Physio block 4
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Physio block 4
Physio block 4
What are the 3 hormones that the kidney secretes?
1,23 Vitamin D (active form)
Which nephrons serve to create concentrated urine?
What structure in the Juxtamedullary nephrons serves to create concentrated urine?
What is the name for the peritubular capillaries in a juxtamedullary nephron?
What part of the glomerular capillary presents the most significant barrier to filtration of plasma proteins?
basement membrane --lamina rara interna, lamina densa, lamina rara externa
What is attached to the basement membrane by foot processess that allows for filtration slits?
In exercising muscles why are K+ released ?
for vasodilation purposes
What are 3 loop diuretics?
Where do loop diuretics act?
thick ascending limb of Henle
Thiazide diuretics act where?
What are 2 thiazide diuretics?
Where do K+ sparing diuretics act?
What are 3 K+ sparing diuretics?
What are some conditions that causes hyperkalemia?
alpha adrenergic receptors
beta 2 adrenergic antagonists
What conditions hypokalemia?
beta 2 adrenergic agonist
alpha adrenergic antagonist
Which cells reabsorb K+ in the DCT?
alpha intercalated cells
Which cells secrete K+ in the DCT?
How does aldosterone stimulates secretion of K+?
Na+ enters principal cell
forces Na/K ATPase pump to pump Na out K in
High conc. of K+ in the cell creates a gradient for secretion of K+
How do diuretics like loop diuretics and thiazide diuretics stimulate secretion of K+?
inhibited reabsorption of Na+ upstream of principal cells creates a gradient of Na for principal cell uptake
-increased Na reabsorption causes increased K+ secretion
Alkalosis causes increases or decreases K+ secretion?
increases K+ secretion
Acidosis increases or decreases K+ secretion?
When is phosphaturia and cAMP in urine seen?
high levels PTH
What are the findings in pseudoparathyrodism?
no cAMP in urine
A defect where would produce pseudoparathyrodism?
How does PTH inhibits phosphate absorption?
Na+/phosphate transporter is inhibited
What is the only diuretic that increases calcium absorption?
What hormone affects reabsorption of urea?
What are the 3 actions of ADH?
-increases water permeability of principal cells in the DCT and CD
-increases Na+/Cl-/K+ cotransporter of the thick ascending limb
-increases urea absorption in the inner medullary CD
What kind of receptors are present on the basolateral membrane of peritubular capillary for ADH?
PTH and ADH use what kind of receptor/signalling cascade?
G protein/cAMP/protein Kinase A
ADH uses what type of aquaporin?
What is the diluting segment?
thick ascending limb
What are the loop diuretics?
What are the K+ sparing diuretics?
What is the cortcal diluting segment?
ADH acts on what cells in the late DCT and Collecting duct?
How is Nephrogenic Diabetes treated?
with thiazide diuretics
What is the action of Thiazide diuretcs?
stop Na+ absorption in the early DCT
increased Na+ and H20 absorption in PCT
How is central or Neurogenic Diabetes Insipidus treated?
What are the diluting segments of the nephron?
thick ascending limb
In the presence of ADH is the water clearance positive or negative?
In the absence of ADH, is the water clearance positive or negative?
What hormone could cause clearance of H20 to be zero?
Loop Diuretics---furosemide, bumatenide, ethacrynic acid
In what segment of the nephron is free water generated?
thick ascending limb
What effect do loop diuretics have on the absorptions or calcium, magnesium, sodium?
they inhibit them
What is the normal range of arterial pH?
What is the pH range that is compatible with life?
What catalyzes the formation of carbonic acid?
What are the fixed acids?
sulfuric--from methionine, cystein
The buffering capacity is greatest where?
within one unit of the pk
In respiratory acidosis, is there hypocalcemia or hypercalcemia?
In respiratory alkalosis is there hypo or hypercalcemia?
Why does acid-base disturbance produce changes in Ca conc.?
Because H binds to albumin which leaves Ca free in plasma---hypercalcemia
In alkalosis--no H binds to albumin so Ca binds to albumin producing Alkalosis
What is the most significant intracellular buffer?
Hemoglobin in its oxygenated or deoxygenated form is a more effective buffer?
What purpose does it serve?
- as Hb becomes deoxygenated, it takes up CO2 which reacts with H20 to produce H+..which is buffered by the deoxygenated Hb
What are two mechanisms for excreting fixed H+?
- as urinary phosphate
Excretion of H+ is accompanied by what?
synthesis and reabsorption of HCO3-
Where is HCO3- reabsorbed?
In the proximal tubule
What produces isotonic urine?
The excretion of H+ in the late DCT and Collecting Duct is accomplished thru what 2 mechanisms?
H+ ATPase stimulated by aldosterone
Which cells secrete H+ in the late DCT and Collecting Duct?
alpha intercalated cells
Metabolic acid-base disturbances involve what?
Respiratory acid-base disturbances involve what?
When the acid-base disturbance is metabolic, what is the compensatory response?
When the acid-base disturbance is respiratory, what is the compensatory response?
What are two Beta 2 agonists?
Do high or low lung volumes increases the resistance to airflow?
