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HN 320 > The Renal System IV (Lecture 13) > Flashcards

The Renal System IV (Lecture 13) Flashcards

1
Q

True or False: Increase in solute reabsorption increases osmotic gradient for water reabsorption

A

True

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2
Q

What are 5 examples of increase in solute reabsorption increases osmotic gradient for water reabsorption?

A

ADH  increases water reabsorption

ADH increases the number of sodium channels in the apical membrane of principal cells

ADH  increases sodium entry into cells

Angiotensin II increases ADH secretion  stimulates water reabsorption

ANP decreases ADH secretion  decreases water reabsorption

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3
Q

What are the 3 things to happen during a physiological response to a hemorrhage?

A

Decrease in blood volume  decrease in MAP

Neural control of heart and vasculature (Baroreceptor reflex)

Hormonal control of blood volume

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4
Q

What are the four hormonal controls of blood volume during hemorrhage?

A

ADH
Renin-angiotensin-angiotensin II-aldosterone system
Decreased glomerular filtration rate
Kidneys secrete erythropoietin

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5
Q

Hydrogen ion concentrations or pH of arterial blood is regulated by the ______ and ______.

A

Lungs and kidneys

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6
Q

Normal pH of arterial blood is ______.

A

7.35-7.45

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7
Q

What are the 5 complications to acid-base disturbance?

A

Conformation change in protein structure  alter proteins’ function

Changes in excitability of neurons

Changes in potassium balance

Cardiac arrhythmias

Vasodilation

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8
Q

What are 3 examples on fluctuating acid base content based on input metabolism?

A

CO2, lactic acid, keto acids

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9
Q

What are What are 3 examples on fluctuating acid base content based on output?

A

H+ kidneys, CO2 lungs

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10
Q

True or False: Carbon dioxide is a source of acid.

A

True

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11
Q

Normal PCO2 arterial blood = ______.

A

40 mm Hg

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12
Q

Increased plasma [CO2] = respiratory ______

Decreased plasma [CO2] = respiratory ______

A

Acidosis, alkalosis

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13
Q

______ is a decreased pH through something other than CO2.

A

Metabolic acidosis (metabolic alkalosis is opposite)

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14
Q

What 5 things can lead to metabolic acidosis?

A

High-protein diet

High-fat diet

Strenuous exercise

Severe diarrhea (loss of bicarbonate)

Renal dysfunction

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15
Q

What 3 things can lead to metabolic alkalosis?

A

Excessive vomiting (loss of hydrogen ions)

Consumption of alkaline products (baking soda)

Renal dysfunction

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16
Q

What are the 3 lines of defense against acid-base disturbances.

A

Buffering of hydrogen ions

Respiratory compensation

Renal compensation

17
Q

True or False: Renal compensation is the quickest defense against changes in pH.

A

False, buffering

18
Q

What is the most important ECF buffer?

A

Bicarbonate

19
Q

What are the two types of IFC buffers?

A

Proteins and phosphates

20
Q

True or False: Respiratory compensation is the second line of defense?

A

True. takes minutes to have effect

21
Q

True or False: Increased ventilation = increase in CO2 and decreased ventilation = decrease in CO2.

A

False, vice versa

22
Q

What is the negative feedback loop for decrease in plasma pH?

A

decrease in plasma pH = detect by peripheral chemoreceptors

then increase in ventilation = decrease in plasma PCO2

leads to increase in plasma pH

23
Q

What is the third line of defense?

A

Renal compensation

24
Q

True or False: Renal compensation takes hours to days.

A

True

25
Q

How does renal compensation protect against acid-base disturbances

A

Regulates excretion of hydrogen ions and bicarbonate in urine

Regulates synthesis of new bicarbonate in renal tubules

26
Q

What are the effects of increased acidity on renal compensation?

A

Increased secretion of hydrogen ions

Increased reabsorption of bicarbonate

Increased synthesis of new bicarbonate

27
Q

True or False: In the proximal tubule, bicarbonate reabsorption coupled to hydrogen ion secretion

A

True

28
Q

What are the 3 actions in the proximal tubule procedure in regards to mechanisms against acid-base disturbances?

A

Under normal conditions, 80-90% of filtered bicarbonate is reabsorbed

Hydrogen ions are secreted

Sodium is reabsorbed

29
Q

True or False: In the distal tubule and collecting duct, secretion of hydrogen ions coupled to synthesis of new bicarbonate ions occurs.

A

True

30
Q

What are the 2 actions in the distal tubule and collecting duct procedure in regards to mechanisms against acid-base disturbances?

A

Newly formed bicarbonate ions to the plasma

Hydrogen ions secreted into the tubular fluid

31
Q

What two ways is glutamine used in renal compensation?

A

Regulation of hydrogen ion secretion, bicarbonate reabsorption, and bicarbonate synthesis by kidneys is usually sufficient

During severe acidosis

32
Q

What are the 2 actions of the glutamine metabolism procedure in regards to mechanisms against acid-base disturbances?

A

New bicarbonate ion is added to the blood

Hydrogen ion is secreted in the form of ammonium

33
Q

If rhe Henderson- Hasselbalch equation is [HCO3–]/[CO2] < 20:1 then its ______ or when its [HCO3–]/[CO2] > 20:1 then its ______.

A

Acidosis, alkalosis

34
Q

Respiratory acidosis is caused by ______ whereas respiratory alkalosis is caused by ______.

A

Hypoventilation, (lung diseases) hyperventilation (fever, anxiety)

35
Q

What are 4 examples of metabolic acidosis?

A

Example: diarrhea (loss of bicarbonate), diabetes mellitus (keto acids), strenuous exercise (increases lactic acid), renal failure

36
Q

What effect does metabolic acidosis have?

A

Respiratory compensation
Increased ventilation  decreased CO2
Converts HCO3– and H+ to produce CO2  decreasing free H in blood

Renal compensation
Increased H+ secretion
Increased HCO3– reabsorption
Increased synthesis of new bicarbonate

37
Q

What are the 2 examples of metabolic alkalosis?

A

Examples: vomiting (loss of gastric contents), ingestion of alkaline drugs (antacids)

38
Q

What effect does metabolic alkalosis have?

A

Respiratory compensation
Decreased ventilation  increased CO2
CO2 combines with H20  HCO3– and H+  increasing free H in blood

Renal compensation
Decreased H+ secretion
Decreased HCO3– reabsorption
Decreased synthesis of new bicarbonate

39
Q

Acidosis occurs when bicarbonate is lower that ______ and PCO2 is higher then ______.

A

24 mM and 40 mm Hg, vice versa for alkalosis

HN 320 (17 decks)

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