Na, K, Cl

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Na, K, Cl
2014-05-16 06:30:50
Na Cl
Na, K, Cl
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  1. 1. To have optimal envr for metabolic rxns, what must there be? (3)

    2. Sources of water? (2) Losses? (4)

    3. What are electrolytes? 3 most important ones?

    4. Sources of sodium, potassium, chloride? RDAs?
    1. Correct osmotic pressure, temperature, pH

    2. Oral, metabolic --> urine, feces, sweat, insensible loss 

    3. Free hydrated ions that weakly bind to organic molecules - Na, K, Cl 

    4. Cured meats, soy sauce, canned soups, processed foods (same with Cl)

    Potassium is from fruits (raisins, plums, orange juice, plantains bananas) and veggies (beans, lentils, sweet potato), dairy products

    Cl is with sodium

    Na(Cl) = 1.5(2.3) g/day, potassium = ~5 g/day
  2. 1. What are the transporters for sodium (3), potassium (3), chloride (2)? 

    2. Which of the transporters are essential for life? Which are important in kidney? (2)
    1. Sodium - epithelial sodium channels (ENaCs), voltage-gated sodium channels (Nav), sodium chloride co-transporter (NCC)

    Potassium - Voltage-gated sodium channels (Kv), calcium activated channels (Kca), inward rectifier potassium channels (Kir channels)

    Chloride - chlroide channels, transcellular chloride exchanger

    2. All; NCC and Kir
  3. 1. Where are ENaCs found? (4 specific)

    2. What are they essential for? (3)

    3. What are they regulated by? (3)

    4. What blocks ENaCs?

    5. What is voltage-gated Na channels for? In what cells? (3)

    6. Where is Sodium Chloride transporter found? What is it inhibited by?
    1. All epithelial cells - intestine, kidney, lung, colon

    2. Essential for (1) regulation of sodium balance (2) blood volume (3) blood pressure - reuptake of Na+ in kidney

    3. ENaCs are regulated by (1) Aldosterone (2) ADH/vasopressin (3) glucocorticoids - turns down immune system

    4. Amiloride

    5. For action potential in excitable cells - nerve, muscle, and neuroendocrine cells

    6. Kidney, inhibited by thiazide diuretics
  4. 1. What are Kv channels responsible for? What activates them?

    2. What are Kca activated potassium channels for? What are the 3 subtypes? What types of conductance for each?

    3. What are KIR channels for? Where are they found?

    4. How many types of chloride channels are there? Mutation in which causes cystic fibrosis?

    5. Where are chlroide channels present? particularly in what cells? (4)

    6. What are transcellular chloride exchangers exchanging?  Examples? (4) What word describes these exchangers? Why? What neutralizes charge?
    1. Action potential in excitable cells - caclium

    2. Selectively transports K+ across biological membranes. there's small, intermediate, and bigK channels (conductance)

    3. Kir channels are for making a pore in kidney for rapid potassium excretion into urine

    4. 13. CFCR

    5. In most cells, particularly kidney, lung, muscle, nerve cells

    6. Negative charge for ositive charge. Examples are Cl for bicarbonate, hydroxyl ion, potassium, or sodium. These are electrogenic - creating an imbalance by increasing positive charge in cell.

    Neutralized by Na+/K+ ATPase
  5. How is Na, K, Cl transported into intestinal cell? (3) Draw

    Which occurs in colon?
    • 1. Na/Glucose transport
  6. 1. How much of Na, K, Cl is absorbed? How much of this occurs in small intestine?

    2. When K+ excess occurs, what happens in colon?

    3.What is the main regulating factor for electrolytes? How does it affect Na, K?

    4. What does aldosterone affect? (2) Which is most important homeostasic regulator of Na/K levels?

    5. When does aldosterone affect Na+ and K+ in kidney? How?
    1. 99%, 90-95%

    2. Net secretion of K+ in colon occurs

    3. Aldosterone. It increases Na+ levels and excretion of K+.

    4. Kidney and colon. Kidney

    5. When Na+ levels are low. It increases resorption of Na+ and increases excretion of K+
  7. 1. Which electrolytes are dominant in plasma and interstital fluid? (2)

    2. What 3 things are dominant in IC fluid? 

    3. What is key to life? What happens if there are mutations?
    1. Na, Cl

    2. K+, proteins, organic phosphates

    3. Na+/K+ ATPase (3 Na in, 2 K out) requires ATP. If there are mutations, then death.
  8. What are the functions of Na, K, Cl? (5)
    • 1. EC volume fluid (Na+ is main)
    • 2. Membrane potentials in nerves and muscles (Na, K)
    • 3. Cl is secreted as HCl for parietal cells for digestion

    4. Interactions with macrions (nucleic acids, glycosaminoglycans)

    5. Activation of enzymes (Na+/K+ ATPase, Cl --> angiotensin converting enzyme ACE)
  9. 1. How many g of Na, Cl, K are there in human body?

