Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BRS Physio > Renal and Acid-Base Physiology > Flashcards

Renal and Acid-Base Physiology Flashcards

1
Q

2/3 of TBW

A

intracellular fluid

K, Mg, protein and organic phosphates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

1/3 of TBW

A

extracellular fluid
1/4 is plasma
3/4 is interstitial fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Marker for TBW

A

tritiated H2O, D2O

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Marker for ECF

A

Sulfate, inulin, mannitol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Marker for Plasma

A

Radioiodinated serum albumin (RISA), Evans Blue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Interstitial Fluid marker

A

measured indirectly

ECF-plasma volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Marker for ICF

A

measured indirectly

TBW-ECF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Infusion of isotonic NaCl - addition of isotonic fluid

A

isosmotic volume expansion

ECF volume increases but no change in osmolarity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Diarrhea - loss of isotonic fluid

A

isosmotic volume contraction

ECF volume decreases no change in osmolaritiy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Excessive NaCl intake - addition of NaCl

A

Hyperosmotic volume expansion
osmolarity of ECF increases and water shifts from ICF to ECF
ICF osmolarity increases until it equals that of ECF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

sweating, fever, diabetes insipidus

A

hyperosmotic volume contraction

decrease in ECF, ICF volume and increase ECF osmolarity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

SIADH

A

hyposmotic volume expansion

increase in ECF & ICF volume and decrease in ECF osmolarity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Adrenal Insufficiency

A

hyposomotic volume contraction

decrease in ECF volume, increase in ICF volume, ECF osmolarity is decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clearance Equation

A

CL = (UV)/P
U is urine conc
V is urine vol/time
P is plasma conc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Vasoconstriction of renal arterioles on RBF

A

RBF will decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Low conc of Ang II

A

preferentially constricts efferent arterioles and increase GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ACE-inhibitors on GFR

A

dilate efferent arterioles thus decreasing GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Vasodilation of renal arterioles on RBF

A

increase in RBF, is produced by PGE2 and PGI2, bradykinin, NO and dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Macula Densa

A

increases renal artery pressure leads to increased delivery of fluid to macula densa
increased load causes constriction of nearby afferent arteriole, increasing resistance to maintain constant blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Measurement of renal plasma flow

A

clearance of PAH, it is filtered and secreted by renal tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

RPF equation

A

Cpah = (Upah*V)/Ppah

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Measurement of RBF

A

RBF = RPF/(1-Hb)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Measurement of GFR

A

clearance of inulin

Cin = (Uin*V)/Pin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

BUN and serum [creatinine] increase

A

when GFR decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Filtration Fraction

A

FF = GFR/RPF

normal is ~0.20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

increases in FF causes

A

increase in protein conc of peritubular capillary blood

increased reabsorption in proximal tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

decreases in FF causes

A

decreases in protein conc of peritubular capillary blood

decreased reabsorption in proximal tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

GFR Starling eqtn

A

GFR = Kf[(Pgc-Pbs)-(OSMgc-OSMbs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Constriction of Afferent Arteriole (sympathetic)

A

decrease GFR, decrease RPF, no change in FF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Constriction of Efferent Arteriole (angII)

A

increase GFR, decrease RPF, increase FF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

increased plasma [protein]

A

decrease GFR, no change in RPF, decrease FF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Kidney Stone

A

decrease GFR, no change in RPF, decrease FF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Filtered Load

A

GFR * [plasma]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Excretion rate

A

V * [urine]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Reabsorption rate

A

Filtered Load - Excretion Rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Secretion Rate

A

Excretion Rate - Filtered Load

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Splay (on Tm for glucose)

A

excretion of glucose before glucose is fully saturated

ususllay between 250 and 350

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

HA form predominates in which type of urine?

A

acidic urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

A- form predominates in which type of urine?

