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physio- exam 3 > renal part 3 > Flashcards

renal part 3 Flashcards

1
Q

what is the normal pH range for the human body? what is the normal bicarbonate concentration?

A

normal pH range = 7.35-7.45

[HCO3-] = 24 m

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2
Q

_______ acids can be exhaled or dissipated by the lungs; re: CO2

A

volatile

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3
Q

________ acids from metabolism or the diet, and they must be regulated by the renal system

A

non-volatile

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4
Q

________ bind to excess or free H+ to increase acid carried in urine without decreasing pH

A

buffers

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5
Q

what buffers are used by the kidney?

A

HCO3- (bicarbonate)

HPO42- (phosphate)

NH3 (ammonium)

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6
Q

_______ production within tubular cells eliminates H+ and produces an HCO3- that is reabsorbed

A

ammonium

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7
Q

The kidney regulates acidity of the urine by regulating _______ reabsorption

A

HCO3- (bicarbonate)

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8
Q

what are the 3 ways the kidney can regulate blood pH by using bicarbonate ions?

A
  1. decrease body pH by not reabsorbing all HCO3-
  2. no effect on body pH by reabsorbing all HCO3-
  3. increase body pH by reabsorbing all and producing more HCO3- (typical)
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9
Q

production and reabsorption of what molecule results in H+ secretion

A

bicarbonate

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10
Q

where does bicarbonate reabsorption begin?

A

proximal tubule

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11
Q

how is H+ secreted by the proximal tubule cells?

A

H+ is secreted via Na+ / H+ antiporter

can also have H+ ATPase pumps and H+/K+ ATPase pumps operating to secrete H+

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12
Q

in the proximal tubule, HCO3- is transported/reabsorbed across _________ membrane

A

basolateral

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13
Q

80% of filtered _________ is reabsorbed in proximal tubule

A

HCO3- (bicarbonate)

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14
Q

how is H+ secreted by the cells of the late distal tubule, and the collecting duct?

A

H+ is secreted via an H+ ATPase pumps and an H+/K+ ATPase pump

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15
Q

_________ cells of the distal tubule, and collecting duct, will excrete H+

A

intercalated

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16
Q

what causes alkaline urine?

A

incomplete reabsorption of HCO3-

increase excretion of HCO3- by not neutralizing all that is in the tubular fluid

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17
Q

Cells of the proximal tubule detect intracellular pH and can alter _________ activity accordingly

A

Carbonic anhydrase (CA)

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18
Q

if the body is acidic, the kidney can use ______ as an additional buffer to increase excretion of H+

A

phosphate (HPO4- )

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19
Q

After all HCO3- has been reabsorbed and HPO4- is depleted, the kidney will produce what?

A

ammonium (as a third buffer)

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20
Q

NH4+ is produced in the proximal tubules by metabolism of _________

A

glutamine

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21
Q

the NH4+ system is regulated by what?

A

systemic pH

22
Q

acidosis upregulates synthesis of enzymes for ________ metabolism

A

glutamine

23
Q

Much of the NH4+ leaving the proximal tubule is reabsorbed by what structure?

A

the ascending limb of the loop of Henle

24
Q

diffusion trapping can increase the concentration of ______ in the urine

A

NH4+ (ammonia)

25
Q

Net acid excretion (NEA) occurs after all filtered _________ is reabsorbed

A

HCO3-

26
Q

what causes Respiratory acidosis? how does the kidney respond to this?

A

low pH due to CO2 build-up

renal compensatory response: produce new HCO3-

27
Q

what causes Respiratory alkalosis? how does the kidney respond to this?

A

high pH due to low PCO2

renal compensatory response: excrete HCO3-

28
Q

what causes respiratory alkalosis?

A

hyperventilation, anxiety, altitude, fever, drugs

29
Q

what causes Metabolic acidosis?

A

causes include diabetic ketosis, diarrhea, renal failure

30
Q

how does the respiratory system respond to metabolic acidosis? the kidneys?

A

respiratory compensatory response: hyperventilate

renal compensatory response: produce new HCO3-

31
Q

what causes metabolic alkalosis?

A

causes include vomiting, antacids, hemorrhage

32
Q

how does the respiratory system respond to metabolic alkalosis? the kidneys?

A

respiratory compensatory response: hypoventilate

renal compensatory response: excrete HCO3

33
Q

gastrointestinal absorption of _________ is balanced by renal excretion

A

calcium

34
Q

__________ increases excitability of neural and muscle tissue; tetany

A

hypocalcemia

35
Q

what are the effects of hypercalcemia?

A

cause cardiac arrhythmia and disorientation; can lead to death

36
Q

A decrease in ___________ will increase the amount of free Ca2+

A

plasma pH

37
Q

T/F: acidosis can lead to hypocalcemia

A

FALSE

alkalosis can lead to hypocalcemia

38
Q

what 3 hormones regulate calcium levels?

A

1) parathyroid hormone (PTH)
2) calcitriol
3) calcitonin

39
Q

when is PTH secreted? what does it cause?

A
  • released in response to hypocalcaemia

- increases bone resorption, increases renal Ca+ reabsorption

40
Q

PTH causes the production of what other hormone?

A

calcitriol

41
Q

how does calcitriol effect calcium uptake?

A

stimulates active transport mechanism for Ca2+ absorption in the intestine

42
Q

what is the molecular precursor for calcitriol?

A

vitamin D

43
Q

___________ will facilitates action of PTH and increases renal Ca2+ transport

A

calcitriol

44
Q

_________ (a hormone) is released in response to hypercalcaemia

A

calcitonin

45
Q

where is most calcium reabsorbed?

A

proximal tubule

46
Q

how is calcium absorbed by the thick ascending limb?

A

transcellular and paracellular transport

47
Q

what part of the nephron contains a basolateral calcium pump?

A

distal tubule

48
Q

what regulates the expression of Ca2+ transporters on the distal tubule?

A

regulated by PTH

49
Q

what structure of the nephron is NOT associated with Ca2+ reabsorption?

A

collecting duct

50
Q

how does calcitriol effect the GI tract?

A

causes INCREASED absorption of calcium (and phosphate)

physio- exam 3 (9 decks)

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