    2. What does loss of electrolytes lead to?

    3. How is Na excreted? What is it accompanied by?

    4. How is potassium excreted?
    1. Na - 100 g, Cl - 95 g, K+ - 140 g

    2. Diarrhea, diabetes, profuse sweating

    3. Urinary >> dermal = fecal. Chloride

    4. Urinary=fecal >>Dermal
  10. 1. What organs regulate electorlyte homeostasis? Which is most important?
    2. How do kidneys regulate? (2) Which is least important for long-term regulation?
    3. If all mechs are intact, how much filtrate should be lost?
    4. Where does aldosterone play significant role?

    5. What are the 3 main mechanisms of electorlyte balance?
    1. Kidneys (intestines). KIDNEYS

    2. (1) Adjusting filtration rate (amount filtered in glomerulus) (2) resorption/secretion rate. Filtration rate

    3. 5%

    4. distal convoluted tubule

    5. Vascular pressure receptors, renin-angiotensin-aldosterone system, natiuretic peptides
  11. 1. What are the 3 things that control renal excretion?

    2. What are the types of vascular pressure receptors and which ones are we focusing one?

    3. What does AVP lead to? (2)

    4. Where are vascular low pressure receptors found? (2) What do they do? (2)

    5. Where are vascular high pressure receptors found? (2) What do they do? (3)
    1. Changes in EC fluid volume --> change in effective circulating volume --> change in fullness/pressure of circulation (cardiac output, blood pressure, etc)

    2. Vagus vs. Arginin-vasopressin peptide pathways/sympathetic 

    3. AVP leads to increased retention of water and constriction of blood vessels

    4. Low pressure receptors are found in distension of cardiac atria and pulmonary vein --> decreases vagal activity and activates AVP secretion

    5. High pressure receptors are found in aortic arch and carotid sinus --> incresaes vagal activity, inhibits AVp secretion, and reduces renal sympathetic activity
  12. 1. Where are receptors for renin-angiotensin-aldosterone system found? (2) types?

    3. What are the 2 types of natiruetic peptides? Where are they produced?

    4. Draw how salt deficit leads to decreased salt excretion and water excretion
    1. Regulates renal hemodynamics and sodium transport.

    Baroreceptors in glomerulus sense changes in perfusion (amt of blood entering glomerulus) while chemoreceptors in distal tubule sense changes in Na+ load. 

    3. ANP (atrial) and BNP (brain); heart

  13. 1. What can happen in NaCl retention/excess? 3
    2. What does hypernatremia (Na>145 mEq/L) and hypervolemia lead to?

    3. What causes NaCl deficiency?

    4. What does hyponatremia (Na<135 mEq/L) and hypovolemia lead to?
    1. Congestive heart failure and hyperaldosteronism (can cause Mg2+ deficiency too)

    2. Hypertension

    3. Osmotic diuresis (diabetes) - prevents resorption of salt, diuretics, nephron damage, hypoaldosteronism (lack of Na resorption), Non-renal (diarrhea, vomiting)

    4. hyponatremia (<135 mEq/L) and hypovolemia --> hypotension and fast pulse rate --> may progress to severe hypovolemia  with dizziness and syncpoe
  14. 1. What is hyperkalemia vs. hypokalemia defined as? Which is more common

    2. What causes hyperkalemia? (2)

    3. Clinical manifestations of hyperkalemia? (3)

    4. What does hypoklameia lead to? (2-3 exmaples)

    5. What causes hypokalemia? (3)

    6. What are clinical manifestations of hypoklaemia (4)

    7. What causes K+ secretion while retaining Na+?
    1. Hyper = >5.5mM in plasma, Hypo = < 3.5 mM

    2. Hyperkalemia - defects in excretion of K+ due to (1) nephron alterations or (2) lack of response to aldosterone

    3. Hyperkalemia - sinus bradycardia, ventricullar fibrillation, cardiac arrest (heart problems)

    4. Hypo leads to metabolic/endocrine disorders (diabetes, hyperaldosteronism, metabolic alkalosis)

    5. Non-renal (Gi resections, malabsorption, Mg2+ def)

    6. Neuromuscular/muscular dysfunctions - weakness, cramps, paralysis. Heart problems -dysrhythmias and arrest
  15. 1. What is associated with Na+ excretion? 
    2. What does dietary K+ supplementatino do? (3)
    3. When is high K+ intake most beneficial?
    4. What is excessive alcohol consumption associated with?
    • 1. SYSTOLIC but not diastolic BP
    • 2. Improves endothelial function, vascular/CV structure, and functional parameters

    3. When Na+ intake is high (ratio is important)

    4. Hypertension (dose-response)