Term
| Kidney maintains constancy of ECF by excretion of what? |
|
Definition
|
|
Term
| What do kidneys excrete to maintain K+ concentration? |
|
Definition
|
|
Term
| Kidneys product of metabolism? |
|
Definition
|
|
Term
What hormone sources are found in kidney?
(3) |
|
Definition
| angiotensin II, erthropoitin, and prostoglandins. |
|
|
Term
| Reabsorption of kidney involves which part? |
|
Definition
|
|
Term
| Excretion of kidney involves which part? |
|
Definition
|
|
Term
| Secretion of kidney involves which part? |
|
Definition
|
|
Term
| A nephron consists of what? (2) |
|
Definition
| Glomerulus and renal tubule |
|
|
Term
| Renal Tubule has the following segments? (4) |
|
Definition
| Proximal Tubule, Loop of Henle (thick ascending and thin ascending/descending limb), Distal Tubule, Collecting Duct. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Water, together with dissolved solutes (but not ____) can pass through blood plasma to inside of the capsule and the nephron tubule. |
|
Definition
|
|
Term
| Volume of filtrate produce by both kidney s per minute is called? |
|
Definition
| Glomerular Filtration Rate |
|
|
Term
| What is the fluid called that enters the glomerular capsule? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Where does most of the water return to? |
|
Definition
|
|
Term
| Where is glucose reabsorbed? |
|
Definition
|
|
Term
| How does glucose become reabsorbed? |
|
Definition
|
|
Term
| What happens when plasma glucose concentrations are less than 250mg/dl? |
|
Definition
| All of filtered glucose can be reabsorbed. |
|
|
Term
| What happens when plasma glucose concentration is greater than 350mg/dl? |
|
Definition
| Carrier is saturated (no increased rate of absorption.) |
|
|
Term
| With the excretion of glucose, when plasma concentration is less than 250mg/dl, what occurs? What excretion occurs? |
|
Definition
| All filtered glucose is reabsorbed. Excretion is zero. |
|
|
Term
| With the excretion of glucose, when plasma concentration is greater than 350mg/dl, what occurs? |
|
Definition
| Reabsorption is saturated, glucose is excreted in urine. |
|
|
Term
| Where is Na+ filtered through? |
|
Definition
|
|
Term
| Is the Na+ in tubular fluid in Bowman's Capsule (more, less, equal) to that in plasma? |
|
Definition
|
|
Term
| Where else is Na+ reabsorbed? |
|
Definition
|
|
Term
| How much Na+ is excreted in urine? |
|
Definition
|
|
Term
How much of reabsorption of Na+ occurs in the proximal tubule?
(%?) |
|
Definition
|
|
Term
| What is the site of Glomerulo-tubular balance? |
|
Definition
|
|
Term
| The reabsorption of Na+ and H2O is what proportion in the proximal tubule? |
|
Definition
|
|
Term
| Early proximal tubule reabsorbs what contents? (7 all together) |
|
Definition
| Na+, H20, HCO3-, Glucose, Amino Acids, Phosphate, and lactate. |
|
|
Term
| How is Na+ reabsorbed in the early proximal tubule? |
|
Definition
| By cotransport with glucose, AA's, phosphate, and lactate. |
|
|
Term
| What is another way Na+ is reabsorbed? |
|
Definition
| Cotransport with Na+, H+ exchange, linked directly to reabsorption of filtered HCO3-. |
|
|
Term
Which of the following are reabsorbed by the middle and late proximal tubule?
A. Glucose,
B. Amino Acids
C. HCO3-
D. All of the above
E. None of the above |
|
Definition
| E. None of the above. All 3 have already been reabsorbed by the early proximal tubule. |
|
|
Term
| What is reabsorbed in the middle and late proximate tubule? (2) |
|
Definition
|
|
Term
| What % of filtered Na+ is reabsorbed in the thick ascending limb of the loop of Henle? |
|
Definition
|
|
Term
| What co transporters are in the luminal membrane of the Thick Ascending limb of the loop of Henle? |
|
Definition
|
|
Term
| What is the thick ascending limb of the loop of Henle impermeable to? |
|
Definition
|
|
Term
| How is NaCl reabsorbed in the thick ascending limb of the loop of Henle? |
|
Definition
|
|
Term
| As a result of NaCl re absorption in the thick ascending limb of the loop of Henle, what happens to the osmolarity of Na+ and tubular fluid? |
|
Definition
|
|
Term
| The distal tubule and collecting duct reabsorb what % of filtered Na+? |
|
Definition
|
|
Term
| How does the distal tubule and collecting duct reabsorb NaCl? |
|
Definition
|
|
Term
| The distal tubule and collecting duct is impermeable to what substance? |
|
Definition
|
|
Term
| 2 cell located in the late distal tubule and collecting duct? |
|
Definition
Principal Cells
Alpha intercalated cells |
|
|
Term
| Features of the Principal Cells (2)? |
|
Definition
1. Reabsorb Na+ and H20
2. Secrete K+ |
|
|
Term
| What increases Na+ re absorption and also increases K+ secretion? |
|
Definition
|
|
Term
| What increases H20 permeability (in principal cells)? |
|
Definition
| Antidiuretic Hormone (ADH) |
|
|
Term
| Why is Antidiuretic Hormone important for H20 permeability? |
|
Definition
| Abscence of ADH makes cell almost impermeable to H20. |
|
|
Term
| How does Alpha Intercalated Cells secrete H+? |
|
Definition
| Adenosine Triphosphatase (ATP ase) |
|
|
Term
|
Definition
|
|
Term
| What other substances do Alpha Intercalated cells reabsorb? |
|
Definition
|
|
Term
Where is most of the body's K+ located?
A. ICF
B. ECF |
|
Definition
|
|
Term
| A shift of K+ out of cells causes ? |
|
Definition
|
|
Term
| A shift of K+ into cells causes? |
|
Definition
|
|
Term
| K+ is filtered, reabsorbed, and secreted by the _________? |
|
Definition
|
|
Term
| How is K+ balance achieved? |
|
Definition
| When urinary exretion of K+ equals dietary intake of K+ |
|
|
Term
| How does filtration occur across the glomerular capillaries? |
|
Definition
|
|
Term
What % of K is reabsorbed in proximal tubule?
What else is reabsorbed? |
|
Definition
|
|
Term
| Thick ascending limb of the loop of Henle reabsorbes what % of filtered K+? |
|
Definition
|
|
Term
| What does reabsorption of K+ involve in the Thick ascending limb of the loop of Henle? |
|
Definition
| Na+-K+-2Cl- cotransporter(luminal membrane) of cells |
|
|
Term
| Reabsorption or secretion of K+ in the distal tubule and collection duct depends on what? |
|
Definition
|
|
Term
| Where does secretion of K+ occur? (Review) |
|
Definition
|
|
Term
Which of these factors can NOT affect the secretion of K+?
A. Dietary intake
B. Aldosterone levels
C. Acid-Base Status
D. Urine Flow Rate
E.K+/Na+ solute concentration |
|
Definition
| E. K+/Na+ solute concentration |
|
|
Term
| A diet in high K+ does what for K+ secretion? |
|
Definition
| Increases secretion of K+ |
|
|
Term
| How are the alpha intercalated cells stimulated to reabsorb K+ (Review) |
|
Definition
|
|
Term
| What is the function of Aldosterone? (Review) |
|
Definition
|
|
Term
| What is the mechanism of Aldosterone? |
|
Definition
| Increased Na+ entry into cells across luminal membrane and increased pumping of Na+ out of cells by Na+K+ pump. Stimulation of pump simultaneously increases K+ uptake in principal cells, which in turn increases intra. K+ conc. |
|
|
Term
| What is another function of Aldosterone? |
|
Definition
| Increase the number of luminal membrane K+ channels. |
|
|
Term
| What is Hyperaldosteronism? |
|
Definition
| Increased K+ secretion (Hypokalemia) |
|
|
Term
| What is Hypoaldosteronism? |
|
Definition
| Decrease K+ secretion (Hyperkalemia) |
|
|
Term
| For acid base, what is ions are exchanges across the basolateral cell membrane? |
|
Definition
|
|
Term
Acidosis _______ K+ secretion?
(Increase or decrease) |
|
Definition
|
|
Term
| Mechanism behind acidosis? |
|
Definition
| Blood contains excess H+, so H+ enters cell across basolateral membrane and K+ leaves cell. Result is decreased intracellular K+ concentration and driving force of K+ secretion decreases. |
|
|
Term
Alkalosis ______ K+ secretion?
(Increase or decrease) |
|
Definition
|
|
Term
| Mechanism behind Alkalosis? |
|
Definition
| Blood contains too little H+. H+ leaves cell (basolateral membrane) and K+ enters cell. Result is increased intracellular K+ and driving force of K+ increased. |
|
|
Term
What percent of filtered urea is reabsorbed?
Where is this urea reabsorbed? |
|
Definition
|
|
Term
| What increases urea permeability of inner medullary collecting ducts? |
|
Definition
|
|
Term
What percentage of filtered phosphate is reabsorbed?
