters can be released that promote vasodilation?
(Along with what NT?)
Nitric oxide
Vasoactive intestinal polypeptide
AcH
Under normal circumstances, what branch of the nervous system is heart rate under the control of?
Peripheral Nervous System
What is the NTS in the brain stem?
Nucleus Tractus Solitarus
What does the Botulinum toxin A do and what is it used to treat?
(How treat?)
Binds to and degrades SNAP-25, preventing exocytosis of AcH and other N.T
Treat an overactive bladder - prevent stimulation of muscarinic receptor on detrusor muscle
Where should a drug be targeted for:
a) widespread effect
b) specific target
a) Sympathetic nerves in CNS/Sympathetic ganglion
b) Neuroeffector junction
What drug can be used to inhibit noradrenaline synthesis?
Alpha methyl tyrosine
What drug can inhibit noradrenaline storage and what does it do?
Reserpine
Block VMAT
How is noradrenaline normally uptaken into vesicles?
Via Vesicular Monoamine Transporter (VMAT)
What is noradrenaline metabolised by if not reuptaken?
Other hormones with this enzyme as well
Monoamine Oxidase (MAO) Dopamine, Serotonin
What drug(s) can inhibit noradrenaline release and how?
Clonidine
Alpha-2 adrenergic receptor specific agonist and activation of these receptors inhibits N.T. release
What drug(s) can promote noradrenaline release? (Secondary effect of one?)
Amphetamine - also inhibits MAO, increase free NA
Tyramine
Ephedrine
What selective blocker(s) block alpha 1 adrenergic channels?
Doxazosin
Tamsulosin
What is an example(s) of a non-selective beta blocker?
Labetolol
Propanolol
What is an example(s) of a beta-1 selective blocker?
Atenolol
What are some adverse effects of beta blockers?
Fatigue Reduced Peripheral Blood Flow Bronchoconstriction Increased risk of Cardiac Failure Risk of hypoglycemia
What receptor does Salbutomol effect?
Selective agonist of beta-2 receptor
What 2 enzymes are endogenous and exogenous catecholamines broken down by?
MAO - Monoamine Oxidase
COMT - Catechol-O-Methyl Transferase
What drugs inhibit MAO?
Phenylzine
Moclobemide
Selegiline
What is the top, middle and bottom bit of the stomach called?
Fundus
Corpus
Antrum
What chemical messengers are parietal cells acid secretion regulated?
AcH
Histamine
Gastrin
What enzymes do the pancreas, SI, and salivary glands secrete to digest carbs?
Pancreas - alpha amylase
Salivary glands - alpha amylase
SI - 1,6-glucosidase
What enzymes does the stomach, pancreas and SI secrete to digest proteins?
Stomach - pepsins, HCl
Pancreas - Carboxypeptidases
SI - Amino-peptidases, dipeptidases
What hormone causes contraction of gall bladder and where is it secreted from?
(What else does the hormone cause?)
Cholecystokinin
Secreted by cells in duodenum
Relaxation of sphincter of Oddi
What is bilirubin?
Yellow compound that occurs in normal catabolic pathway
From breakdown of heme
What are enterocytes?
Intestinal absorptive cells
Columnar epithelial, line inner surface of SI and LI
What are chylomicrons?
Re-esterified LCFA, monoglyc, lysophospholipids, cholesterol (absorbed by enterocytes)
Have specific apoproteins
Where are apoproteins made in enterocytes and where do they go?
In RER
Moves to SER + associates with newly synthesised trigylcerides
What is the receptor for AcH in the heart?
Muscarinic AcH receptor (mAcHR)
What nerve supplies the parasympathetic innervation for the heart?
Vagus nerve carries parasymp preganglionic axons
What is the receptor for noradrenaline in the heart?
Beta-1 adrenoreceptor
How is noradrenaline synthesised from tyrosine and what are the enzymes involved?
