Goodman & Gilman's: Chapter 25 - Renal Excretory Function Quiz
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Questions and Answers

What is the main function of diuretics in the context of renal physiology?

  • Regulate renal glomerular filtration rate
  • Increase blood volume
  • Precisely regulate electrolyte content
  • Control body fluid osmolality (correct)

    • Which of the following disease states may disrupt the fine balance maintained by renal nephrons in regulating fluid volume and electrolyte content?

  • Diabetes mellitus
  • Hypertension (correct)
  • Asthma
  • Osteoarthritis

    • What is the role of diuretics in adjusting the composition of body fluids in certain disorders?

  • Reduce electrolyte loss
  • Enhance water retention
  • Increase Na+ excretion (correct)
  • Decrease urine flow

    • What can abnormalities in the finely tuned homeostatic system controlling body fluid osmolality lead to?

    <p>Serious and potentially life-threatening deviations in plasma osmolality</p> Signup and view all the answers

    How do diuretics affect renal hemodynamics in the context of regulating body fluids?

    <p>Increase glomerular filtration rate</p> Signup and view all the answers

    Why is precise regulation of body fluid osmolality essential?

    <p>To avoid life-threatening deviations in plasma osmolality</p> Signup and view all the answers

    What is the primary target of hydrochlorothiazide (HCTZ) in the renal system?

    <p>Distal convoluted tubule (DCT)</p> Signup and view all the answers

    Which enzyme is targeted by cyclooxygenase (COX) inhibitors?

    <p>Lipoxygenase (LOX)</p> Signup and view all the answers

    What is the function of 1-deamino-8-D-AVP (desmopressin, DDAVP) in the context of renal physiology?

    <p>Treats diabetes insipidus (DI)</p> Signup and view all the answers

    Which of the following lipoproteins plays a role in reverse cholesterol transport?

    <p>High-density lipoprotein (HDL)</p> Signup and view all the answers

    What is the primary pharmacological action of a mineralocorticoid receptor antagonist (MRA)?

    <p>Blocks the effects of mineralocorticoids</p> Signup and view all the answers

    In the context of renal excretory function, what does GFR stand for?

    <p>Glomerular filtration rate</p> Signup and view all the answers

    Which enzyme is targeted by carbonic anhydrase inhibitors?

    <p>CA (cyclic adenosine monophosphate)</p> Signup and view all the answers

    What is the primary site of action for loop diuretics in the renal system?

    <p>Loop of Henle</p> Signup and view all the answers

    What is the average number of times the extracellular fluid volume is filtered across the renal glomeruli per day?

    <p>12 times</p> Signup and view all the answers

    Which abbreviation represents the hormone that regulates water balance by acting on the kidneys?

    <p>AVP</p> Signup and view all the answers

    Which abbreviation is associated with nonsteroidal anti-inflammatory drugs?

    <p>NSAID</p> Signup and view all the answers

    Which of the following disease states is NOT mentioned as potentially disrupting the balance maintained by renal nephrons in regulating fluid volume and electrolyte content?

    <p>Diabetes</p> Signup and view all the answers

    What is the mechanism of action of aldosterone-induced protein (AIP) in the context of renal excretory function?

    <p>Enhancement of sodium reabsorption</p> Signup and view all the answers

    What is the abbreviation for phospholipase C in the context of renal physiology?

    <p>PLD</p> Signup and view all the answers

    What is the primary target for thiazide diuretics in the renal system?

    <p>Distal convoluted tubule</p> Signup and view all the answers

    What is the primary mechanism of action of diuretics in adjusting the volume or composition of body fluids in certain disorders?

    <p>Increasing urine flow and Na+ excretion</p> Signup and view all the answers

    Abnormalities in the homeostatic system controlling body fluid osmolality can lead to deviations in plasma osmolality that are:

    <p>Potentially life-threatening</p> Signup and view all the answers

    In the context of renal physiology, what does the abbreviation PKG represent?

    <p>Protein kinase G</p> Signup and view all the answers

    Which abbreviation is associated with thick ascending limb in the renal system?

    <p>TGF</p> Signup and view all the answers

    What is the essential function of the finely tuned homeostatic mechanism controlling body fluid osmolality?

