BIOC34H3 Lecture Notes - Lecture 21: Metabolic Acidosis, Tubular Fluid, Proximal Tubule

86 views4 pages

skyprairie-dog454

29 Apr 2018

School

Department

Course

Professor

For unlimited access to Class Notes, a Class+ subscription is required.

BIOC34:(Lecture(20( ( Final(

Mar.%14,%2018%

84%

Acid-Base%Balance"

Acid-Base*Regulation*by*Renal*System*

• During%metabolic%acidosis,%the%kidney:%

o Increases%HCO3-%reabsorption%

o Increases%H+%secretion%

o Synthesizes%HCO3-%

• In%response%to%metabolic%alkalosis,%the%kidney:%

o Decreases%HCO3-%reabsorption%

o Decreases%H+%secretion%

Acidosis*in*the*Proximal*Tubule*

• When%blood%pH%is%acidic,%HCO3-%

that’s%been%filtered%into%the%

tubular%fluid%reacts%with%

secreted%H+%to%form%H2CO3%

which%is%converted%into%H2O%

and%CO2%by%CA(catalysis%

• The%CO2%diffuses%into%the%

epithelial%cell%and%is%converted%

to%H+%and%HCO3%once%more%by%

CA%along%with%another%H2O%

• The%H+%is%returned%to%the%tubular%fluid%to%react%with%another%HCO3-%while%

HCO3%is%transported%into%the%peritubular%fluid%with%Na/HCO3%co-transporters%

and%Cl/HCO3%antiporters%

• Overall:%

o HCO3-%is%reabsorbed%into%the%plasma%

o H+%is%secreted%into%the%tubular%fluid%and%excreted%as%H2O%

o Na+%is%reabsorbed%as%

well%

Acidosis*in*Distal*Tubule*and*

Collecting*Duct*

• In%the%proximal%tubule,%all%of%

HCO3-%has%been%reabsorbed%

so%in%the%tubular%fluid%it%must%

be%synthesized%

• CO2%diffuses%from%the%

peritubular%fluid%into%the%cell%

and%reacts%with%H2O%to%

produce%HCO3-%and%H+%

o The%HCO3%s%transported%into%peritubular%fluid%via%HCO3/Cl%anti-porter%

o The%Cl%transported%into%the%cell%is%transported%back%out%à%Cl%

recycling%

Unlock document

This preview shows page 1 of the document.
Unlock all 4 pages and 3 million more documents.

Already have an account? Log in

Document Summary

Acid-base regulation by renal system: during metabolic acidosis, the kidney, increases hco3, increases h+ secretion, synthesizes hco3. In response to metabolic alkalosis, the kidney: decreases hco3, decreases h+ secretion. Ca along with another h2o: the h+ is returned to the tubular fluid to react with another hco3. Hco3 is transported into the peritubular fluid with na/hco3 co-transporters and cl/hco3 antiporters: overall: Is reabsorbed into the plasma: hco3, h+ is secreted into the tubular fluid and excreted as h2o, na+ is reabsorbed as well. Hco3 so in the tubular fluid it must be synthesized: co2 diffuses from the peritubular fluid into the cell and reacts with h2o to. And h+ produce hco3: the hco3 s transported into peritubular fluid via hco3/cl anti-porter, the cl transported into the cell is transported back out cl recycling. Final: the h+ is transported into the tubular fluid and reacts with hpo4.

Related Questions

1. Which hormone responsible for calcium absorption is synthesized by the kidneys?
a. Calcitriol b. Glucagon c. Erythropoietin d. Antidiuretic hormone

2. Which of the following regulations is not performed by the kidney?
a. acid-base balance b. blood pressure c. glycolysis d. blood production

3. The hormone require for blood pressure regulation and release by the kidney is _____.
a. erythropoietin b. renin c. calcitriol

4. Almost all nutrients and about 65% of sodium are actively reabsorbed in this part of the nephron, transported from the filtrate back to the plasma.
a. proximal tubule b. descending limb c. ascending limb d. collecting duct

5. Which site is where most regulation happens?
a. proximal tubule b. nephron loop and vasa recta c. distal tubule & collecting duct

6. The site for countercurrent multiplier and exchange in the nephron is ________.
a. proximal tubule b. nephron loop and vasa recta c. distal tubule & collecting duct

7. The function of the kidneys is evaluated by measuring the
a. tubular reabsorption b. tubular secretion c. glomerular filtration rate

8. Abnormal amount of leukocytes in urine is termed _____.
a. ketonuria b. hematuria c. pyuria d. glycosuria e. nitrituria

9. In diabetes mellitus the clinical term for the abnormal urinalysis is called ________.
a. ketonuria b. hematuria c. pyuria d. glycosuria e. proteinuria