Tyrosine ==> DOPA (Tyrosine hydroxylase)
DOPA ==> Dopamine (DOPA Carboxylase)
Dopamine ==> Noradrenaline (Dopamine beta-hydroxylase)
What is the drug imipramine and what does it do?
Tricyclic antidepressant
Increases amount of noradrenaline in synapses by inhibiting uptake
How is AcH formed and what is the enzyme?
AcCoA + Choline ==> AcH (choline acetyl)
Choline acetyl transferase
Is AcH excitatory or inhibitory at:
a) Heart cells
b) Skeletal muscle
a) Inhibitory
b) Excitatory
What is the receptor in the skeletal muscle for AcH?
Nicotinic AcH Receptor (nAcHR)
What is myasthenia gravis?
When body produces antibodies against nAcH receptors
What receptor is on blood vessels in the gut for noradrenaline?
Alpha-1 adrenergic
What receptor is on blood vessels in skeletal muscle for noradrenaline?
Beta-2 adrenergic
What receptor is on sweat glands for AcH?
Muscarinic AcH receptor
What is pilocarpine?
Muscarinic AcH receptor agonist
What nerve is associated with parasympathetic stimulation of the salivary glands?
Chorda lingual nerve
What is the max rate of salivary flow in humans?
1ml/min.g
What is intrinsic factor?
Glycoprotein combines with vitamin B12
Aiding absorption in ileum
What is the section of the stomach just before the duodenum?
Pylorus
What are the 3 stages of stomach digestion?
Propulsion
Grinding
Retropulsion
What cell(s) in the stomach secrete HCl?
Parietal (oxyntic) cells
What cell(s) in the stomach secrete mucus?
Superficial epithelial cells
Mucous neck cells
What cell(s) in the stomach secrete pepsin and other digestive enzymes?
Chief cells
Endocrine cells
What are fenestrated capillaries?
Capillaries that have pores that allow larger molecules through
What is the constant concentration parietal cells secrete H+?
150mEq/L
What is an ECL cell?
Enterochromaffin-like cell
Neuroendocrine found in gastric glands of gastric mucosa beneath epithelium
What endocrine hormone(s) does the D cell secrete and what does it do?
Somatostatin
Binds to g cell in stomach epithelium, limits further gastrin secretion
What does the drug omeprazole do?
Selectively and irreversibly inhibits H+, K+, ATP-ase by forming a disulphide link
Prevent acid secretion
What cells help regulate the rhythmic cycles of activity of the visceral smooth muscle?
Pacemaker cells (interstitial cells of Cajal)
How many litres of food are ingested before the stomach pressure stops being constant?
1L
What is the frequency of peristaltic waves in the stomach when food is being digested?
3 per minute
How much chyme is usually delivered to the duodenum?
3ml
What are the hormones involved in the regulation of gastric activity?
Secretin
Cholecystokinin (CCK)
Gastric Inhibitory Peptide (GIP)
Motilin
What are the 2 interconnected plexuses in the enteric nervous system?
Myenteric
Submucosal
What transporter transports fructose?
GLUT5
What are oligopeptides?
Peptide molecule that have small no of AA residues
How are oligopeptides absorbed into the intestine?
H+/Oligopeptide cotransporter PepT1
Into enterocyte across apical membrane
What are the 2 membranes in an enterocyte?
Apical membrane
Basolateral membrane
What is Hartnup disease?
Autosomal-recessive disorder
L-phenylalanine cannot be uptaken
Can absorb if in form dipeptide L-phenylalanyl-L-leucine
What is cystinuria?
Autosomal recessive disorder
L-arginine cannot be uptaken
Can absorb if in form dipeptide L-arginyl-L-Leucine
How is vitamin A absorbed from intestine?
Absorbed and transported in newly synthesised chylomicrons
Taken up by liver for further hydrolysis of retinyl esters
How is vitamin E absorbed?
Absorbed primarily in form of alpha and gamma tocopherol
Incorporated into chylomicrons + VLDL
What enzymes hydrolyse dietary retinyl esters in the lumen?