    <p>Balancing water intake and solute-free water excretion</p> Signup and view all the answers

    What abbreviation is commonly used for the syndrome of inappropriate secretion of ADH in renal physiology?

    <p>SIADH</p> Signup and view all the answers

    Which enzyme do cyclooxygenase (COX) inhibitors target?

    <p>Lipoxygenase (LOX)</p> Signup and view all the answers

    What is the primary pharmacological action of desmopressin (DDAVP) in renal physiology?

    <p>Activation of mineralocorticoid receptors (MR)</p> Signup and view all the answers

    Which abbreviation stands for the absorptive Na+-K+-2Cl− symporter?

    <p>NKCC1</p> Signup and view all the answers

    What is the role of hydrochlorothiazide (HCTZ) in the renal system?

    <p>Blocks epithelial Na+ channels (ENaC)</p> Signup and view all the answers

    What does the abbreviation BNP represent in the context of medication?

    <p>Brain natriuretic peptide</p> Signup and view all the answers

    Which diuretic class primarily acts on the Na+-K+-2Cl- symport in the thick ascending limb of the loop of Henle?

    <p>Osmotic diuretics</p> Signup and view all the answers

    Which cation is not directly affected by diuretics in terms of excretory effects?

    <p>Na+</p> Signup and view all the answers

    What is a potential renal hemodynamic effect of diuretics acting on the thick ascending limb?

    <p>Increased renal blood flow (RBF)</p> Signup and view all the answers

    Which diuretic class primarily acts on the proximal tubule by inhibiting carbonic anhydrase?

    <p>Inhibitors of Na+-Cl- symport</p> Signup and view all the answers

    Which ion's handling may be altered by diuretics in addition to K+, H+, Ca2+, and Mg2+?

    <p>Na+</p> Signup and view all the answers

    What phenomenon describes the period when Na+ intake and excretion are equal but at a lower ECFV and body weight after a diuretic is discontinued?

    <p>The braking phenomenon</p> Signup and view all the answers

    Which system is primarily responsible for the 'braking phenomenon' observed after diuretic discontinuation?

    <p>SNS</p> Signup and view all the answers

    How do diuretics impact the renal handling of cations other than Na+?

    <p>Increase K+ excretion</p> Signup and view all the answers

    Which electrolyte's renal handling is NOT directly influenced by diuretics according to the text?

    <p>Na+</p> Signup and view all the answers

    How can renal hemodynamics be indirectly impacted by diuretics?

    <p>Promoting TGF activation</p> Signup and view all the answers

    Which group of medications inhibits carbonic anhydrase?

    <p>Symport inhibitors</p> Signup and view all the answers

    Which of the following is true about the effects of symport inhibitors?

    <p>They may increase bicarbonate and phosphate in some cases</p> Signup and view all the answers

    Which class of medications are acetazolamide, dichlorphenamide, and methazolamide examples of?

    <p>Carbonic anhydrase inhibitors</p> Signup and view all the answers

    What is the main effect of carbonic anhydrase inhibitors?

    <p>Marked increase in bicarbonate and phosphate</p> Signup and view all the answers

    How do symport inhibitors differ from carbonic anhydrase inhibitors in their effects?

    <p>Symport inhibitors can increase bicarbonate and phosphate in some cases, unlike carbonic anhydrase inhibitors</p> Signup and view all the answers

    Which term describes a slight increase in fractional excretion of a particular substance?

    <p>(+)</p> Signup and view all the answers

    What does the symbol 'V(–)' indicate in the context of fractional excretion?

    <p>Marked decrease in fractional excretion</p> Signup and view all the answers

    Inhibitors such as acetazolamide primarily target which enzyme?

    <p>Carbonic anhydrase</p> Signup and view all the answers

    Which abbreviation is associated with the absorption of Na+ and Cl− in the renal system?

    <p>ENCC1</p> Signup and view all the answers

    What is the abbreviation for mineralocorticoid receptor antagonist in the context of renal pharmacology?

    <p>MRA</p> Signup and view all the answers

    In renal physiology, which abbreviation is associated with the inner medullary collecting duct?

