Urinary- Urine Conc, Diuretics, Secretion

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Urinary- Urine Conc, Diuretics, Secretion
2015-09-16 19:33:11
vetmed urinary

vet med urinary
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  1. The kidneys need to be functioning to produce _________ urine.
    concentrated OR dilute (non-functioning-isosthenuria)
  2. The deeper you go into the medulla, ...
    the more conc the interstitium gets
  3. As UF moves down the descending loop of henle, water moves __________ from _________ to _________.
    passively; lumen; conc interstitium
  4. Concentration of UF _________ as it moves down the loop of henle.
  5. The ascending loop of henle is impermeable to _________; it has the _________ to actively pump _________ from ________ to _________.
    water; Na+K+2Cl- pump; sodium; the lumen; the interstitium
  6. Concentration of UF __________ as it moves up the loop of henle.
    decreases (water trapped, sodium actively pumped out)
  7. What 2 pathways can be taken to alter urine conc in the cortical collecting tubule?
    impermeable to water, pump out sodium, dilute urine; open water channels for water to passively leave the lumen to conc interstitium, concentrate urine
  8. With the countercurrent multiplier, UF enters the proximal tubule--> in ascending LoH, _____________--> more UF enters proximal tubule--> _____________--> ongoing to produce ____________
    solutes actively pumped to interstitium, concentrating it; water leaves proximal tubule, pulled into conc interstitium; electrochemical concentrating gradient
  9. The vasa recta travels alongside the _________.
    descending and ascending LoH
  10. The vasa recta has _______ flow; flow that is too _______ may cause...
    sluggish; rapid; wash out of the solutes and decrease concentrating ability.
  11. As blood goes down the vasa recta, ________ from the interstitium diffuses into the blood and _________ diffuses out.
    solutes; water
  12. As blood goes up the vasa recta, ________ enters the blood and ________ exit it.
    water; solutes
  13. Why is urea important to urine concentration?
    uea provides half the concentration gradient; therefore, decreased urea--> decreased conc gradient--> decrease concentrating ability
  14. Urea is ________ at the glomerulus; it is _________ in the proximal tubule.
    freely filtered; passively reabsorbed
  15. As water is reabsorbed from the cortical collecting duct, urea concentration __________; at the UF moves through the medullary collecting duct, urea moves into the _________ through urea transporters, helping to create the _________.
    increases; interstitium; conc gradient
  16. How is urea from the medullary interstitium recycled?
    interstitial urea diffuses into the thin loop of henle when urea conc is low--> urea is carried up the loop of henle and goes back through the system
  17. Give 3 examples of circumstances that may impair urine concentrating ability.
    increased blood flow in vasa recta, decreased urea, hyponatremia
  18. ADH is made in the _________ of the _________.
    supraoptic nucleus; hypothalamus
  19. Osmoreceptors in the brain are outside of the __________, making it easy for them to....
    BBB; monitor blood osmolality.
  20. Stimuli for ADH release. (6)
    osmoreceptors detect minor changes in blood osmolality, baroreceptors sence large changes in blood volume/pressure,nausea, pain, anxiety, morphine
  21. Effects of ADH. (5)
    vasoconstriction, aquaporins inserted in luminal membrane of collecting duct, more water reabsorbed from lumen, increased urine SG, lower urine volume
  22. When ADH is absent... (4)
    no aquaporins, waters trapped in lumen of collecting duct, low urine SG, high urine volume
  23. Excess ADH causes __________.
    volume retention
  24. Low ADH causes __(2)__.
    dilute urine, hypernatremia
  25. Diuretic inhibit _________ in the renal tubule, leading to...
    sodium reabsorption; solute and water loss.
