Renal - Pt 5 Hormonal Effects

Question 1

Aldosterone is a [] saving hormonal pathway.

Answer 1

sodium

Question 2

Aldosterone release pathway:

1. Liver continuously produces [], which travels thorugout the circulation.
2. If the kidney detects low sodium levels, through [] [] cells, the [] cells produce renin.
3. Renin converts inactive angiotensinogen into [].
4. Angiotensin I is converted to [] from the enzyme [] [] []. This process is usually done in the []
5. Angiotensin II travels to the [] gland via the bloodstream where it stimulates the release of []
6. Aldosterone travels to the late [] and [] where it effects reabsorption.

Answer 2

1. Liver continuously produces angiotensinogen, which travels thorugout the circulation.
2. If the kidney detects low sodium levels, through macula densa cells, the juxtaglomerular cells produce renin.
3. Renin converts inactive angiotensinogen into angiotensin I.
4. Angiotensin I is converted to Angiotensin II from the enzyme Angiotensin converting enzyme. This process is usually done in the lungs
5. Angiotensin II travels to the adrenal gland via the bloodstream where it stimulates the release of Aldosterone
6. Aldosterone travels to the late DCT and CD where it effects reabsorption.

Question 3

Within the late DCT and CD, Aldosterone has 3 main effects:

1. increases the synthesis and activity of the []/[] pump which is inserted into the [] membrane
2. Increasesthe synthesis and insertion of [] leak channels in the [] membrane
3. Increases the synthesis and insertion of [] channels in the [] membrane.

Answer 3

1. increases the synthesis and activity of the sodium/potassium pump which is inserted into the basolateral membrane
2. Increases the synthesis and insertion of potassium leak channels in the apical membrane
3. Increases the synthesis and insertion of sodium channels in the apical membrane.

Question 4

The net effect of aldosterones actions in the late DCT and CD is to increase [] ion secretion and [] ion reabsorption.

Answer 4

The net effect of aldosterones actions in the late DCT and CD is to increase potassium ion secretion and sodium ion reabsorption.

Question 5

T/F

The PCT is always permeable to water?

Answer 5

TRUE!

Question 6

The main sites of reabsorption are the [] and []

Answer 6

PCT and TAL

Question 7

Main sites of net secretion are the late [] and []

Answer 7

DCT and CD

Question 8

The main sites of tubuloglomerular feedback are the [] and []

Answer 8

TAL and Early DCT

Question 9

[] is referred to as the diluting segment of the nephron

Answer 9

TAL

Question 10

The [] is the site of action of furosemide

Answer 10

TAL

Question 11

The [] and [] are the site of ADH action

Answer 11

TAL and late DCT

Question 12

The [] and [] are the sites of aldosterone action

Answer 12

late DCT and CD

Question 13

The [] is the site of NKCC transporters

Answer 13

TAL

Question 14

The [] is the site of iso-osmotic reabsorption of sodium, chloride, and water.

Answer 14

PCT

Question 15

• ANP causes the kidney to [] water and sodium loss, after detecting and [] in blood volume.
• ANP causes vaso-[] and a [] in TPR.

Answer 15

• ANP causes the kidney to increase water and sodium loss, after detecting an increase in blood volume.
• ANP causes vaso-dilation and a decrease in TPR.

Question 16

Within the nephron, ANP has 3 main actions:

• Relaxes​ the [] arteriole and constrict the [] arteriole –> [] in GFR –> [] in exretion of Na+ in urine
• [] the sodium/potassium pump in the [] and [] –> [] Na+ reabsorption

Answer 16

• Relaxes​ the afferent arteriole and constrict the efferent arteriole –> increase in GFR –> Increase in exretion of Na+ in urine
• Inhibits the sodium/potassium pump in the late DCT and CD –> decreased Na+ reabsorption

Question 17

ANP can also act to systemically [] the vasculature, leading to a [] in blood pressure

Answer 17

vasodilate; drop

Question 18

In the kidney, ANP acts as an antagonist to []

Answer 18

Aldosterone

Question 19

[] is any substance that increases urine output

Answer 19

Diuretics

Question 20

Diuretics can be classified into 3 main types:

1. Substances that [] GFR (mild increase in urine output)
2. Substances that [] ADH release (potent increase in urine output)
3. Osmotic or []-[]-[] substances (potent increase in urine output.)

Answer 20

1. Substances that increase GFR (mild increase in urine output)
2. Substances that inhibit ADH release (potent increase in urine output)
3. Osmotic or renal-transport-inhibiting substances (potent increase in urine output.)

Question 21

Diuretics that affect GFR:

1. Caffeine - [] afferent arteriole
2. ANP - [] afferent arteriole, and [] the effeerent arteriole

• Both of these create a urine product that is [] to plasma ~300 mOsm

Answer 21

1. Caffeine - dilates afferent arteriole
2. ANP - dilates afferent arteriole, and constricts the effeerent arteriole

• Both of these create a urine product that is isomotic to plasma ~300 mOsm

Question 22

• Examples of diretics that inhibit ADH: []and [].
• In diabetes [], ADH is not produced and/or detected within the body
• In these instances, the urine excreted by the body is []-osmotic compared to the plasma.

Answer 22

• Examples of diretics that inhibit ADH: Ethanol and Narcotics.
• In diabetes Insipidus, ADH is not produced and/or detected within the body
• In these instances, the urine excreted by the body is hypo-osmotic compared to the plasma.

Question 24

• Example of diuresis due to osmotically active solutes: []
  
  • Glucoss [] the transport maximum for reabsorption
  • Water [] follows glucose
  • Usually due to diabetes []
• The urine formed in these instances is relatively []-osmotic versus plasma.

Answer 24

• Example of diuresis due to osmotically active solutes: Glucose
  
  • Glucoss exceeds the transport maximum for reabsorption
  • Water osmotically follows glucose
  • Usually due to diabetes mellitus
• The urine formed in these instances is relatively iso-osmotic versus plasma.

Question 25

Carbonic Anhydrate Inhibitors:

1. [] reabsorption of bicarbonate in []
2. Some [] will follow the bicarbonate
3. Can be limited by resultant []

Answer 25

1. Inhibits reabsorption of bicarbonate in PCT
2. Some sodium will follow the bicarbonate
3. Can be limited by resultant acidosis

Question 26

Loop Diuretics (Potent)

1. Example: []
2. Interrupts counter-current [] system
3. []-wasting diuretic..so patients oculd suffer form []

Answer 26

1. Example: Furosemide
2. Interrupts counter-current multiplier system
3. Potassium-wasting diuretic..so patients oculd suffer form hypochalimia

Question 27

Thiazide-type Diuretic

1. [] sodium chloride transporter in the []

Answer 27

Inhibits; Late DCT

Question 28

Aldosterone antagonists

• []-saving diuretic
• Affects are seen in the [] and []
• Usually given when a patient isn’t tolerating [] [] and have a lot of sid effects

Answer 28

• Potassium-saving diuretic
• Affects are seen in the Late DCT and CD
• Usually given when a patient isn’t tolerating loop diuretics and have a lot of sid effects