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Human Physiology > Renal and Acid-Base Physiology > Flashcards

Renal and Acid-Base Physiology Flashcards

[from BRS physiology deck]

1
Q

Marker for ECF

A

Sulfate, inulin, mannitol

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2
Q

Interstitial Fluid marker

A

measured indirectly

ECF-plasma volume

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3
Q

Marker for ICF

A

measured indirectly

TBW-ECF

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4
Q

Clearance Equation

A

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

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5
Q

Vasoconstriction of renal arterioles on RBF

A

RBF will decrease

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6
Q

Low conc of Ang II

A

preferentially constricts efferent arterioles and increase GFR

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7
Q

ACE-inhibitors on GFR

A

dilate efferent arterioles thus decreasing GFR

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8
Q

Vasodilation of renal arterioles on RBF

A

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

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9
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

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10
Q

Constriction of Afferent Arteriole (sympathetic)

A

decrease GFR, decrease RPF, no change in FF

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11
Q

Constriction of Efferent Arteriole (angII)

A

increase GFR, decrease RPF, increase FF

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12
Q

increased plasma [protein]

A

decrease GFR, no change in RPF, decrease FF

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13
Q

Kidney Stone

A

decrease GFR, no change in RPF, decrease FF

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14
Q

Reabsorption rate

A

Filtered Load - Excretion Rate

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15
Q

Secretion Rate

A

Excretion Rate - Filtered Load

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16
Q

HA form predominates in which type of urine?

A

acidic urine

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17
Q

A- form predominates in which type of urine?

A

alkaline

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18
Q

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

A

Proximal Tubule

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19
Q

Isosmotic process in the renal tubules

A

in Proximal Tubules

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20
Q

Carbonic anhydrase inhibitor

A

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

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21
Q

Late Proximal tubules reabsorbs what

A

Sodium and Chloride

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22
Q

Reabsorbs 25% of filtered Na+

A

Thick Ascending Limb of Henle

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23
Q

impermeable to water

A

Thick ascending limb of henle, early distal tubule

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24
Q

Principal Cells

A

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

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25
Q

alpha-intercalated cells

A

secrete H+ by H-ATPase, stimulated by aldosterone

reabsorbs potasium by H/K-ATPase

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26
Q

Increases the urea permeability of the inner medullary collecting ducts

A

ADH

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27
Q

Low urine flow rate

A

greater urea reabsorption

28
Q

high urine flow rate

A

greater urea excretion

29
Q

Phosphate reabsorbed in the PT

A

85% via Na-Phos Cotransport

30
Q

PTH

A

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

31
Q

secreted when hyperosmotic plasma and decreased blood volume

A

ADH

increases H2O permeability in LDT and CD principal cells

32
Q

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

A

Aldosterone

33
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

34
Q

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

A

ANP, cGMP

used to increase GFR, decrease Na reabsorption

35
Q

MoA of AngII

A

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

36
Q

Volatile Acid

A

CO2

37
Q

When are buffers most effective?

A

within 1pH unit of the pK of buffer

38
Q

Most important extracellular buffer

A

HCO3-

39
Q

Most important urinary buffer

A

Phosphate

40
Q

Intracellular Buffers

A

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

41
Q

Henderson-Hasselbalch Eqtn

A

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

42
Q

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

A

Linear portion

43
Q

Primary reabsorption site for HCO3-

A

proximal tubule

44
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

45
Q

ECF volume and HCO3-

A

ECF volume expansion results in decreased HCO3- reabsorption

ECF volume contraction results in increased HCO3 reabsorption

46
Q

Diffusion Trapping

A

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

47
Q

NH3 and acidosis

A

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

48
Q

Inhibits NH3 synthesis

A

Hyperkalemia

49
Q

Kussmaul Breathing

A

respiratory compensation for metabolic acidosis

50
Q

Serum Anion Gap

A

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

51
Q

Hypoventilation

A

respiratory compensation for metabolic alkalosis

52
Q

Decerase in respiratory rate and retention of CO2

A

Respiratory Acidosis

increase in both H+ and HCO3-

53
Q

Winter Formula

A

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

54
Q

Anion Gap with K+

A

= ([Na] + [K]) − ([Cl] + [HCO3])

55
Q

Metabolic Acidosis increase anion gap

A 
Increase Anion ( >12 ): MUDPILES
	Methanol
	Uremia
	Diabetic Ketoacidosis
	Paraldehyde
	Iron, Isoniazide
	Lactate
	Ethylene Glycol
	Salicylates, Starvation
56
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

57
Q

Nasogastric suction

A

causes metabolic alkalosis

58
Q

medical procedures that cayse metabolic alkalosis with chloride sensitivity

A

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

59
Q

Metabolic Acidosis - pH, primary disturbance, compensatory response

A

decreased pH, decreased HCO3

compen - decrease pCO2

60
Q

Metabolic Alkalosis - pH, primary disturbance, compensatory response

A

increased pH, increased HCO3

compen - increase pCO2

61
Q

Respiratory Acidosis - pH, primary disturbance, compensatory response

A

decreased pH, increased pCO2

compen - increase HCO3

62
Q

Respiratory Alkalosis - pH, primary disturbance, compensatory response

A

increased pH, decreased pCO2

Compen - decrease HCO3

63
Q

Furosimide, ALbuterol, Na Polysterene Sulfonate

A

Cause Hypo-K

64
Q

Spironolactone, ACEi, Ibuprofen

A

Cause Hyper-K

65
Q

Grossest Food Ever?

A

Onions

Human Physiology (7 decks)

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