10. The possible cause of increase ____________ in urine is liver pathology o gallstones.
a. bile b. erythrocytes c. nitrites d. glucose e. protein

11. Proteinuria is caused by increase glomerular permeability due to kidney trauma, heavy mental, toxins, exertion, hypertension or glomerular nephritis.
a. True b. False

12. The normal pH of urine ranges from _____ to _____.
a. 2.2, 4.5 b. 10.3, 13.5 c. 8.0, 10.2 d. 4.5, 8.0 e. 6.0, 7.0

13. The average specific gravity of urine is slightly higher than 1.000 because the solutes it contains.
a. True b. False

14. __________ is the term for the normal smell of fresh urine.
a. Asparagus b. Nitrites c. Urinoid d. Ammonia

15. The concentration of this pigment in urine change the color of it.
a. Urinoid b. Nitrites c. Urobilin d. Calcium

16. The failure of a kidney to develop is termed _________________.
a. renal agenesis b. horseshoe kidney
c. supernumerary kidney d. pelvic kidney

17 Renal ptosis refers to the ___________ movement of the kidney within the abdominal cavity.
a. anterior b. posterior c. superior d. inferior

18. Renal failure refers to the diminish o absent renal function caused by the destruction of about ___ of the kidney.
a. 20% b. 40% c. 60% d. 90%

19. Renal calculus may occur from crystallized glucose after high levels in blood.
a. True b. False

20. An untreated UTI that spread to the kidneys is termed ____________.
a. urethritis b. cystitis c. pyelonephritis d. dysuria

21. Pain is an associated symptom of an UTI, and this is termed as __________.
a. urethritis b. cystitis c. pyelonephritis d. dysuria

22. Incontinence refers to ___________ whereas retention refers to____________
a. inability to involuntary control urination, failure to eliminate urine normally.
b. failure to eliminate urine normally, inability to voluntary control urination
c. inability to voluntary control urination, failure to eliminate urine normally
d. failure to eliminate urine normally, inability to involuntary control urination

23. All of the following are physical characteristics of urine except:
a. Color and transparency b. Odor c. pH d. specific gravity e. taste

24. Preformed water includes the water absorbed from food and drink whereas metabolic water includes the water from cellular respiration and dehydration.
a. True b. False

25. Sensible water los is not measured. In contrast insensible water loss is measured and includes sweat and transpiration.
a. True b, False

26. ____________ water loss is dependent upon the degree of hydration and is hormonally regulated in the tubules and collecting ducts of the kidney.
a. Sensible b. Insensible c. Obligatory d. Facultative
27. ___________ water loss is a loss of water that always occur regales of the state of hydration of the body.
a. Sensible b. Insensible c. Obligatory d. Facultative

28. Fluid is lost from the body through the following normal mechanism except:
a. breathing b. sweating c. defecation d. urination e. vomiting

29. Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬The stimuli that activates the thirst center include all of the following except:
a. decreased salivary secretions b. distention of the stomach
c. increased blood osmolality d. decreased blood pressure

30. Stimuli for inhibiting the thirst center are produced when fluid intake is greater than fluid output.
a. True b. False

31. Fluid balance is regulated by monitoring blood volume, blood pressure, and blood plasma osmolarity.
a. True b. False

32. This electrolyte imbalance can lead to confusion, coma, paralysis of breathing muscles, and death.
a. hypenatremia b. hyperkalemia c. hypercalcemia d. hypocalcemia

33. _____________ may cause muscle weakness and irregular heart beat that can lead to cardiac arrest.
a. Hyponatremia b. Hyperkalemia c. Hypercalcemia d. Hypokalemia

34. Numbness, tingling, increase heat rate, and muscle spasm that can lead to tetany is caused by _____.
a. hypenatremia b. hyperkalemia c. hypercalcemia d. hypocalcemia

35. If a patient needs IV fluids like 0.9% saline solution it means the solution contains 0.9 gr of _______ to every 100 ml of sterile water.
a. glucose chloride b. calcium chloride c. potassium chloride d. sodium chloride

36. Which of the following individual will be more vulnerable to dehydration?
a. Young adults b. Middle-aged adults c. Elderly d. Infants e. c & d

37. Diabetes insipidus refers to:
a. hypersecretion of insulin b. hyposecretion of antidiuretic hormone
c. hyposecretion of insulin d. hypersecretion of antidiuretic hormone
e. none of the above

38. During vomiting the major loss is ___________ whereas in diarrhea there is an extensive loss of ________.
a. hydrochloric acid (HCl), bicarbonate (HCO3) b. bicarbonate (HCO3), hydrochloric acid (HCl)
c. bicarbonate (HCO3), glucose d. hydrochloric acid (HCl), sodium

