Brainscape's Knowledge GenomeTM

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


See full index

PHGY 210 > Renal VI > Flashcards

Renal VI Flashcards

1
Q

What are the 2 types of alkalosis? What is the cause of each?

A

Respiratory alkalosis: results from altered respiration
Metabolic alkalosis: results from other causes

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

What are the 2 types of acidosis? what is the cause of each?

A

Respiratory acidosis: results from altered respiration
Metabolic acidosis: results from other causes

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

What are the 3 steps of the kidneys’ response to acidosis?

A
  1. Sufficient H+ are secreted to reabsorb all the filtered HCO3-
  2. More H+ are secreted and new HCO3- is synthesized for the plasma. The H+ is bound to non-HCO3- buffers, such as HPO42-.
  3. Tubular glutamine metabolism and ammonium excretion are enhanced, which also contributes new HCO3- to the plasma.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the end result of the kidneys’ response to acidosis?

A

More new HCO3- than usual are added to the plasma, compensating for the acidosis. The urine is now highly acidic.

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

What is the lowest attainable pH for urine?

A

4.4

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

What are the 3 steps of the response of the kidneys to alkalosis?

A
  1. Rate of H+ secretion is inadequate to reabsorb all the filtered HCO3-, so significant amounts of HCO3- are excreted in the urine.
  2. There is little or no H+ secretion on non-HCO3- buffers.
  3. Tubular glutamine metabolism and ammonium excretion are decrease so that little or no new HCO3- is contributing to the plasma.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the net result of the kidneys’ response to alkalosis?

A

Plasma HCO3- will decreases, thereby compensating for the alkalosis. The urine will be highly alkaline.

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

What is the highest possible pH for urine?

A

pH > 7.4

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

For the following disorders, state whether H+, HCO3-, and CO2 increase or decrease:
a) Respiratory acidosis
b) Respiratory alkalosis
c) Metabolic acidosis
d) Metabolic alkalosis

A

a) H+ increase, HCO3- increase, CO2 increase
b) H+ decrease, HCO3- decrease, CO2 decrease
c) H+ increase, HCO3- decrease, CO2 decrease
d) H+ decrease, HCO3- increase, CO2 increase

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

For the following disorders, state the primary abnormality responsible and whether it affected CO2 or HCO3.
a) Respiratory acidosis
b) Respiratory alkalosis
c) Metabolic acidosis
d) Metabolic alkalosis

A

a) CO2 change
b) CO2 change
c) HCO3- change
d) HCO3- change

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

For respiratory acidosis, explain how H+, pCO2, and HCO3- affect each other using the Hendelsson formula.

A
  • H+ increases because it is acidosis
  • Primary cause is respiration - if you add CO2, this will shift the reaction to the right and add extra H+. CO2 therefore must increase.
  • HCO3- must increase to match the increase in CO2. This will be the compensation mechanism of the kidneys.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

For respiratory alkalosis, explain how H+, pCO2, and HCO3- affect each other using the Hendelsson formula.

A
  • H+ decreases because it’s alkalosis
  • Primary cause is respiration - if you remove CO2, this will shift the reaction to the left and remove H+. CO2 must therefore decrease.
  • HCO3- must therefore decrease to match the decrease in CO2. This will be the compensation mechanism of the kidneys.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

For metabolic acidosis, explain how H+, pCO2, and HCO3- affect each other using the Hendelsson formula.

A
  • H+ increases because it’s acidosis
  • Primary cause is metabolism - removing HCO3- will shift equation to the right. HCO3- must therefore decrease.
  • CO2 must decrease to match.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

For metabolic alkalosis, explain how H+, pCO2, and HCO3- affect each other using the Hendelsson formula.

A
  • H+ decreases because it’s alkalosis
  • Primary cause is metabolism - adding HCO3- will shift equation to the left. HCO3- must therefore increase.
  • CO2 must increase to match.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Give an example of a disease/disorder that can cause respiratory acidosis and explain how.

A

In emphysema, the lungs cannot breathe out sufficient CO2. This kind of resp failure can cause CO2 retention and respiratory acidosis.

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

Give an example of a disease/disorder that can cause respiratory alkalosis and explain how.

A

Happens via hyperventilation, such as when we go to high altitudes. This can also be pathological, when you’re panicking or in distress. Pregnant ladies also tend to hyperventilate.

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

Give an example of a disease/disorder that can cause metabolic acidosis and explain how.