    <p>IMCD</p> Signup and view all the answers

    Which enzyme do mineralocorticoid receptor antagonists primarily target in the renal system?

    <p>HSD</p> Signup and view all the answers

    What abbreviation represents the lipoxygenase enzyme in the context of renal pharmacology?

    <p>LOX</p> Signup and view all the answers

    Why are diuretics specifically used in disorders like heart failure and cirrhosis?

    <p>To adjust the volume or composition of body fluids</p> Signup and view all the answers

    What can result from abnormalities in the finely tuned homeostatic mechanism controlling body fluid osmolality?

    <p>Serious and potentially life-threatening deviations in plasma osmolality</p> Signup and view all the answers

    In the context of renal physiology, what is the primary function of a mineralocorticoid receptor antagonist (MRA)?

    <p>To inhibit the actions of aldosterone</p> Signup and view all the answers

    What is the role of symport inhibitors in the renal system?

    <p>Increase Na+ excretion</p> Signup and view all the answers

    What does the abbreviation 'VRUT' represent in the context of medication?

    <p>Vasopressin-regulating urea transporter</p> Signup and view all the answers

    In the context of renal physiology, what does the abbreviation 'WCV' represent?

    <p>Water-containing vesicle</p> Signup and view all the answers

    How do diuretics affect renal hemodynamics in the context of regulating body fluids?

    <p>Alter the rate of urine flow</p> Signup and view all the answers

    What is the primary role of 'LOX' in the medication context?

    <p>Lipoxygenase</p> Signup and view all the answers

    Which of the following abbreviations represents a 'syndrome of inappropriate secretion of ADH'?

    <p>SIADN</p> Signup and view all the answers

    What is the function of 'SGK-1' in the context of medication?

    <p>Serum and glucocorticoid-stimulated kinase 1</p> Signup and view all the answers

    Which diuretic class primarily acts on the Na+-Cl- symport in the distal convoluted tubule?

    <p>Inhibitors of Na+-K+-2Cl- symport</p> Signup and view all the answers

    Which ion's renal handling can be altered by diuretics other than K+, H+, Ca2+, and Mg2+ according to the text?

    <p>Na+</p> Signup and view all the answers

    What is the primary site of action for diuretics that are inhibitors of renal epithelial Na+ channels?

    <p>Collecting duct</p> Signup and view all the answers

    Which class of diuretics indirectly impacts renal hemodynamics according to the text?

    <p>Loop diuretics</p> Signup and view all the answers

    What is the main excretory effect of diuretics acting on the proximal tubule by inhibiting carbonic anhydrase?

    <p>Increased HCO3- excretion</p> Signup and view all the answers

    What phenomenon describes the period when Na+ intake and excretion are equal but at a lower ECFV and body weight after a diuretic is discontinued?

    <p>Braking phenomenon</p> Signup and view all the answers

    What is the primary mechanism responsible for the decrease in body weight and ECFV when Na+ intake equals excretion after diuretic discontinuation?

    <p>RAAS waning effect</p> Signup and view all the answers

    Which ion's handling may be altered by diuretics in addition to K+, H+, Ca2+, and Mg2+?

    <p>Na+</p> Signup and view all the answers

    In the context of diuretics, what is the primary function of the 'braking phenomenon'?

    <p>Achieve a new steady state</p> Signup and view all the answers

    What is the primary role of atrial natriuretic peptide (ANP) in the context of renal physiology?

    <p>Inhibits sodium reabsorption in the proximal tubule</p> Signup and view all the answers

    How does arginine vasopressin (AVP) impact renal water handling?

    <p>Enhances water retention in the collecting ducts</p> Signup and view all the answers

    What is the primary function of aldosterone-induced protein (AIP) in renal excretory function?

    <p>Enhances sodium reabsorption in the collecting ducts</p> Signup and view all the answers

    Which enzyme is targeted by brain natriuretic peptide (BNP) in the context of medication?

    <p>Renin</p> Signup and view all the answers

    What is the main pharmacological action of desmopressin (DDAVP) in the context of renal physiology?