A

alkaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

How to excrete salicylate acid

A

increase excretion by alkalinizing the urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

compares the concentration of a substance in tubular fluid at any point along the nephron with the conc in plasma

A

Tubular Fluid/Plasma ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

TF/P = 1

A

no reabsorption of substance or reabsorption of the substance is exactly proportional to the reabsorption of water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

TF/P < 1

A

reabsorption of substance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

TF/P > 1

A

secretion of substance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Reabsorbs 2/3 of 67% of filtered Na and H2O in nephron

A

Proximal Tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Isosmotic process in the renal tubules

A

in Proximal Tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Carbonic anhydrase inhibitor

A

diuretic that act in early PT by inhibiting the reabsorption of filtered HCO3-

48
Q

Late Proximal tubules reabsorbs what

A

Sodium and Chloride

49
Q

Reabsorbs 25% of filtered Na+

A

Thick Ascending Limb of Henle

50
Q

inhibits Na-K-2Cl in TAL

A

loop diuretics like furosimide, ethacrynic acid and bumetanide

51
Q

impermeable to water

A

Thick ascending limb of henle, early distal tubule

52
Q

diluting segment

A

TAL, TF/P is <1

53
Q

site of action of thiazide diuretics

A

Distal Convoluted tubules

54
Q

Principal Cells

A

in late distal tubule and collecting duct
Aldosterone - reabsorb Na and H2O & secrete K
ADH - increases H2O permeability

55
Q

K-sparing diuretics

A

spironolactone, triamterene, amiloride

56
Q

alpha-intercalated cells

A

secrete H+ by H-ATPase, stimulated by aldosterone

reabsorbs potasium by H/K-ATPase

57
Q

Causes of Hyperkalemia

A

insulin deficiency, acidosis
digitalis
exercise
cell lysis

58
Q

Causes of Hypokalemia

A

insulin, beta-agonists, alkalosis, hypo-osmolarity

59
Q

Hyperaldosteronism

A

increases K secretion and causes hypokalemia

60
Q

Hypoaldosteronism

A

decreases K secretion and causes hyperkalemia

61
Q

Increases the urea permeability of the inner medullary collecting ducts

A

ADH

62
Q

Low urine flow rate

A

greater urea reabsorption

63
Q

high urine flow rate

A

greater urea excretion

64
Q

Phosphate reabsorbed in the PT

A

85% via Na-Phos Cotransport

65
Q

PTH

A

inhibits phsophate reabsorption in PT by activating adenylate cyclase
increased Calcium reabsorption by activating AC in distal tubule

66
Q

Treatment of idiopathic hypercalciuria

A

Thiazide diuretics

67
Q

TAL competition

A

Mg and Ca compete for reabsorption, hypercalcemia causes an increase in Mg excretion
hypermagnesemia causes an increase in Ca excretion

68
Q

hyperosmotic urine

A

when ADH levels are high, water deprivation, hemorrhage, SIADH

69
Q

maintenance of the corticopapillary osmotic gradient

A

Countercurrent exchange in the vasa recta
countercurrent mulitplication in the loop of Henle
ADH has a big part in reabsorption of NaCl and Urea to make the gradient

70
Q

Impermeable to water

A

TAL, therefore NaCl will be reabsorbed making the urine dilute therefore TF/P <1.0
Early distal convoluted tubule as well

71
Q

Late Distal Tubules and high ADH

A

ADH increases the H2O permeability of principal cells

TF/P = 1.0

72
Q

Collecting Ducts and high ADH

A

ADH increases the H2O permeability of principal cells

TF/P >1.0

73
Q

Renal Tubules without ADH

A

PT: TF/P = 1.0 (isosmotic)

TAL, early DT, late DT, and CT: TF/P <1.0

74
Q

Used to estimate the ability to concentrate or dilute urine

A

Free water Clearance

  • no ADH: Ch2o is (+)
  • yes ADH: Ch2o is (-)
75
Q

Primary Polydipsia

A

decreased ADH, decreased serum Na, hyposmotic urine, High urine flow rate, positive free water clearance

76
Q

Central Diabetes Insipidus

A

decreased ADH, increased serum Na, hyposmotic urine, High urine flow rate, positive free water clearance

77
Q

Nephrogenic diabetes insipidus

A

increased ADH, increased serum Na, hypoosmotic urine, high urine flow rate, positive free water clearnace

78
Q

Water Deprivation

A

increase ADH, high/normal serum Na, hyperosmotic urine, low uring flow, negative free water clearance

79
Q

SIADH

A

really increased ADH, decreased Na because too much water reabsorption, hyperosmotic urine, low urine flow rate, negative free water clearance

80
Q

Stimulates 1alpha-hydroxylase

A

PTH

81
Q

secreted when hyperosmotic plasma and decreased blood volume

A

ADH

increases H2O permeability in LDT and CD principal cells

82
Q

released when there is a decreased in blood volume and an icnrease in plasma [K]

A

Aldosterone

83
Q

Actions of Aldosterone

A

increase sodium reabsorption in DT principal cells
increase K secretion in DT principal cells
increase H+ secretion in DT alpha-intercalated cells

84
Q

what is release with an increase in atrial pressure and its MoA

A

ANP, cGMP

used to increase GFR, decrease Na reabsorption

85
Q

MoA of AngII

A

increases Na/H-exchange and HCO3- reabsorption in proximal tubule

86
Q

Volatile Acid

A

CO2

87
Q

When are buffers most effective?