39. Lactic acidosis results from:
a. prolongs intense exercise b. congestive heart failure
c. insufficient insulin production d. a & b e. a, b & c

40. Ketoacidosis results from:
a. prolongs intense exercise b. congestive heart failure
c. insufficient insulin production d. a & b e. a, b & c

41. In respiratory alkalosis, respiratory rate increases and blood __________ _____________.
a. CO2 increases b. CO2 decreases
c. O2 increases d. O2 decreases e. none of the above

42. Metabolic acidosis compensate with _____________ ______________.
a. respiratory acidosis b. respiratory alkalosis
c. metabolic acidosis e. metabolic alkalosis e. none of the above

43. The step in the digestive process that deals with a series of catabolic steps in which complex food molecules are broken down into their chemical building blocks by enzymes secreted into the lumen of the alimentary tract is called
a. Propulsion b. Ingestion c. Chemical digestion d. Defecation e. Absorption

44. ________________ is the passage of digestive end products from the lumen of the GI tract by active or passive transport into the blood or lymph.
a. Propulsion b. Ingestion c. Chemical digestion d. Defecation e. Absorption

45. In which part of the digestive tract is chemical digestion essentially completed?
a. stomach b. pancreas c. liver d. small intestine e. large intestine

46. The organ that carries most metabolic function in the body is the
a. stomach b. liver c. small intestine d. pancreas

47. The main function of these organs is propulsion: peristaltic waves move food bolus to stomach accomplishing the phase of deglutition
a. Mouth and associated accessory organs b. Pharynx and esophagus
c. Stomach d. Small intestine e. Large intestine

48. Which hormone will be secreted especially if the bolus contains proteins?
a. gastrin b. cholecystokinin c. secretin

49. The following target organs are stimulated by secretin except:
a. stomach b. pancreas c. liver d. gallbladder

50. The stimulus of chime containing amino acids and fatty acids entering the small intestine releases ____________.
a. gastrin b. cholecystokinin c. secretin

51. The cells that produce intrinsic factor, important in the absorption of B12, is the ______ cells.
a. surface mucous b. mucous neck c. parietal d. chief e. G-cells

52. The most numerous of the secretory cells within the gastric glands, which produce zymogen are:
a. surface mucous b. mucous neck c. parietal d. chief e. G-cells

53. The following are functions of hydrochloric acid except:
a. activates pepsinogen b. kills microorganism
c. prevents ulceration of the stomach d. denatures proteins

54. Barrett esophagus refers to an advance case of GERD in which the epithelium changes from columnar secretory to stratified squamous.
a. True b. False

55. Gastric and duodenal ulcer are both peptic ulcers; the difference is that one occurs in the stomach and the other in the first part of the duodenum respectively.
a. True b. False

56. The following are common complication of advanced liver cirrhosis except:
a. jaundice b. edema c. ascites d. gastritis e. intense itching

57. Most cases of appendicitis occurs because fecal matter obstructs the appendix. As the inflammation worsens the parietal peritoneum becomes inflamed as well.
A. True b. False

58. The majority of colorectal cancer appears in the following areas except:
a. descending colon b. sigmoid colon c. rectum d. proximal ileum

59. Polyps are outgrowths from the colon mucosa whereas diverticulosis are bulges in the intestinal lining.
a. True b. False

60. Celiac disease is an autoimmune disorder. The damage in the small intestine is the smooth muscle which interferes with absorption.
a. True b. False

amaranthfrog191

1) Which is NOT characteristic of metabolism during theabsorptive state?

a) oxidation of about 50% of the glucose absorbed from a typicalmeal

b) conversion of glucose to glycogen in hepatocytes

c) gluconeogenesis using amino acids

d) glucose not picked up by the liver is converted intotriglycerides.

e) deamination of absorbed amino acids which enteredhepatocytes.

2) In the Krebs cycle, an oxidation-reduction reaction is likelycoupled with a substrate-level phosphorylation. True or False?

3) Glycolysis is an example of oxidative phosphorylation. trueor false?

4)Which of the following statements is incorrect?

a)In the proximal convoluted tubule, sodium ions are reabsorbedthrough the apical membrane by the Na⁺ -glucosesymporters and Na⁺ /H⁺ antiporters

b) In the loop of Henle, Na⁺-K⁺-2Cl^- Symporters reclaim sodium, potassiumand chloride from fluid in the tubule lumen.

c)In the distal convoluted tubule, sodium resorption is mainlyby osmosis

d) In the collecting duct, principle cells absorb sodium.

