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Systems Physiology > Renal Part II > Flashcards

Renal Part II Flashcards

1
Q

Changes in what ion correspond to extra cellular volume changes?

A

Na+

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2
Q

Low Na+ indicates what about plasma volume?

A

Low plasma volume

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3
Q

How does the cardiac system compensate for decreased Na+?

A

Decreased firing of baroreceptors and activation of sympathetic nervous system

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4
Q

Decreased plasma volume and venous return

A

Decreased Na+

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5
Q

How do the kidneys compensate for decreased Na+?

A

Constricting afferent arterioles, decreasing Na+ and H2O excretion

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6
Q

What does aldosterone do to the distal convoluted tubule and cortical collecting duct?

A

Increased Na+ reabsorption

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7
Q

Where does aldosterone act?

A

Distal tubule and cortical collecting duct

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8
Q

How does aldosterone increase Na+ reabsorption?

A

Increased synthesis of Na/K pumps

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9
Q

What is the main goal of RAAS?

A

Raise blood pressure

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10
Q

What does RAAS stand for?

A

Renin-Angiotensin-Aldosterone System

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11
Q

Where does renin come from?

A

Made by the JG cells in the kidney

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12
Q

What is the rate limiting step of RAAS?

A

Renin production

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13
Q

What does renin do?

A

Catalyzes angiotensinogen to angiotensin i

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14
Q

What catalyzes angiotensin i to angiotensin ii?

A

ACE

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15
Q

What does ACE stand for?

A

Angiotensin converting enzyme

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16
Q

What produces ACE?

A

Capillary endothelium

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17
Q

What does angiotensin ii promote?

A

Increased aldosterone secretion and systemic vasoconstriction of arteries

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18
Q

Which member of the RAAS is produced in excess?

A

Angiosinogen

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19
Q

How do the renal sympathetic nerves stimulate renin production?

A

they directly innervate the JG cells, increased sympathetic activity —> increased activity of JG cells

20
Q

Which cells are referred to as the intrarenal barorecptors?

A

JG cells

21
Q

What do JG cells respond to?

A

Arteriole stretching - less stretched afferent arteriole = more renin secretion

22
Q

What is the purpose of the macula densa cells?

A

Sense Na+ content in tubular fluid and communicate with JG cells

23
Q

What does the atrial natriuretic peptide (ANP) do?

A

Decreases blood pressure by increasing Na+ secretion

24
Q

How does ANP decrease blood pressure?

A

Inhibits Na+ reabsorption and increases GFR

25
Q

What stimulates ANP?

A

Atrial distension from increased plasma volume

26
Q

What step of RAAS do ACE inhibitors (such as lisinopril) act on?

A

angiotensin i doesn’t get converted to angiotensin ii

27
Q

What step of RAAS do angiotensin i receptor blockers act on? (ex: losartan)

A

doesn’t allow angiotensin i to convert to angiotensin ii

28
Q

Which medications are an example of an aldosterone receptor blocker?

A

epleronone and spironolactone

29
Q

What does furasamide (Lasix) do?

A

Inhibits the N/KCC transporter in the loop of Henle, decreases blood pressure (loop diuretic)

30
Q

What happens when the N/KCC transporter is blocked?

A

Ions can’t get across, the medullary interstitial fluid is blocked and water can’t get properly reabsorbed

31
Q

Where are osmoreceptors located?

A

hypothalamus

32
Q

What stimulates a decrease in osmoreceptor firing?

A

Increased H2O concentration in body (decreased osmolarity)

33
Q

How do osmoreceptors stimulate decreased ADH secretion?

A

decreased firing

34
Q

What does hyperkalemia promote?

A

Aldosterone release

35
Q

How does aldosterone regulate potassium?

A

Increased aldosterone results in increased potassium secretion and na+ reabsorption

36
Q

What happens to aldosterone during hypokalemia?

A

Decreased activity

37
Q

HCO3- reabsorption is paired with what?

A

H+ secretion

38
Q

What is the difference between metabolic and respiratory acidosis?

A

Metabolic is a decrease in blood pH, respiratory is an increase in CO2

39
Q

What causes metabolic acidosis?

A

Untreated diabetes or excess lactic acid

40
Q

How is metabolic acidosis compensated for?

A

Hyperventilation, increased renal secretion and excretion of H+, HCO3- reabsorption

41
Q

How is metabolic alkalosis caused?

A

Persistent vomiting - note that this is rare

42
Q

How is metabolic alkalosis compensated for?

A

Hypoventilation, increased renal secretion and excretion of HCO3-, decreased H+ secretion

43
Q

How is respiratory acidosis caused?

A

COPD, sleep apnea, airflow obstruction

44
Q

What compensates for respiratory acidosis

A

Increased renal H+ secretion and excretion, increased HCO3- reabsorption

45
Q

When would respiratory alkalosis be seen?

A

During a panic attack or when hyperventilating

46
Q

How is respiratory alkalosis compensated for?

A

Increased renal secretion and excretion of HCO3-, decreased H+ secretion

Systems Physiology (9 decks)

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