Pancreatic triglyceride lipase (PTL)
Pancreatic Lipase-related Protein 2 (PLRP2)
Intestinal brush border enzyme - phospholipase B (PLB)
What happens to unesterified retinol(ROH)?
Passively diffuses into enterocytes
Complexed with cellular retinol binding protein type 2 (CRBP2)
Re-esterified by retinol acyltransferase
What is the active form of vitamin D called?
Calcitriol
What are the 2 types of nephrons?
Cortical (85%) - outer 2/3 of cortex, short loops of Henle
Juxtamedullary (15%) - inner 1/3 of cortex, long loops of Henle
What are the names of the capillaries around the loops of Henle?
(Name when not around loops of Henle?)
Vasa recta
Glomerular + peritubular
What is glomerular filtration rate(GFR)?
Volume of fluid filtered from glomeruli p/min in ml/min
What 3 factors does GFR rely on?
Starling forces
Surface area of filtration interface
Hydraulic permeability of capillaries
What does PAH clearance equal?
Renal plasma flow
Where is sodium reabsorbed in the loop of Henle?
Passive in thin ascending limb
Actively in thick ascending limb
Not in descending limb
What are the 2 types of cells in the collecting ducts?
Principal cells
Intercalated cells
What is urea?
Breakdown product of protein
What is tonicity?
Concentration of only non-penetrating solutes
What type of aquaporins are on the:
a) Luminal membrane
b) Basolateral membrane
a) AQP2
b) AQP3 + AQP4
What does a low water intake do to plasma osmolality?
Increase it
What is diuresis?
Increases/excessive production of urine
What factors other than osmoreceptors can control ADH and what are their effects?
Inhibit - alcohol
Stimulate - nicotine, nausea, pain, stress
What are the 2 main types of diabetes insipidus?
Neurogenic - congenital/head injury
Nephrogenic - inherited (mutated V2 receptor)/aquired
What 3 elements maintain K balance?
Renal excretion
Gastrointestinal losses
Cellular shifts
What is hypokalemia?
Plasma [K+] < 3.5mM
What is hypokalemia caused by?
Increased external losses
Redistribution into cells
Inadequate K+ intake
Increased external losses in urine
What is hyperkalemia?
Plasma [K+} > 5.5mM
What is hyperkalemia caused by?
Decreased external losses
Redistribution out of cells
What are the 5 actions of angiotensin II?
Stimulates proximal tubule Na+ reabsorption Stimulates ADH release Causes aldosterone secretion Causes thirst Vasoconstricts small arterioles
What is the AT1 receptor, where is it located and what does it cause?
Angiotensin II Type 1 receptor
Present on luminal + basolateral membrane
Stimulates Na+ reabsorption
What peptides are released when the heart stretches due to high blood volume/pressure?
Natriuretic peptides (NP)
What are the 2 types of NP?
ANP - secreted from atrial myocardium
BNP - secreted from ventricular myocardium
Where does bicarbonate (HCO3-) reabsorption occur?
Proximal tubule
Ascending LoH
Cortical collecting duct - intercalated cells type A
What is the cause of respiratory acidosis?
Caused of insufficient CO2 excretion by lungs
What are the 2 types of respiratory acidosis?
Acute - abrupt failure in ventilation
Chronic - 2ndary to many diseases e.g. airway obstruction, lung damage
What are the 3 main responses in the body to regulate acid-base status?
Chemical buffers
Brainstem respiratory centre
Renal mechanisms
What is metabolic acidosis characterised by?
A fall in plasma bicarbonate conc
What is the cause of respiratory alkalosis?
Excessive central respiratory drive
Does colon epithelium have villi?
No, it’s flat with deep crypts
What are the 2 types of water absorption?
Paracellular - via tight junctions between cells
Transcellular - across cell membranes via aquaporins
What is action of the cholera toxin?