A

within 1pH unit of the pK of buffer

88
Q

Most important extracellular buffer

A

HCO3-

89
Q

Most important urinary buffer

A

Phosphate

90
Q

Intracellular Buffers

A

Organic Phosphates & Proteins like Imidazole and alpha-amino groups and Hb
deoxyHb is better buffer than oxyHb

91
Q

Henderson-Hasselbalch Eqtn

A

pH = pK + loh ([A-]/[HA])

92
Q

Buffer is most effective in what part of a titration curve?

A

Linear portion

93
Q

Primary reabsorption site for HCO3-

A

proximal tubule

94
Q

pCO2 and HCO3-

A

increased pCO2 => increased rates of HCO3- reabsorption, basis for renal compensation for respiratory acidosis
decreased pCO2 => decreased rates of HCO3- reabsorption, renal compensation for respiratory alkalosis

95
Q

ECF volume and HCO3-

A

ECF volume expansion results in decreased HCO3- reabsorption

ECF volume contraction results in increased HCO3 reabsorption

96
Q

Diffusion Trapping

A

H+ is secreted into lumen via H-ATPase and combines with NH3 to form NH4

97
Q

NH3 and acidosis

A

in acidosis, adaptive increase in NH3 synthesis occurs thus increasing gradient for NH3 diffusion

98
Q

Inhibits NH3 synthesis

A

Hyperkalemia

99
Q

Kussmaul Breathing

A

respiratory compensation for metabolic acidosis

100
Q

Serum Anion Gap

A

For metabolic Acidosis
[Na]-([Cl]+[HCO3])
normal is 12mEq/L

101
Q

Hypoventilation

A

respiratory compensation for metabolic alkalosis

102
Q

Decerase in respiratory rate and retention of CO2

A

Respiratory Acidosis

increase in both H+ and HCO3-

103
Q

Winter Formula

A

PCO2 = (1.5 x HCO3) + 8 ± 2
• If Measured < Expected = Respiratory Alkalosis
• If Measured > Expected = Respiratory Acidosis

104
Q

Anion Gap with K+

A

= ([Na] + [K]) − ([Cl] + [HCO3])

105
Q

Metabolic Acidosis increase anion gap

A 
Increase Anion ( >12 ): MUDPILES
	Methanol
	Uremia
	Diabetic Ketoacidosis
	Paraldehyde
	Iron, Isoniazide
	Lactate
	Ethylene Glycol
	Salicylates, Starvation
106
Q

Metabolic Acidosis non-gap

A

normal is between 5-12: Hypercholemic
GI Loss: diarhhea, Sx drain, Fistula, Cholestryamine
Renal Loss: Renal tubular acidosis
• Proximal RTA – Acetazolamide (Diuretic)
• Distal RTA – Inpaired H+ Secretion, Cannot Acidify Urine

107
Q

Nasogastric suction

A

causes metabolic alkalosis

108
Q

medical procedures that cayse metabolic alkalosis with chloride sensitivity

A

vomiting, NG suction, diuretics, LR, TPN, Blood

109
Q

Metabolic Acidosis - pH, primary disturbance, compensatory response

A

decreased pH, decreased HCO3

compen - decrease pCO2

110
Q

Metabolic Alkalosis - pH, primary disturbance, compensatory response

A

increased pH, increased HCO3

compen - increase pCO2

111
Q

Respiratory Acidosis - pH, primary disturbance, compensatory response

A

decreased pH, increased pCO2

compen - increase HCO3

112
Q

Respiratory Alkalosis - pH, primary disturbance, compensatory response

A

increased pH, decreased pCO2

Compen - decrease HCO3

113
Q

Furosimide, ALbuterol, Na Polysterene Sulfonate

A

Cause Hypo-K

114
Q

Spironolactone, ACEi, Ibuprofen

A

Cause Hyper-K

115
Q

Grossest Food Ever?

A

Onions

BRS Physio (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions