HW Packet #4 & Study Guide
Carbonic anhydrase is the enzyme that catalyzes the hydration of carbon dioxide in renal cells and erythrocytes.
True
Renal calculi (kidney stones) found anywhere along the renal tubule or beyond in the urinary system would be associated with an increase in HP GC.
True
In a healthy person what is the colloid pressure in Bowman's capsule?
0 mmHG
Name the vol or cap of air exhaled in going from a maximum inhale to a maximum exhale.
IRV
Name the vol or cap of air that passes the lips in going from a normal inhale to a maximum inhale.
IRV
In the patient described in the question above, which of the following laboratory values would be expected, compared with normal values? (More than one may apply)
Increased renal excretion of NH4+
What can change HPgc and lead to decreased GFR??
Kidney stone, prostate cancer
aspirin overdose would cause this condition
Metabolic Acidosis
excessive diarrhea would cause this condition
Metabolic Acidosis
hyperventilation would compensate for this condition
Metabolic Acidosis
hypoventilation would compensate for this condition
Metabolic Alkalosis
Name the vol or cap of air that remains in the lungs after a maximum exhale.
RV
over-administration of general anesthetics would cause this condition
Respiratory Acidosis
excreting an acid urine would compensate for this condition
Respiratory Acidosis and Metabolic Acidosis
excreting an alkaline urine would compensate for this condition
Respiratory Alkalosis and Metabolic Alkalosis
The clinical laboratory returned the following values for arterial blood taken from a patient: plasma pH = 7.28, plasma HCO3 = 32 mEq/L, plasma PCO2 = 70 mm Hg. What is this patient's acid-base disorder?
Respiratory acidosis with partial renal compensation
Name one diuretic that works here:
mannitol
Site of hormonally controlled urea permeability
medullary duct
Water reabsorption along the PCT occurs by __(choose one from a-c), resulting primarily from active reabsorption of __(choose one from d-e)_.
passive diffusion (osmosis), sodium
Site known as countercurrent exchangers, pick up excess salt and water.
peritubular capillary or vasa recta
Mannitol works here
proximal convoluted tubule
Principal site of water, ion, glucose and amino acid reabsorption.
proximal convoluted tubule
This site is permeable to ions and permeable to water, iso-osmotic reabsorption
proximal convoluted tubule
Site of bicarbonate synthesis (more than one answer, mark all that apply).
proximal convoluted tubule and late distal convoluted tubule
Osmotic diuretics cause diuresis by
reducing net water reabsorption from the PCT
At a constant GFR, as plasma concentration of a freely filtered substance rises, the tubular load of the substance must ____.
rise in direct proportion to plasma concentration
What generally inhibits plasma proteins from being filtered?
the basal lamina proteins are negatively charged leading to charge/charge exclusions
The primary reason for diuresis in a person with untreated diabetes mellitus is
the large filtered load of glucose has an osmotic effect on the tubule
The primary reason for diuresis in a person with untreated diabetes insipidus is
there is little or no water reabsorption from the collecting duct
This site has the Na+/K+/2Cl- transporter.
thick ascending limb
This site is sensitive to furosemide (Lasix).
thick ascending limb
This site is impermeable to water, not hormonally sensitive. (more than one answer, mark all that apply).
thick ascending limb and early distal convoluted tubule
Tubular fluid will become hyposmotic to plasma, not hormonally regulated.
thick ascending limb and early distal convoluted tubule
Tubular fluid is always maximally hyperosmotic to plasma
tip of the loop of Henle
Exactly how can the hydrostatic pressure in the glomerulus be altered?
vasodilate afferent arteriole, vasoconstrict efferent arteriole
is associated with hyponatremia, hypoglycemia and possible death at times of extreme stress.
Addison's Disease
is associated primarily with hypernatremia, hypoglycemia and hypertension. Not a glycemic issue.
Conn's Disease
is associated with hypernatriemia and hypokalemia, hyperglycemia, moon face and sometimes growth of facial hair.
Cushing's Disease
is characterized by polyuria and polydypsia, but not glycosuria.
Diabetes Insipidus
is classified as either nephrogenic or central.
Diabetes Insipidus
is characterized by polyuria, glucosuria, polydypsia and ketonuria
Diabetes Mellitus
Area sensitive to thiazide diuretics
Early distal convoluted tubule
Macula densa is found here.
Early distal convoluted tubule
Acidosis leads to excitation (muscle twitching, tetany and seizures) while alkalosis leads suppression (lethargy, unresponsiveness, coma) of the excitable tissues.
False
Which of the following would cause the greatest degree of hypokalemia? Chronic treatment with a diuretic such as
Furosemide (Lasix)
A 26-year-old construction worker is brought to the emergency room with a change in mental status after working a 10-hour shift at a site along the interstate freeway. The average outside temperature on this summer day was 97 degrees. The man had been sweating profusely during the day but did not drink water because of a religious practice of fasting during daylight hours. He has a fever of 102 o F, heart rate of 140 beats/min, and blood pressure of 100/55 mm Hg in the supine position. On examination, he has no perspiration, appears to have dry mucous membranes, and is poorly oriented to person, place and time. Assuming that his kidneys were normal yesterday, which set of hormones describes his condition?
High ADH, high renin, high angiotensin II, high aldosterone
If GFR decreases, what happens to tubular load for any substance?
it decreases
Synthesized in the supraoptic and paraventricular nuclei.
ADH
Plasma hyperosmolality at central osmoreceptors results in____
ADH release
How much glucose that was filtered gets reabsorbed in proximal convoluted tubule?
100%
How much of the amino acids that were filtered gets reabsorbed proximal convoluted tubule?
100%
How much filtered sodium is reabsorbed in proximal convoluted tubule?
67%
Pulmonary capillary enzyme activity.
ACE
Acts on membrane receptors at the CD/MD to promote aquaporin insertion.
ADH
Alcohol inhibits its release into circulation.
ADH
Its release is directly stimulated by macula densa.
adenosine
Binds with a cytoplasmic receptor, enters the nucleus and increases gene expression.
aldosterone
Secreted from the adrenal cortex's zona glomerulosa.
aldosterone
Potent vasoconstrictor, also known to have inflammatory properties.
angiotensin II
Area sensitive to diuretics that are "potassium sparing."
late distal convoluted tubule
What is Kf? Does this change over a lifetime?
capillary permeability coefficient, yes!
Site of hormonally regulated potassium secretion
late distal convoluted tubule
Compensation will result in production urine of____ volume and ____ concentration.
low, high
A patient presents in ER with severe injuries resulting from an accident. Patient is hemorrhaging internally and blood pressure is rapidly dropping. Vital signs are taken and procedures will follow to address these injuries. Meanwhile, Baroreceptors are firing at a(n) ___ rate and there is a resulting ___ sympathetic neural outflow.
decreased, increased
Site of water reabsorption; urea TL is 110%
descending limb
In a healthy individual, colloid osmotic pressure is negligible here and affects GFR.
glomerular capsule
Tubular fluid is isosmotic to plasma throughout this region (more than one answer, mark all that apply).
glomerular capsule and proximal convoluted tubule
This patient is experiencing and compensating for _____shock.
hypovolumic
More than one of the following may be correct. Select all correct choices. It might be advisable to treat the patient above with
i.v. isotonic saline
In this patient, RBF and TLNa+ are ___ and consequently, plasma levels of ADH and aldosterone are ____.
increased, increasing
If GFR decreases what happens to the clearance of any substance?
it decreases
