The Renal System IV (Lecture 13)

Question 1

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

Answer 1

True

Question 2

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

Answer 2

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

Question 3

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

Answer 3

Decrease in blood volume  decrease in MAP

Neural control of heart and vasculature (Baroreceptor reflex)

Hormonal control of blood volume

Question 4

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

Answer 4

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

Question 5

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

Answer 5

Lungs and kidneys

Question 6

Normal pH of arterial blood is ______.

Answer 6

7.35-7.45

Question 7

What are the 5 complications to acid-base disturbance?

Answer 7

Conformation change in protein structure  alter proteins’ function

Changes in excitability of neurons

Changes in potassium balance

Cardiac arrhythmias

Vasodilation

Question 8

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

Answer 8

CO2, lactic acid, keto acids

Question 9

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

Answer 9

H+ kidneys, CO2 lungs

Question 10

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

Answer 10

True

Question 11

Normal PCO2 arterial blood = ______.

Answer 11

40 mm Hg

Question 12

Increased plasma [CO2] = respiratory ______

Decreased plasma [CO2] = respiratory ______

Answer 12

Acidosis, alkalosis

Question 13

______ is a decreased pH through something other than CO2.

Answer 13

Metabolic acidosis (metabolic alkalosis is opposite)

Question 14

What 5 things can lead to metabolic acidosis?

Answer 14

High-protein diet

High-fat diet

Strenuous exercise

Severe diarrhea (loss of bicarbonate)

Renal dysfunction

Question 15

What 3 things can lead to metabolic alkalosis?

Answer 15

Excessive vomiting (loss of hydrogen ions)

Consumption of alkaline products (baking soda)

Renal dysfunction

Question 16

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

Answer 16

Buffering of hydrogen ions

Respiratory compensation

Renal compensation

Question 17

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

Answer 17

False, buffering

Question 18

What is the most important ECF buffer?

Answer 18

Bicarbonate

Question 19

What are the two types of IFC buffers?

Answer 19

Proteins and phosphates

Question 20

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

Answer 20

True. takes minutes to have effect

Question 21

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

Answer 21

False, vice versa

Question 22

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

Answer 22

decrease in plasma pH = detect by peripheral chemoreceptors

then increase in ventilation = decrease in plasma PCO2

leads to increase in plasma pH

Question 23

What is the third line of defense?

Answer 23

Renal compensation

Question 24

True or False: Renal compensation takes hours to days.

Answer 24

True

Question 25

How does renal compensation protect against acid-base disturbances

Answer 25

Regulates excretion of hydrogen ions and bicarbonate in urine Regulates synthesis of new bicarbonate in renal tubules

Question 26

What are the effects of increased acidity on renal compensation?

Answer 26

Increased secretion of hydrogen ions Increased reabsorption of bicarbonate Increased synthesis of new bicarbonate

Question 27

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

Answer 27

True

Question 28

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

Answer 28

Under normal conditions, 80-90% of filtered bicarbonate is reabsorbed Hydrogen ions are secreted Sodium is reabsorbed

Question 29

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

Answer 29

True

Question 30

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

Answer 30

Newly formed bicarbonate ions to the plasma Hydrogen ions secreted into the tubular fluid

Question 31

What two ways is glutamine used in renal compensation?

Answer 31

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

Question 32

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

Answer 32

New bicarbonate ion is added to the blood Hydrogen ion is secreted in the form of ammonium

Question 33

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

Answer 33

Acidosis, alkalosis

Question 34

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

Answer 34

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

Question 35

What are 4 examples of metabolic acidosis?

Answer 35

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

Question 36

What effect does metabolic acidosis have?

Answer 36

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

Question 37

What are the 2 examples of metabolic alkalosis?

Answer 37

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

Question 38

What effect does metabolic alkalosis have?

Answer 38

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

Question 39

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

Answer 39

24 mM and 40 mm Hg, vice versa for alkalosis