High lung volumes
What effect on resistance does viscosity have?
viscosity increases resistance
Hypoxia causes what in pulmonary circulation?
Hypoxia in coronary circulation causes what?
What happens to the alveoli in an infant with RDS?
alveoli collapse due to absence surfactant
Spirometry cannot measure which volume?
What is vital capacity?
Inspiratory reserve volume
Expiratory reserve volume
What is functional residual capacity?
Residual volume + expiratory reserve volume
Highest airway resistance is where?
What growth factor is released in exercising muscle to decrease diffusion distant for Oxygen between capillaries and tissues?
Vascular endothelial Growth Factor (VEGF)
Tingle body macrophages are characteristic of what?
Benign reactive lymphadenitis
What cells secrete renin?
What glycoprotein is present on platelet that interacts with GpIb on the vascular endothelium?
What factor along with Gp Ib helps in adhesion of platelets to exposed collage?
von Willebrand Factor
What is the most potent activator of platelets?
What activates phospholipase c in platelets?
Binding of thrombin to platelets does what?
activates Phospholipase C
What are the products of Phospholipase C action?
Activation of protein kinase C in platelets causes what?
release of platelet granules
IP3 released in platelets serves what functions?
release of Ca which binds to MLCK--shape change
activation of Phospholipase A--arachidonic acid--Thromboxane A2--->platelet aggregation
What is the difference between primary and secondary hemeostasis?
Primary--platelet adhesion, aggregation
Tenase complex cleaves what bond in Factor X?
What glycoprotein is used for platelets to aggregate?
What activates factor XII?
What activates Factor VII in Extrinsic pathway?
What is the function of tissue factor complex?
Cleaves VII --->VIIa
Tissue factor and tenase complex cleave what bond in Factor X?
What vitamin is needed for carboxylation of gamma-carboxy glutamyl residue?
Which factor acts as a transglutaminase?
What factor acts as a cofactor to Xa and Prothrombin?
What factor activates factor XIII?
What protein is involved in the dissolution of the secondary hemostatic plug?
What degrades active plasmin in blood?
Pepsinogen is normally bound to what?
Activators of plasminogen cleave what bond on the plasminogen molecule?
What are 3 activators of Plasminogen?
What are the 2 major inhibitors of clotting?
Alpha 2 macroglobulin
Anti-Thrombin III inhibits what factors?
What is the mode of action of Heparin?
Heparin binds to ATIII which allows ATIII to inhibit factors 7,9,10,11,12
What agent inhibits Heparin?
Deficiency of ATIII could lead to what?
What activates Protein C?
Thrombin and Thrombomodulin
Protein C acts with what other protein?
Protein S + Protein C acts to inhibit what clotting factors?
V and VII
Von Willebrand disease is said to be a disease of the intrinsic pathway, why?
because vWF carries factor VIII
What is defective in von Willebrand Disease?
platelet to collagen adhesion via Gb- Ib
Bernard-Soulier Syndrome is characterized by absence of what?
What is the characteristic shape of platelets?
-absence of Gp-bI
A Disorder in which Gp-IIb is deficient is called?
Whats the common form of inherited Hypercoagubility?
deficiency of factor V--Leiden
PTT tests the function of which pathway?
PT tests the function of which pathway?
What effect does Angiotensinogen II have on GFR?
Constricts efferent arteriole so it increases GFR
Increased blood flow thru the afferent arteriole would have what effect on the arterioles?
constriction of afferent arteriole---> maintaining GFR
What hormone mediates the uptake of Urea?
What 2 substances are used to measure GFR?
Why are Creatinine and Inulin used to measure GFR?
because they are neither reabsorbed nor secreted
If GFR is high, what is the conc of creatinine in the serum?
If the GFR is low, what is the concentration of creatinine in the serum?
What is used to measure RBF?
What is used to measure RPF?
What is used to measure afferent arteriole?
What is used to measure efferent arteriole?
If you are dependent on filtration what test should be followed?
If you are dependent on secretion, what test should be followed?
If a drug is totally filtered what is it dependent on?
If a drug is secreted what is it dependent
What causes Fanconi's syndrome?
faulty Na transporter protein in PCT
High urine, CA, Mg, PO4, aa, glu are characteristic of what condition?
Macula Densa senses what?
Glutaminase is located where?
late collecting duct
Spironolactone blocks what?
Triamterene and amelioride block what?
What is the difference in skeletal and smooth muscle with regards to Ca2+ action?
skeletal muscle--Ca binds to troponin c
smooth muscle--Ca binds to calmodulin
Vascular smooth muscles have what ADH receptor, VI and V2?
Streptococcus pyogens produces what that increases body temperature?
CFTR is what type of gated channel?
What are neurophysins?
carrier-proteins used to transport hormones along a tract
In what condition would one see Osteitis Fibrous Cystica?
How would renal failure cause Osteitis Fibrosa Cystica?
decreased Ca absorption due to low vitamin D
increased PTH hormones
Pulsatile release of GnRH is used to treat what?
What factors stimulate the secretion of ADH?
increased osmolarity and decreasedblood volume
Which ETC complexes utilize iron?
Complex I thru IV
Which complex utilizes Cu in the ETC?