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Renal Final > Regulation of Na and H2O Balance > Flashcards

Regulation of Na and H2O Balance Flashcards

1
Q

Major Functions of Early Proximal Tubule

A

Isosmotic reabsorption of solute and water

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2
Q

Cellular Mechanism of Early Proximal Tubule

A

Na+-glucose, Na+ amino acid, Na+ phosphate costransporter

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3
Q

hormone action of early proximal tubule

A

PTH inhibits Na+phosphate cotranpsorter ANG II stimulates Na/H exchange

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4
Q

diuretic function of early proximal tubule

A

osmotic diuretics Carbonic anhydrase inhibitors

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5
Q

Major Function of Late Proximal tubule

A

isosmotic reabsorption of solute and water

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6
Q

cellular mechanism of late proximal tubule

A

NaCl reabsorption driven by Cl- gradient

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7
Q

Hormone action of late proximal tubule

A

not applicable

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8
Q

diuretic actions of late proximal tubule

A

carbonic anhydrase inhibitors

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9
Q

Major function of thick ascending limb of the loop of henle

A

Reabsorption of NaCl without water Dilution of tubular fluid Single effect of countercurrent multiplication Reabsorption of Ca+2 and Mg+2 dirven by lumen-positive potential

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10
Q

Cellular Mechanism of TAL of Loop of Henle

A

Na+, K+, 2Cl- cotransporter

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11
Q

Hormone action of TAL of loop of henle

A

ADH stimulates Na+, K+, 2Cl- cotransporter

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12
Q

Diuretic action of TAL loop of henle

A

Loop diuretics

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13
Q

Major function of Early Distal Tubule

A

Reabsorption of NaCl without water Dilution of tubular fluid

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14
Q

Cellular mechanism of Early Distal tubule

A

Na/Cl cotransporter

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15
Q

Hormone action of early distal tubule

A

PTH sitmulates Ca+2 reabsorption

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16
Q

Diuretic action of early distal tubule

A

Thiazide diuretics

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17
Q

Major function of late distal tubule and collecting ducts (principle cells)

A

Reabsorption of NaCl K+ secretion Variable water reabsorption

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18
Q

Cellular mechanisms of late distal tubule and collecting ducts (principle cells)

A

Na+ channels (ENaC) K channels AQP2 water channels

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19
Q

Hormone action of late distal tubule and collecting ducts (principle cells)

A

Aldosterone stimulates Na+ reabsorption Aldosterone stimulates K+ secretion ADH stimulates water reabsorption

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20
Q

diuretic action of late distal tubule and collecting ducts (principle cells)

A

K+ sparing diuretics

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21
Q

Major functions of late distal tubule and collecting ducts (alpha intercalated cells)

A

Reabsorption of K+ Secretion of H+

22
Q

cellular mechanism of late distal tubule and collecting ducts (alpha intercalated cells)

A

H+/K+ ATPase H+ ATPase

23
Q

Hormone action of late distal tubule and collecting ducts (alpha intercalated cells)

A

H/K ATPase - none H+ ATPase - aldosterone stimulates H+ secretion

24
Q

Diuretic action of late distal tubule and collecting ducts (alpha intercalated cells)

A

H/K ATPase - none H+ ATPase- K+ sparing diuretics

25
Q

Where is Aldosterone secreted?

A

zona glomerulosa of the adrenal cortex

26
Q

Mechanism of action of aldosterone

A

Aldosterone diffuses into cell and induces synthesis of mRNA for a protein involved with Na+ transport in principal cell

27
Q

K+ sparing diuretics Mechanism of action

A

interfere with Na+ reabsorption in the principal cells leads to non working Na/K ATPase so K can’t diffuse into lumen.