Where is it reabsorbed? |
|
Definition
|
|
Term
| How does reabsorption of Phosphate occur? |
|
Definition
| Na+-phosphate cotransport |
|
|
Term
| What % of filtered load of phosphate is excreted in urine? |
|
Definition
|
|
Term
| What inhibits phosphate reabsorption in the proximal tubule? |
|
Definition
|
|
Term
| How does inhibition of phosphate reabsorption occur? |
|
Definition
| Activating Adenylate cyclase, PTH causes phospaturia, and then increases urinary cAMP. |
|
|
Term
| 60% of plasma Ca+ is filtered where? |
|
Definition
|
|
Term
| What two parts reabsorb more than 90% of filtered Ca+ that are coupled to Na+ reabsorption. |
|
Definition
1. Proximal Tubule
2. Thick Ascending Limb |
|
|
Term
| How much Ca+ is reabsorbed by Distal Tubule and Collecting Duct? |
|
Definition
|
|
Term
| What increases Ca+ reabsorption by activating Adenylate cyclase in distal tubule? (Review) |
|
Definition
|
|
Term
Where is magnesium reabsorbed?
(3 places) |
|
Definition
1. Thick ascending limb
2. Proximal Tubule
3. Distal Tubule |
|
|
Term
| Where does Mg+ and Ca+ compete for reabsorption? |
|
Definition
|
|
Term
What does hypercalcemia cause an increase of?
What mechanism causes this? |
|
Definition
Increased Mg+ excretion
By inhibiting Mg+ reabsorption |
|
|
Term
When is concentrated urine produced?
(2 cases) |
|
Definition
1. Urine osmolarity > Blood osmolarity
2. ADH levels are high |
|
|
Term
| What is the corticopapillary osmotic gradient? |
|
Definition
| Gradient of osmolarity (cortex to papilla) |
|
|
Term
What composes corticopapillary osmostic gradient?
(2) |
|
Definition
|
|
Term
| How is corticopapillary osmotic gradient established? |
|
Definition
| Countercurrent multiplication and urea recycling |
|
|
Term
| How is corticopapillary osmotic gradient maintaned? |
|
Definition
| Countercurrent exchange in vasa recta |
|
|
Term
| How is 2/3 of filtered H20 is reabsorbed in the proximal tubule? |
|
Definition
|
|
Term
In the proximal tubule, what else is reabsorbed with H20? (Review)
( 5 items) |
|
Definition
Na+
Cl-
HCO3-
Glucose
AAs (Amino Acids) |
|
|
Term
| What is another name for the thick ascending limb of the loop of Henle? |
|
Definition
|
|
Term
| How is NaCl absorbed in thick ascending limb of loop of Henle? |
|
Definition
|
|
Term
| The early distal tubule (High ADH) reabsorbs _____ but is impermeable to ______? |
|
Definition
|
|
Term
| What increases H20 permeability of principal cells of late distal tubule? |
|
Definition
|
|
Term
What characteristics are associated with Glomerulonephritis?
(3) |
|
Definition
Body Tissue Swelling (Edema)
High Blood Pressure
Red Blood Cells (RBC) in urine |
|
|
Term
| Primary Glomerulonephritis affects what? |
|
Definition
|
|
Term
| What is the main cause of Acute Glomerulonephritis? |
|
Definition
| Complication of throat or skin infection (strep) |
|
|
Term
| Chronic Glomerulonephritis is occasionally caused by ? |
|
Definition
| Hereditary Nephritis (inherited genetic disorder) |
|
|
Term
Edema
Puffiness occurs where first?
Where is it most prominent? |
|
Definition
|
|
Term
Edema Treatment
What can help kidney excrete excess sodium and water? |
|
Definition
|
|
Term
Edema Treatment
What is prescribed to help treat high blood pressure? |
|
Definition
| ACE inhibitor, Angiotensin II receptor blockers (ARBs) |
|
|
Term
Acute Glomerulonephritis Treatment
When a bacterial infection is suspected, what is prescribed? |
|
Definition
|
|
Term
| What change in dietary intake an help to reduce the rate of kidney deterioation? |
|
Definition
|
|
Term
| What are the options for a patient with end stage kidney failure? |
|
Definition
Dialysis
Kidney Transplant |
|
|
Term
Pyelonephritis
What is the main cause? |
|
Definition
Bacterial infection (E. Coli)
Can affect one of both kidneys |
|
|
Term
Pyelonephritis
How can the infection spread? (2 main ways) |
|
Definition
Up urinary tract to kidneys
Bacteria through blood stream |
|
|
Term
Pyelonephritis
Symptoms associated?
(5) |
|
Definition
Chills
Fever
Back Pain
Nauseau
Vomiting |
|
|
Term
Pyelonephritis
What is the main treatment? |
|
Definition
|
|
Term
Stone in the Urinary Tract
Stones, or _____ are hard masses that form anywhere in the urinary tract and can cause pain, bleeding, obstruction of the flow of urine, or an infection. |
|
Definition
|
|
Term
| What is the main cause of stones? |
|
Definition
| Urine becomes too saturated with salts, urine lacks inhibitiors of stone formation |
|
|
Term
| What is the main inhibitor of stone formation? |
|
Definition
|
|
Term
| About 80% of stones are composed of _______? |
|
Definition
|
|
Term
| Stones are more common in people with ______________? |
|
Definition
|
|
Term
Stones of the Urinary Tract
Which treatment is not clear to be helpful? |
|
Definition
| Drinking plenty of fluids |
|
|
Term
Stones of the Urinary Tract
Name a few of the treatments that can help with stones?
(3) |
|
Definition
Alpha-Adrenergic blockers (Tamsulosin)
Potassium Citrate
Calcium Channel Blockers (Verapamil) |
|
|
Term
| The pain of renal colic may be relieved with ______________________ or ____________? |
|
Definition
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Opioids |
|
|
Term
| What are the two types of acids produced in the body? |
|
Definition
Volatile acid
Non volatile acid |
|
|
Term
|
Definition
|
|
Term
| What produces the volatile acid? |
|
Definition
| Aerobic metabolism of cells |
|
|
Term
| How does this process occur? |
|
Definition
CO2 + H20 and forms H2C03 (weak acid).
Then dissociates into H+ and HCO3 |
|
|
Term
| What catalyzes the reversible reaction for the volatile acid? |
|
Definition
|
|
Term
| Nonvolatile acids are also known as _______ _______? |
|
Definition
|
|
Term
What is included in the category of nonvolatile acids?
(2) |
|
Definition
1. Sulfuric Acid H2SO4 (product of protein catabolism)
2. Phosphoric acid (product of phoslipid catabolism) |
|
|
Term
Other fixed acids that can be overproduces in disease include?
(3) |
|
Definition
1. Ketoacids
2. Lactic acid
3. Salicylic acid |
|
|
Term
| What is the purpose of buffers? |
|
Definition
| Prevent a change in pH when H+ are added or removed from a solution. |
|
|
Term
| Where are buffers most effective? |
|
Definition
| Within 1.0 pH unit of pK of buffer. |
|
|
Term
| The major extracellular buffer is ______? |
|
Definition
HC03-
Produced from CO2 and H2O |
|
|
Term
| The minor extracellular buffer is _________? |
|
Definition
|
|
Term
| Why is phosphate important? |
|
Definition
|
|
Term
| The excretion of H+ as H2PO4- is called? |
|
Definition
|
|
Term
| What are 2 intracellular buffers? |
|
Definition
1. Organic phosphates
2. Proteins |
|
|
Term
| What is the major intracellular buffer? |
|
Definition
|
|
Term
| Where does reabsorption of filterd HCO3- occur? |
|
Definition
| Primarily in proximal tubule |
|
|
Term
| First Feature in reabsorption of filtered HCO3- |
|
Definition
| 1. H+ and HCO3- are produced in proximal tubule from CO2 and H2O. CO2 and H2O combine to form H2CO3 (Carbonic acid). Catalyzed by intracellular carbonic anhydrase. H2CO3 dissociates into H+ and HCO3-. H+ is secreted into lumen (Na+H+ exchange) HCO3- is reabsorbed. |
|
|
Term
| Second feature in reabsorption of filtered HCO3- |
|
Definition
| In lumen, secreted H+ combines with HCO3- to form H2CO3, which disassociates into CO2 and H2O, catalyzed by brush bored carbonic anhydrase. CO2 and H2O diffuse into the cell to start cycle again. |
|
|
Term
| Third feature in reabsorption of filtered HCO3- |
|
Definition
| Process results in net reabsorption of filtered HCO3-. Not in net secretion of H+. |
|
|
Term
HCO3- (Filtered Load)
______ in the filtered load of HCO3-, and results in _______ rate of HCO3- reabsorption. |
|
Definition
|
|
Term
In the plasma HCO3- concentration becomes very high (metabolic alkalosis), the filtered load will exceed reabsorptive capacity.
What action occurs after this? |
|
Definition
| HCO3- will be excreted in urine |
|
|
Term
What is the relationship between PCO2 and HCO3-?
Why does this occur? |
|
Definition
Increased PCO2, Increased HCO3-.
H+ secretion is increased.
Decreased PCO2, Decreased HCO3-.
H+ secretion is decreased. |
|
|
Term
| ECF volume expansion results in ______ HCO3- reabsorption. |
|
Definition
|
|
Term
| ECF volume concentration results in _____ HCO3- reabsorption (contraction alkalosis). |
|
Definition
|
|
Term
Angiotensin II
Stimulates (what ion exchange) and thus (increases or decreases) HCO3- reabsorption. |
|
Definition
|
|
Term
Excretion of fixed H+
Two mechanisms |
|
Definition
1. Titratable acid
2. NH4+ |
|
|
