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Phys exam 5 > Renal 5 > Flashcards

Renal 5 Flashcards

1
Q

Regulation of Tubular reabsorption Essential to maintain a precise balance between ____ and ______

A

GFR and tubular reabsorption

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2
Q

T/F: Reabsorption of some solutes can be individually adjusted.

A

True

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3
Q

Tubular reabsorption is controlled by what 3 mechanisms?

A

Local Control Mechanisms
Nervous System
Endocrine System

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4
Q

What are the 2 local control mechanisms of tubular reabsorption?

A

Tubuloglomerular Feedback Response (TGF)

Glomerulotubular Balance (GTB)

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5
Q

______:
Autoregulation of GFR.
Keeps GFR constant
Afferent and Efferent arteriolar resistance related to flow rate of NaCl by macula densa

A

TGF Response:

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6
Q

GFR _____ leads to ______ NaCl to macula densa leads to TGF response _______ GFR

A

increase; increase; decreases

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7
Q

_______:
Autoregulation of PT reabsorption rate
PT reabsorption rate related to tubular load
As tubular LOAD increases, rate of REABSORPTION increases.
Depends on changes in peritubular capillary and renal interstitial fluid Starling’s forces.

A

Glomerular Tubule Balance (GTB)

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8
Q

Due to GTB, As tubular LOAD ______, rate of REABSORPTION increases.

A

increases

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9
Q

Due to GTB, As tubular LOAD increases, rate of REABSORPTION _______.

A

increases

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10
Q

Together the TGF and GTB help to prevent overloading of the distal tubule segment when GFR ______ due to pressure changes or other disturbances

A

increases

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11
Q

An increase in GFR, leads to an ______ in reabsorption rate of the proximal tubule

A

Increases

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12
Q

If ____ is not present, an increase in GFR will lead to no reabsorption causing the urine volume to greatly increase

A

GTB

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13
Q

____ is increased salt excretion

A

Natriuresis

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14
Q

____ is increased water excretion

A

Diuresis

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15
Q

Small increases in _____ can cause marked increases in urinary Na+ and H2O excretion.

A

MAP

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16
Q

Small increases in MAP can cause marked increases in urinary ____ and _____ excretion.

A

Na+ and H2O excretion

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17
Q

Normal kidney function and pressure natriuresis mechanisms assure that large changes in salt and water intake accommodated with only minor changes in what 3 things?

A

ECF volume
CO
MAP

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18
Q

What 5 hormones regulate tubular reabsorption?

A
  • aldosterone
  • angiotensin II
  • antidiuretic hormone (ADH)
  • atrial natriuetic peptide (ANP or ANF)
  • parathyroid hormone
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19
Q

What hormones Stimulates Na+ reabsorption and K+ Secretion?

A

Aldosterone

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20
Q

What causes there to be a slow onset response for aldosterone?

A

Steroid hormones have to cross cell membrane and alter gene expression

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21
Q

Why causes there to be a long duration of response from aldosterone?

A

Long half life

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22
Q

What 2 conditions cause an increase of aldosterone secretion?

A

Increased plasma K+
Angiotensin II
(changes associated with Na+and volume depletion or low blood pressure)

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23
Q

What 2 conditions cause an decrease of aldosterone secretion?

A

Atrial natriuretic factor (ANF)

Increased Na+ concentration (osmolarity; weak)(changes associated with increased Na+ and volume or high blood pressure)

24
Q

Increases H+ secretion by intercalated cells of late distal & cortical collecting tubule membrane: excess levels may cause metabolic alkalosis.
Increases Na+ reabsorption and K+ secretion by sweat and salivary glands.
Increases Na+ absorption by intestinal (colon) mucosa

A

Aldosterone

25
Q

Aldosterone causes increased ____ secretion by intercalated cells of late distal & cortical collecting tubule membrane: excess aldosterone levels may cause metabolic alkalosis.

A

H+

26
Q

Aldosterone Increases Na+ reabsorption and K+ secretion by ____ and _____ glands

A

sweat and salivary glands.

27
Q

Aldosterone Increases ____ absorption by intestinal (colon) mucosa

A

Na+

28
Q

Hormone: Major Regulator of Na+ and Water Reabsorption; increases Bicarb reabsorption and increases H+ secretion

A

Angiotensin II

29
Q

Stimulates aldosterone production.
Directly increases Na+ reabsorption (proximal, loop, distal, collecting tubules).
Constricts efferent arterioles and enhances peritubular capillary reabsorption:
-Decreased PC in peritubular capillaries
-Increased Colloid osmotic pressure in capillary in
peritubular capillaries (Increases PG which Increases the filtration fraction)

A

Angiotensin II

30
Q

Hormone: Increases Water Reabsorption of the apical membrane by aquaporin-2 channels

A

ADH

31
Q

What 2 things stimulate ADH release?

A

Increased ECFosm

Decreased MAP

32
Q

What 2 things stimulate Angiotensin II release?

A

Decreased MAP

Decreased ECFvol

33
Q

Increases H2O permeability via activation of Gαs Protein linked receptor
Activates cAMP
Increases the synthesis and insertion of AQP-2 into luminal membrane.

A

ADH

34
Q

Where does ADH act?

A

Late Distal Tubule (DT) and Collecting Duct CD

35
Q

Where does Ang II act?

A

Most nephron segments

36
Q

Where does Aldosterone act?

A

Principal cells of collecting duct

37
Q

Hormone: Increase GFR and↓ Na+Reabsorption (↑ Na+ Excretion)

A

ANP

38
Q

What stimulates ANP?

A

Cardiac atria in response to stretch

39
Q

Directly inhibits Na+and H2O reabsorption in PT
Increases GFR (dilates afferent, constricts efferent arterioles).
Inhibits renin release and aldosterone formation.
Helps to minimize blood volume expansion (CHF).

A

ANP

40
Q

Constricts arterioles.
Stimulates renin release.
Decreases GFR and renal blood flow.
Directly stimulates Na+reabsorption via α receptors on tubule epithelial cells in PT and TAL.

A

Sympathetic Nervous System

41
Q

Decreases Na+ and H2O Excretion

A

SNS

42
Q 
\_\_\_\_ is critical for:
⁻Normal cell function
⁻Neural transmission
⁻Membrane excitability
⁻Bone structure⁻Blood Coagulation
⁻Intracellular signaling
A

Ca ++

43
Q

The majority of Ca is in _____

A

bones

44
Q

What form of Ca is tightly regulated?

A

ECF Ca ++

45
Q

What form of Ca is the most important for functions in the body?

A

Ionized Ca++

46
Q

How much of plasma Ca ++ is filtered?

A

60%

47
Q

How much of filtered Ca++ is reabsorbed in the PCT?

A

65%

48
Q

How much of Ca++ is reabsorbed in loop of Henle in TAL?

A

25-30%

49
Q

How much of Ca++ is reabsorbed in Distal and collecting tubule?

A

4-9%

50
Q

How much of Ca++ is excreted?

A

1%

51
Q

____ Regulates Ca++Reabsorption in TAL and DT

A

PTH

52
Q

What is the stimulus for PTH release?

A

Low Ca++

53
Q

Where is PTH secreted from?

A

Chief cells of PTG

54
Q

_____ transport:
50% by para-cellular bulk flow; passive
Favored by +8 mV luminal charge
50% transcellular; entry passive

A

Ca++

55
Q

The primary transport of Ca++ is ____ by PTH?

A

Increased

Phys exam 5 (9 decks)

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