self-study renal

Question 1

MUDPILES

Answer 1

Methanol

uremia

diabetic ketoacidosis

paraldehyde, phenformin

iron, isoniazid

lactic acid

ethylene glycol

salicylate

Question 2

water makes up what percent of total body weight?

Answer 2

60%

Question 3

ECF and ICF make up what fraction of total body water respectively?

Answer 3

ECF = 1/3 TBW

ICF = 2/3 TBW

Question 4

how is sodium reclaimed in the thick ascending limb?

Answer 4

NKCC transporter –> into epithelial cell

K transporter –> back out in lumen

• creates electrical gradient to pull in more Na+ and other divalent cations(Mg, Ca…)

Question 5

Na and H relationship in the proximal tubule

Answer 5

Na/H exchanger will move H into lumen and reabsorb Na

part of the process of reclaiming bicarb as well

• H can recombine with bicarb in the lumen, which can be split into CO2 and H2O and reabsorbed to make/reabsorb bicarb

Question 6

bartter’s syndrome

Answer 6

deficiency in NKCC channels, apical K channels, or basolateral Cl channels – all in TAL

characterized by:

• low BP
• hypokalemia
• metabolic alkalosis
• high renin and aldosterone
• hypercalciuria

Bart is a TAL man

Question 7

primary transporter in DCT

which diuretics inhibit this transporter?

Answer 7

Na/Cl transporter(NCC transporter)

inhibited by THIAZIDE diuretics

• reduce calcium losses
• dont eliminate urinary concentrating ability

Question 8

gittelman’s syndrome

Answer 8

deficiency of NCC in DCT

characterized by:

• hypokalemia
• alkalosis
• hypomagnesemia
• hypocalciuria

Question 9

principal cell function

what drugs affect transporters in this cell?

Answer 9

apical ENac –> moves sodium in down gradient

apical ROMK –> moves potassium out down gradient

obligatory basolateral Na/K pump

aldosterone affects pretty much all these to bring more sodium in – results in more K kicking out

Question 10

spironolactone blocks…

Answer 10

aldosterone receptors in CD principal cells

Question 11

amiloride blocks….

Answer 11

ENac channels on CD principal cells

Question 12

Liddle’s Syndrome

Answer 12

overactivity of ENaC (in CD principal cell)

hypertension

hypokalemia

suppression of renin levels

Question 13

normal values for:

Na Cl BUN Glucose

K HCO3 Cr

Answer 13

140 104 15 100

4 24 1

Na Cl BUN Glucose
K HCO3 Cr

Question 14

normal pH?

normal PaCO2?

Answer 14

pH = 7.36 - 7.44

PaCO2 = 36-44mmHg

Question 15

what do alpha intercalated cells do; where are they

Answer 15

get rid of H+

reclaim Bicarb

located in collecting duct

Question 16

what do beta intercalated cells do; where are they

Answer 16

get rid of bicarb apically by reabsorbing Chloride and H+ on basolateral

located in collecting duct