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Physiology 1 > Regulation of Fluid/Electrolyte Balance > Flashcards

Regulation of Fluid/Electrolyte Balance Flashcards

1
Q

How much sodium is reabsorbed in the PCT?

A

65%

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2
Q

How much sodium is reabsorbed in the ascending loop of Henle?

A

25%

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3
Q

How much sodium is reabsorbed in the DCT?

A

8%

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4
Q

What hormones affect the volume of urine?

A

ADH, Aldosterone, ANP

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5
Q

What do ADH and Aldosterone do?

A

insert aquaporin and sodium channels causing urine to become concentrated and little

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6
Q

What does ANP do?

A

inhibits effects of ADH and Aldosterone - removes channels

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7
Q

What can a increase in BP trigger?

A

release of ANP

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8
Q

What can a decrease in BP trigger?

A

release of Aldosterone and ADH

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9
Q

What factors influence Glomerular Filtration Rate (GFR)?

A
  • Glomerular Hydrostatic pressure
  • Capsular hydrostatic pressure
  • Glomerular Osmotic pressure
  • Systemic blood pressure
  • Renin-angiotensin-aldoterone system
  • Disease
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10
Q

What does the juxta-glomerular apparatus do?

A

Measures and responds to changes in Na+ conc of the filtrate

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11
Q

What does the juxta-glomerular apparatus connect?

A

connects the distal convoluted tubule with the glomerulus

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12
Q

What are the cells of the juxta-glomerular apparatus?

A

macula densa
juxta-glomerular cells (modified smooth muscle cells)
mesangial cells

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13
Q

What is the role of the macula dense cells?

A

detect sodium concentration

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14
Q

What is the role of the juxta-glomerular cells

A

Adjust the diameter of the afferent arteriole via vasoconstriction or vasodilation

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15
Q

What is the role of the mesangial cells

A

supporting cells

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16
Q

What does blood pressure drive?

A

glomerular hydrostatic pressure

17
Q

What do macula densa cells release to drive vasoconstriction during low BP?

A

prostaglandins

18
Q

What do juxtaglomerular cells release to drive RAAS during low BP?

A

renin

19
Q

What do macula densa cells release to drive vasodilation during high BP?

A

adenosine which directs juxta-glomerular cells to constrict the afferent arteriole

20
Q

What are the steps of the renin- angiotensiogen system?

A
  1. Angiotensinogen released into circulation
  2. Renin converts angiotensinogen into Angiotensin I
  3. Angiotensinogen converting enzyme coverts angiotensin I into angiotensin II
  4. Angiotensin II potent vasoconstrictor – rapidly increases blood pressure
21
Q

Where is ACE produced primarily?

A

in the vascular endothelium of lungs

22
Q

Where does angiotensin 2 bind?

A

receptors on:
1. Arterioles - constriction
2. Hypothalamus- thirst (encourage fluid)
3. Pituitary gland – release of
ADH
4. Adrenal cortex-release of
aldosterone

23
Q

Where is ANP released from?

A

atria of the heart

24
Q

What causes the release of ANP?

A

baroreceptors detect rise of BP in heart

25
Q

As kidney function decreases, what also decreases?

A

glomerular filtration rate (GFR)

26
Q

What does the GFR tell the kidneys?

A

the systemic blood pressure

27
Q

What are the consequences of reduced kidney function due to CKD?

A

o Inadequate removal of fluid and waste products of metabolism

o Inappropriate activation of RAAS (hypertension)

28
Q

Why is CKD a high risk for cardiovascular?

A

hypertension

29
Q

Why can hypertension cause CKD?

A

damage to glomerular capillaries due to high blood flow

30
Q

Why is diabetes a high risk for CDK and cardiovascular?

A

hyperglycaemia affects bloodflow (low blood flow)

31
Q

What are the causes of CDK?

A
  • Hypertension
  • Diabetes
  • High Cholesterol
  • Kidney Infections
  • Glomerulonephritis
  • Polycystic kidney disease
  • Kidney stones
  • Long-term use of NSAIDS
32
Q

What are symptoms of CDK?

A
  • Hypertension
  • Nausea
  • Oedema (ankles, hands or feet, lungs)
  • Blood/protein in urine
  • Anaemia
  • Weak/painful bones
33
Q

How can hypertension be regulated?

A
  • Diet (reduce to salt intake)/weight loss
  • Diuretics (furosemide)
  • ACE inhibitors/angiotensin receptor blockers (ARBs)
  • Aldosterone agonists (nuclear receptors or sodium channels)
34
Q

Where does furosemide bind?

A

NKCC2

35
Q

What % function is stage 5 CKD characterised by?

A

15%

36
Q

What is required at stage 5 CKD?

A

transplant/ dialysis

37
Q

What is dialysis?

A

Artificial removal of waste, solutes, water and toxins from blood

38
Q

What are the types of dialysis?

A
  • Haemodialysis
  • Peritoneal dialysis

Physiology 1 (25 decks)

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