A

Diarrhea: contains a lot of bicarbonate. This bicarbonate loss will cause acidosis

18
Q

Give 2 examples of a disease/disorder that can cause metabolic alkalosis and explain how.

A

Happens with vomiting, as it is very acidic. Can also be caused by hyperaldosteronism, which causes increases secretion of H+ at the DCT and CCD.

19
Q

What are diuretics?

A

Drugs used clinically to increase the volume of urine excreted are known as diuretics.

20
Q

Describe the general effects of diuretics on the tubules.

A

Diuretics act on the tubules to inhibit the reabsorption of sodium, chloride, and/or bicarbonate, resulting in increased excretion of these ions. Water excretion increases too. They also inhibit water reabsorption, increasing excretion.

21
Q

Where do loop diuretics exert their effect?

A

They act on the thick ascending limb of the loop of Henle.

22
Q

Give an example of a loop diuretic.

A

Furosemide

23
Q

Explain the effect of loop diuretics in the tubules.

A

They inhibit cotransport of sodium, chloride, and potassium (Na+-K+-2Cl- cotransporter) in the thick ascending limb of the loop of Henle.

24
Q

Explain the effect of potassium-sparing diuretics. Include where in the tubule they have their effect.

A

They inhibit sodium reabsorption in the CCD and inhibit potassium secretion there. Thus, unlike other diuretics, plasma concentration of potassium does not decrease.

They accomplish this by either blocking the action of aldosterone or blocking the (aldosterone-regulated) epithelial sodium channel in the CCD.

25
Q

Give 2 examples of potassium-sparing diuretics.

A

Amiloride, spironolactone.

26
Q

What is the difference between the functioning of amiloride and spironolactone?

A

Amiloride blocks the apical sodium channel in the cortical collecting duct cells, preventing sodium reabsorption. Spironolactone blocks the aldosterone receptors, which consequently blocks all the transporters.

27
Q

How do potassium-sparing diuretics differ from other diuretics in terms of their treatment of potassium?

A

They block potassium secretion, causing hyperkalemia. This is unusual, as the other classes cause hypokalemia. This drug is not super powerful, but its advantage is that it prevents hypokalemia. Potassium gets retained.

28
Q

What is the typical clinical use of diuretics?

A

Edema (extracellular fluid accumulation)

29
Q

Give 2 examples of edema disorders that requie the use of diuretics.

A

Congestive heart failure and hypertension.

30
Q

Explain how diuretics help with congestive heart failure.

A

Because the heart is not pumping very strongly, the effective circulating volume is low and the kidneys are not receiving enough blood flow. The RAA system kicks in and the kidneys try to retain fluid and salt. In this condition, the extra fluid goes in the lungs mainly, which makes people short of breath. Diuretics are used in this scenario.

31
Q

Explain how diuretics help with hypertension.

A

Hypertension involves the renal retention of salt and water, so diuretics are used to reverse this.

32
Q

Give 6 examples of common features of kidney disease/failure.

A
  1. Proteinuria (protein in the urine)
  2. Accumulation of waste products (urea, creatinine, phosphate, sulfate, etc.) in the blood
  3. High potassium concentration in the blood
  4. Metabolic acidosis
  5. Anemia (decreased secretion of erythropoeitin)
  6. Decreased secretion of 1,25deoxyvitamin D
33
Q

What is the threshold of kidney damage past which the kidney cannot survive?

A

When more than 90% of nephrons stop working

34
Q

Name an advantage and a disadvantage of hemodialysis.

A

Advantage: very efficient
Disadvantage: very time consuming and requires frequent visits to the hospital

35
Q

Describe how hemodialysis works.

A

Arterial blood from patient gets pumped into dialyzer, which removes waste products through a membrane made up of strands of dialysis tubing. The contaminated dialysis fluid filters out and new dialysis fluid gets pumped in. When cleared, the blood flows back into the patient as venous blood.

36
Q

How does peritoneal dialysis work?

A

The lining of the patient’s peritoneum is used as a dialysis membrane. Fluid is injected into the peritoneal cavity via a tube inserted through the abdominal wall.

37
Q

Name an advantage of peritoneal dialysis.

A

it can be done at home or while travelling, even at night so that it’s less disruptive.

38
Q

What is the most effective renal replacement therapy?

A

Kidney transplant

39
Q

What are the 2 possible sources for a kidney transplant?

A

Recently deceased person or living related/unrelated donor.

40
Q

What is the major obstacle to kidney transplantation?

A

There is an organ shortage.

41
Q

True or false? You can function normally with one kidney.

A

True.

PHGY 210 (36 decks)

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