Permanently activates adenylyl cyclase
Elevating cAMP in crypt cells
Enhancing secretion
What is the most prevalent bacteria in gut flora?
Gram negative bacteria
Bifido bacteria
What type of bacteria can breakdown fibre?
Colonic bacteria
Calculation for mean arterial blood pressure (MABP)?
MABP = CO x TPR
cardiac output x total peripheral resistance
What 2 things does increasing the length of the sarcomere cause?
Increased cross-bridge overlap
Increased Ca sensitivity of myofilaments (troponin C)
Briefly describe vascular smooth muscle contraction with noradrenaline
Noradrenaline binds to alpha 1 receptor
Activates g protein, activates phospholipase C which breaks down PIP2 ==> IP3 + DAG
IP3 - open channel on SR, release Ca2+
DAG - Open RGC, increase Ca2+ + membrane depolarisation by opening VGCC
Goes to neighbouring cells via gap junctions
G protein also activates rho kinase which increases Ca2+ sensitization
Briefly describe NO-mediated vasodilation
NO activates guanylate cyclase, converts GTP ==> cGMP which activates protein kinase G
Opens K+ channels on membrane + membrane hyperpolarized (also VGCC closed so x Ca2+ enter)
SERCA + PMCA ATPases activated so Ca2+ decrease
cGMP broken down ==> GMP by phosphodiesterase (PDE)
Briefly describe cAMP mediated vasodilation
Binding of adrenaline/adenosine/prostacyclin to beta 1/2 receptors
Activates adenylate cyclase which ATP ==> cAMP
Activates protein kinase A, same effects as protein kinase G
cAMP broken down ==> AMP by PDE
What are spontaneous oscillations in smooth muscle called?
Slow wave (most visceral sm)
What are autacoids?
Physiologically active factor released by cells typically acts locally + briefly on other cells
How many subunits in a nicotinic receptor and what receptors are found in muscle + ganglionic?
5 subunits Muscle receptor (N1) - 2 x alpha 1 type, beta 1, gamma, epsilon Ganglionic receptor (N2) - 2 x alpha 3 type, 3 x beta 4 type
What is the difference between antagonist and agonist?
Antagonist blocks receptor + blocks response
Agonist binds to receptor + stimulates response
What causes gallstones?
Too much H2O absorption from bile
Too much bile acid absorption from bile
Too much cholesterol in bile
Inflammation of epithelium
Outline cobalamin handling by stomach + proximal SI
Cobalamin bound to proteins in food - acid pH + pepsin release it from dietary protein
Gastric glands secrete haptocorrin, bind to CBL
Gastric parietal cells secrete IF
Pancreas secretes HCO3- + proteases
CBL released after proteolytic degradation of haptocorrin
IF-CBL complex forms which ileal enterocyte absorbs
How do glomerular mesangial cells alter their S.A for filtration?
Contain sm filaments that can contract cell
What Na transporters are present on the luminal membrane of the proximal tubule?
Na+-H+ exchanger (NHE3) (Na+ into cell)
Na+-Glc/AA symporter
What Na transporters are present on the luminal membrane of the thick ascending limb?
Na+-K+-2Cl- cotransporter
(N+, K+ into cell)
K+ channel (K+ into filtrate)
What Na transporters are present on the basolateral membrane of the thick ascending limb?
Na+-K+ ATPase pump
What Na transporters are present on the basolateral membrane of the distal tubule?
Na+-K+ ATPase pump
What Na transporters are present on the luminal membrane of the distal tubule?
Na+-Cl- cotransporter
What Na transporters are present on the luminal membrane of the principal cells of collecting duct?
Na+ channel
What Na transporters are present on the basolateral membrane of the principal cells of collecting duct?
Na+-K+ ATPase pump
What do these values of Ch2o reflect?
a) >0
b) = 0
c) <0
a) Hypo-osmotic (dilute) urine
b) Iso-osmotic urine
c) Hyper-osmotic (concentrated) urine