Term
| at first there is an increase in sodium excretion and a drop in ECFV, ECFV stays low, but the sodium excretion decreases after a while |
|
Definition
| what happens to ECFV and sodium excretion when diuretic therapy is administered? |
|
|
Term
Proximal tubule
acetaozolamide
reduces the Na/H+ exchange |
|
Definition
| where do CAI diuretics act, give an example of one, and describe what cellular mechanism it inhibits |
|
|
Term
Thick ascending limb
furoseamide
inhibts triple pump |
|
Definition
| where do loop diuretics act, give an example of one, and describe what cellular mechanism it inhibits |
|
|
Term
Distal convoluted tubule
HydroChloroThiaZide
inhibit NaCl cotransporter |
|
Definition
| where do thiazide diuretics act, give an example of one, and describe what cellular mechanism it inhibits |
|
|
Term
CCT
amiloride - inhbits ENAC
sprinolactone - inhibits MR (mineralcorticoid receptors) |
|
Definition
| where do K-sparing diuretics act, give an example of one, and describe what cellular mechanism it inhibits |
|
|
Term
| using an H+/Na+ ATP exchanger |
|
Definition
| how is H+ secreted in the PCT? |
|
|
Term
| CO2 is diffused in from the lumen and carbonic anhydrase combines it with water to make HCO3- which diffuses out the basal side back to the renal interstitial fluid |
|
Definition
| how is HCO3- reabsorbed in the PCT? |
|
|
Term
|
Definition
| how is H+ secreted in the thick ascending limb? |
|
|
Term
| Na/2Cl/K+ ATP triple symport thing, loop diuretics block this (furosimide, ethacrynic acid, bumetamide) |
|
Definition
| how are sodium, chloride and potassium reabsorbed in the Thick ascending limb? what diuretic blocks this? |
|
|
Term
a symport Na, Cl ATP pump
thiazides |
|
Definition
| how is sodium reabsorbed in the early distal tubule? what diuretics block this? |
|
|
Term
Na+ channel blockers like Amiloride and Triamterene
they block ENaC, so decreased Na+ in the cell messes up the Na/K+ exchanger and so K+ is not secreted |
|
Definition
| what diuretic causes hyperkalemia? |
|
|
Term
| they maintain Na/H2O balance but eventually they fail and cause uremia -> coma -> death |
|
Definition
| what happens with increased age to nephrons? |
|
|
Term
GFR/nephron increases because they have to compensate for the others, but overall GFR decreases
more urine volume per nephron is produced too, but less concentrated |
|
Definition
| when you have renal disease and lose a kidney, what happens to GFR/nephron? total GFR? |
|
|
Term
| it hypertrophys, the surviving nephrons enlarge |
|
Definition
| what happens to a kdiney after nephrons are lost? |
|
|
Term
|
Definition
| can nephrons be regenerated? |
|
|
Term
|
Definition
| what does persistent proteinuria mean? |
|
|
Term
1) BP
2) urine albumin
3) serum creatinine |
|
Definition
| what 3 simple tests detect CKD? |
|
|
Term
primary kidney disease
1) decreases nephron #
2) which causes hypertrophy and vasodilation of surviving nephrons
3) increase in arterial pressure
4) increased glomerular pressure and/or filtration
5) this results in glomerular sclerosis
6) this decreases nephron number |
|
Definition
| describe the vicious cycle |
|
|
Term
| inability to concentrate or dilute urine |
|
Definition
|
|
Term
| decreases because you can't concentrate it as well |
|
Definition
| what happens to specific gravity of urine as you lose nephrons |
|
|
Term
|
Definition
| What disease causes decreased Na+ resorption, decreased K+ secretion, lack of aldosterone |
|
|
Term
Bartter's disease
(same as loop diuretics)
this can cause hypokalemia, (increased K+ and H+ secretion) and metabolic akylosis |
|
Definition
| what disease is genetic and causes decreased Na+, Ca++, & HCO3-, reabsorption, hypotension, ***decreased activity of Na-K-2Cl transporter*** |
|
|
Term
|
Definition
| what disorder causes the same things as thiazide diuretics (decreased reabsorption in early distal tubule) |
|
|
Term
| spironolactone (K sparing diuretic) |
|
Definition
| what do you use to prevent hypokalemia especially in Bartter's syndrome? |
|
|
Term
| Glucocorticoid remediable aldosteronism (GRA) |
|
Definition
| what causes excess aldosterone secretion due to abnormal control of aldosterone synthase by ACTH(genetic) |
|
|
Term
|
Definition
| what disorder is caused by a 11-HSD deficiency increasing the effect of aldosterone? |
|
|
Term
|
Definition
| what disorder causes excess Aniotensin II formation? |
|
|
Term
| inappropriate ADH syndromes |
|
Definition
| what disease causes excess ADH or V2R activity (and hypertension)? |
|
|
Term
Liddle's syndrome
occurs early in life(genetic)
note: this is the opposite effect of K sparing diuretics (specifically the Na+ channel blockers) |
|
Definition
| what disorder causes excessivity of amiloride sensitive Na+ channel (genetic) leading to excess sodium reabsorption in the late distal tubule and collecting duct? |
|
|
Term
| aldosterone increases K+ secretion |
|
Definition
| why does conn's syndrome cause hypokalemia? |
|
|
Term
1) aldosterone
2) high extracellular K+
3) sodium (volume) delivery
4) acid base status: alkalosis increases secretion, acidosis decreases K+ secretion |
|
Definition
| what 4 things increase K+ secretion? |
|
|
Term
| it increases, just about directly proportional |
|
Definition
| what happens to urinary K+ excretion as plasma aldosterone level increases? |
|
|
Term
| converts cortisol to cortisone |
|
Definition
|
|
Term
|
Definition
| what disease is apparent mineralocorticoid excess, which causes Na+ retention, K+ & H+ excretion, resulting in hypertension, edema, hypokalemia(weakness and muscle spasm), and metabolic alkalosis |
|
|
Term
|
Definition
| what disease results from eating too much licorice |
|
|
Term
| idk there is something jacked up with the aldosterone specificity |
|
Definition
| what happens to 11-hydroxysteriod dehydrogenase (11-HSD) in pesudohypoaldosteronism? |
|
|
Term
Na+ reabsorption: increases
Na+ excretion: remains constant
blood pressure: increases
plasma renin: decreases
aldosterone: decreases |
|
Definition
| what does liddle's do to Na+ reabsorption? Na+ excretion? blood pressure? plasma renin? aldosterone? |
|
|
Term
1) Na+ channel blockers (amiloride, triamterene)
2) or a kidney transplant |
|
Definition
| what is the treatment of liddle's? |
|
|
Term
| spironolactone (aldosterone antagonist) |
|
Definition
| what is the treatment of pseudohypoaldosteronism? |
|
|
Term
|
Definition
| what disorder is characterized by a generalized decrease in resorption often in proximal tubules? |
|
|
Term
| genetic, heavy metal damage, drugs(tetracyclins), mutiple myeloma, tubular necrosis(ischemia) |
|
Definition
| what are the causes of Fanconi syndrome? |
|
|
Term
|
Definition
| what disease causes decreased H+ secretion leading to acidosis, and is caused by either genetic things or renal injury |
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