5) Which of the following might indicated abnormal kidneyfunction?

a)creatinine clearance less than 120-140 mL/min

b)serum creatinine less than 1.5 mg/dL (135 mmol/liter)

c) glucose in the urine

d) creatinine clearance less than 120-140 mL/min and serumcreatinine less than 1.5 mg/dL (135 mmol/liter) are bothcorrect

e)creatinine clearance less than 120-140 mL/min, serumcreatinine less than 1.5 mg/dL (135 mmol/liter), and glucose in theurine are all correct

6) ACE inhibitors can lower blood pressure because inhibitingACE

a) stops the secretion of renin

b) prevents the formation of angiotensin I

c) prevents the formation of angiotensin II

d)increases the secretion of aldosterone

e)prevents norepinephrine from binding alpha 1 receptors onblood vessels

7) Which of the following statements is TRUE?
1. Hydrogen ions are secreted by Na⁺/H⁺antiporters in the proximal tubules.
2. H⁺ATPases (proton pumps) in the collecting ductssecrete hydrogen ions.
3. Cl^-/HCO₃^- antiporters help withhydrogen ion reabsorption.

8) Which of the following is mismatched?

a)Sodium ions ï¿½ Level is controlled by aldosterone, antidiuretichormone, and atrial natriuretic.

b) Chloride ions ï¿½ Level is controlled by chloride ion leakagechannels and antiporters.

c) Potassium ions ï¿½ Level is controlled by aldosterone.

d) Bicarbonate ions ï¿½ Level is controlled mainly by kidneys.

e) Calcium ions ï¿½ Level is regulated by osmosis.

9) Which of the following statements is correct?

a) In the menstrual phase, follicle stimulating hormonestimulates development of secondary follicles in the ovaries andprostaglandins cause loss of the stratum functionalis.

b)In the preovulatory phase, secondary follicles start tosecrete estrogens and inhibin. One becomes a dominant follicle andsecretes estrogens and inhibin causing decreased FSH secretionleading to atresia of less developed follicles. In the uterus, theendometrium undergoes repair under the influence of estrogens.

c)In ovulation, release of luteinizing hormone causes release ofthe secondary oocyte.

d) In the postovulatory phase, progesterone and estrogens aresecreted by the corpus luteum promote thickening of the endometriumpreparing for implantation. If no pregnancy occurs, progesteroneand estrogen levels drop and menstruation occurs.

e) all of these statements are correct

10)The secretory phase of the uterine cycle is associatedwith

a)increased secretion of progesterone and formation of thecorpus albicans.

b)increased secretion of progesterone and formation of thecorpus luteum.

c) increased secretion of luteinizing hormone and rupture of themature follicle.

d)increased secretion of estrogen and maturation of thesecondary follicle

e) increased secretion of follicle stimulating hormone andovulation.

11) Filtered fluid leaving the glomerular capillariesIMMEDIATELY enters the

a) glormerulus

b) proximal convulted tubule

c) collecting duct

d) glomerular capsule

e) loop of henle

12)Which correctly associates structure with tissue type?

a)PCT: simple cuboidal epithelium consisting of principle cellsand intercalated cells

b)descending limb and thin ascending limb of nephron loop:simple squamous epithelial cells

c) thick ascending limb of nephron loop: simple cuboidalepithelial cells with prominent brush borders of microvilli

d) DCT: simple cuboidal to low columnar epithelial cells

e) collecting duct: stratified cuboidal epithelial cells

13) Regulation of the volume and osmolarity of body fluidsoccurs first in the

a) proximal convoluted tubules.

b) distal convoluted tubules.

c) loop of Henle.

d) glomerular capsule.

e) collecting ducts.

14) Which is NOT True about podocytes?

a) their pedicels form filtration slits

b) they make up the parietal layer of the glomerular capsule

c) they are modified simple squamous epithelial cells

d)all of these choices statements about podocytes are true

15) In the process of forming concentrated urine, symporters inthe loop of Henle cause sodium ions and chloride ions to build upin the renal medulla helping to form the osmotic gradient. ADHincreases reabsorption of water by principal cells in thecollecting ducts.

True or False?

viridianmallard359

BIOC34H3 Lecture Notes - Lecture 21: Metabolic Acidosis, Tubular Fluid, Proximal Tubule

Document Summary

Get access

Related Documents

BIOC34H3 Lecture Notes - Lecture 20: Distal Convoluted Tubule, Tubular Fluid, Proximal Tubule

BIOC34H3 Lecture Notes - Lecture 20: Carbonic Anhydrase, Proximal Tubule, Tubular Fluid

BIOC34H3 Lecture Notes - Lecture 20: Distal Convoluted Tubule, Tubular Fluid, Proximal Tubule

Related Questions