28
Q

Factors that promote Na+ reabsorption

A
  • Activation of renal sympathetic nervous system - Activation of RAAS - Secretion of Aldosterone
29
Q

Factors that promote Na+ excretion

A
  • Release of ANP, BNP - Release of urodilatin - Intrarenal prostaglandins
30
Q

Renal Sympathetic activity

A

increased Na+ reabsorption increased renin secretion ADD IMAGE

31
Q

Factors that promote Renin secretion

A
  • renal sympathetic stimulation (fall in perfusion pressure sensed at cardiopulmonary baroreceeptors leads to direct stimulation of renin secretion via beta 1 receptor activation in JG apparatus) - tubuloglomerular feedback (dec NaCl deliver to macular densa = inc renin secretion) - intrarenal baroreceptor (wall of afferent arteriole; afferent arteriolar vasoconstriction = dec pressure at granular cells = inc renin secretion
32
Q

Renal sympathetic stimulation

A

fall in perfusion pressure sensed at cardiopulmonary baroreceeptors leads to direct stimulation of renin secretion via beta 1 receptor activation in JG apparatus

33
Q

Tubuloglomerular feedback

A

dec NaCl deliver to macular densa = inc renin secretion

34
Q

Intrarenal baroreceptors

A

located in wall of afferent arteriole; afferent arteriolar vasoconstriction = dec pressure at granular cells = inc renin secretion

35
Q

What effect would a loop diuretic have on renin secretion?

A

Loop diuretic causes diuresis leads to decreased ECV and dec perfusion pressure leading to an INCREASE in renin secretion

36
Q

ANGII stimulates:

A
  • inc systemic arteriolar cosntriction - inc renal arteriolar contriction (efferent > afferent, inc GFR, dec RBF) - inc Na reabsorption at PCT - inc Thirst - inc ADH secretion from posterior pituitary - inc aldosterone secretion from adrenal cortex
37
Q

Effect of ANGII on Efferent Arteriole

A

ANGII increases Efferent Arteriolar constriction => inc GFR => dec RBF => increased glomerular hydrostatic pressure => increased filtration

38
Q

Effect of ANGII on glomerular mesangial cells

A

Glomerular mesangial cell contraction => dec surface area available for filtration => decrease filtration to offset increase in filtration caused by efferent arteriolar constriction

39
Q

Response of RAAS to dec ECF vol

A

ADD IMAGE

40
Q

Aldosterone action at late distal convoluted tubule principal cell

A

reabsorbs Na excretes K, H reabsorbs Cl- hyperaldosteronism = hypokalemia, alkalemia

41
Q

Feedback control of Aldosterone

A

things that inhibit aldosterone - decreased plasma K - increased ECV - increased ECF volume - increased BP

42
Q

Factors controlling aldosterone secretion

A

ADD IMAGE

43
Q

ANP does:

A
  • inc GFR (via afferent dilation/efferent constriction) - inhibits Na reabsorption at medullary collecting duct - decreases renin secretion - decreases aldosterone secretion - systemic vasodilation - decreased AVP secretion, action
44
Q

ANP response to increased ECF volume

A

ADD IMAGE

45
Q

Urodilatin made by and why:

A

DCT, CD due to increased atrial pressure and increased ECF volume

46
Q

Urodilatin mechanism of action

A

suppresses Na and water reabsorption by medullary collecting duct ***No effect on systemic circulation

47
Q

Response to increased Na intake

A

ADD IMAGE

48
Q

response to decreased Na intake

A

ADD IMAGE

49
Q

ADH/AVP action

A
  • increased permeability of late distal tubule and collecting duct to water via insertion of aquaporis - increases activity of Na/K/2Cl co transporter - increases urea permeability in the inner medullary collecting ducts
50
Q

ADH secreted by:

A

supraoptic nucleus in hypothalmus transported to posterior pituitary gland and released

51
Q

Control of ADH secertion

A

osmoreceptors, baroreceptors

52
Q

Two major stimuli for ADH release

A

hyperosmolality volume depletion (hypothalamic osmoreceptors more important then hepatic osmoreceptors)

Renal Final (4 decks)

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