BCH 4123 Lecture Notes - Lecture 4: Ethylene Glycol, Alpha-Ketoglutaric Acid, Glutamine

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Functions: contraction of heart and rhythm, neuromusclular excitability, acid base status regulation. Balance: absorption in gut almost 100% Distribution: 100mm inside cell and 4mm outside of cell regulated by atpase. Atpase stimulated by 2 activation or increased icf [na: na-h antiporter. 1 na+ in and 1 h+ out. Stimulated by insulin and indirect mechanism feeding into atpase: h+/k+ exchange. Excretion: 60-70% reabsorbed in proximal tubule, 20-30% reabsorbed in loop of henle, secretion occurs in collecting duct and distal tubule. Controlled by aldosterone (transcription of enac to stimulate atpase) flow rate of tubule (quick delivery of sodium for enac. sweeps k away) K+ concentration in collecting duct and distal tubule cells (increased [k], increased secretion) Plasma [k] < 3. 5mm (ri = 3. 5-5. 1mm) Symptoms: cardiac arrhythmias caused by hyperpolarization (jumpy heart, skeletal muscle and smooth muscle weakness, stimulates kidney to make more bicarb. Vomiting, diarrhea, laxative abuse: renal loss. Thiazide and loop diuretics (k wasting diuretics and increase flow rate)

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