  26. What are the two classes of diuretics?
    chemical diuretics (affect pumps), osmotic diuretics
  27. Furosemide is a __________; it works in the _________.
    loop diuretic; loop of henle
  28. Furosemide is secreted by the _________ and reaches the _______ side of the ________ by tubular flow; it binds to ____________, and inhibits it.
    proximal tubule; luminal; loop of henle;Cl- site of Na+K+Cl- pump
  29. Furosemide keeps __(4)__ in the _______.
    Na+, K+, Cl-, water; tubular lumen
  30. Side effects of furosemide. (4)
    hypokalemia, hypovolemia, metabolic alkalosis, ototoxicity (deafness)
  31. Thiazide diuretics impair the __________ in the __________.
    Na+Cl- cotransporter; distal tubule
  32. Thiazide diuretics are considered ___________, meaning minimal drug is needed to reach maximal effect.
    low ceiling
  33. Thiazide diuretics are used to ___________ in ___________ patients.
    decrease excretion of calcium; stone-forming
  34. Spironolactone is a ___________; it works by preventing...
    aldosterone antagonist; aldosterone from inserting Na+ and K+ channels, preventing the reabsorption of Na+ and secretion of K+
  35. Substances that are freely filtered at the glomerulus and increase the osmolality of the ultrafiltrate.
    osmotic diuretics
  36. What kind of diuretic is used to dilate the tubules and expels casts?
    osmotic diuretics
  37. How do you adjust the drug dosage of a drug with a long half-life and conc does not have to be sustained to continue having an effect?
    lengthen dosing interval; new interval= old interval (patient cre/normal cre)
  38. How do you adjust the dosage of a drug for a time-dependent drug and when the minimum drug conc is important?
    decrease the dose; new dose= old dose (normal cre/patient cre)
  39. What substances are excreted? (5)
    K+, H+, ammonium, urate, organic acids and bases
  40. The vast majority of potassium is located ___________.
    inside cells
  41. Factors that shift K+ into cells. (2)
    insuline, aldosterone
  42. Diseases that shift K+ out of cells. (2)
    diabetes, addison's
  43. Hyperkalemia causes ________________.
    life-threatening arrhythmias
  44. The principal cells reabsorb ___________ and secrete __________ under the influence of __________.
    sodium; potassium; aldosterone
  45. Factors controlling K+ secretion. (3)
    activity of Na+K+ATPase pump, electrochemical gradient from blood to lumen, permeability of luminal membrane to K+
  46. Intercalated type A cells __________ K+.
  47. Lack of aldosterone, _________, can cause severe _________.
    addison's disease; hyperkalemia
  48. An increase in K+ secretion is due to... (3)
    increase in extracellular [K+], increased aldosterone, increased distal tubular flow
  49. An increase in serum potassium conc increases excretion in 3 ways:
    increase in activity of the Na+K+ATPase pump, increased interstitial conc compared to inside cells, direct stimulation of aldosterone secretion
  50. Increased aldosterone increases the ________________.
    activity of the Na+K+ATPase pump
  51. Aldosterone _______ K+; K+ _________ aldosterone.
    decreases; increases
  52. When flow through the distal tubule is relatively slow, K+ _________ in the _________; the gradient b/w the cell interior and lumen diminishes, slowing ____________.
    accumulates; lumen; K+ leaking into the lumen
  53. When flow through the distal tubule is fast, K+ is continuously ____________, maintaining a ____________.
    washed downstream; large gradient for diffusion
  54. Acute acidosis _______ the ____________, thus __________ K+ secretion.
    slows; Na+K+ATPase pump; decreasing
  55. K+ is required for...
    repolarization of the membrane of an excitable cells.
  56. With hypokalemia, cell membranes are ___________; therefore, ______ K+ leaking should take place to reach threshold and generate an action potential; this can cause __________.
    hyperpolarized; more; weakness
  57. With hyperkalemia, initially the cell is __________, but with more severe hyperkalemia, _________ potential is less than _________ potential, making the cells unable to ________.
    hyperexcitable; resting; threshold; repolarize
  58. Organic acids and bases are secreted by...
    non-specific acid and base carriers in the proximal tubule.
  59. What 2 defects in Dalmatians make them susceptible to urate stones?
    decrease proximal tubule uric acid reabsorption, increase distal tubular urate secretion----> urolithiasis