    <p>Promotes water retention in the collecting ducts</p> Signup and view all the answers

    What do the symbols (++, +, (+), , NC, V, V(+), V(), and I) represent in the context of fractional excretion?

    <p>Effects on different ions and molecules</p> Signup and view all the answers

    Which of the following diuretics is an exception to the general effects seen with carbonic anhydrase inhibitors?

    <p>Metolazone</p> Signup and view all the answers

    What do the abbreviations (++ and V) signify in terms of fractional excretion changes?

    <p>Variable effects on filtration rate</p> Signup and view all the answers

    Which enzyme is primarily targeted by acetazolamide, dichlorphenamide, and methazolamide?

    <p>Carbonic anhydrase</p> Signup and view all the answers

    In the context of renal excretory function, what does the symbol 'I' indicate in terms of fractional excretion?

    <p>Insufficient data</p> Signup and view all the answers

    Which class of medications do symport inhibitors like metolazone and bumetanide belong to?

    <p>Loop diuretics</p> Signup and view all the answers

    'NC' denotes what kind of change in fractional excretion?

    <p>No change</p> Signup and view all the answers

    'V(+)' signifies what kind of effect on fractional excretion?

    <p>Variable increase</p> Signup and view all the answers

    Which diuretic class primarily acts on the Na+-K+-2Cl- symport in the thick ascending limb of the loop of Henle?

    <p>Osmotic diuretics</p> Signup and view all the answers

    What is the main excretory effect of diuretics acting on the proximal tubule by inhibiting carbonic anhydrase?

    <p>Increased uric acid excretion</p> Signup and view all the answers

    Which ion's renal handling can be altered by diuretics other than K+, H+, Ca2+, and Mg2+ according to the text?

    <p>Uric acid</p> Signup and view all the answers

    What does the abbreviation 'VRUT' represent in the context of medication?

    <p>Vasopressin receptor utilization test</p> Signup and view all the answers

    What can abnormalities in the finely tuned homeostatic system controlling body fluid osmolality lead to?

    <p>Fluid overload</p> Signup and view all the answers

    What is the role of diuretics in adjusting the composition of body fluids in certain disorders?

    <p>Balancing electrolyte levels</p> Signup and view all the answers

    What phenomenon occurs when Na+ intake and excretion are equal, but at a lower ECFV and body weight after diuretic discontinuation?

    <p>Braking phenomenon</p> Signup and view all the answers

    What is the primary mechanism responsible for the decrease in body weight and ECFV when Na+ intake equals excretion after discontinuing a loop diuretic?

    <p>Braking phenomenon</p> Signup and view all the answers

    Which electrolyte's renal handling may be altered by loop diuretics in addition to Na+, K+, Ca2+, and Mg2+?

    <p>Cl-</p> Signup and view all the answers

    What is the primary site of action for loop diuretics?

    <p>Loop of Henle</p> Signup and view all the answers

    What is the specific renal hemodynamic effect of loop diuretics on glomerular filtration rate (GFR)?

    <p>Increase GFR</p> Signup and view all the answers

    How do loop diuretics primarily impact the fractional excretion of Na+?

    <p>Increase fractional excretion of Na+</p> Signup and view all the answers

    What is the primary clinical application of loop diuretics according to the text?

    <p>Decreasing total-body NaCl content</p> Signup and view all the answers

    Which compensatory mechanism is NOT mentioned in the text as part of diuretic braking?

    <p>Activation of the parasympathetic nervous system</p> Signup and view all the answers

    Which of the following ions' handling is NOT typically altered by loop diuretics according to the text?

    <p>Calcium (Ca2+)</p> Signup and view all the answers

    Which physiological process is associated with loop diuretics?

    <p>Increased renal blood flow</p> Signup and view all the answers

    What role do loop diuretics play in adjusting extracellular volume and body weight?

    <p>Decrease in extracellular volume and body weight</p> Signup and view all the answers

    In the context of loop diuretics, what is the primary effect on Na+ excretion?

    <p>Sustained net deficit in total-body Na+</p> Signup and view all the answers

    What phenomenon occurs when sodium (Na+) intake and excretion are equal, but at a lower extracellular fluid volume (ECFV) and body weight after loop diuretic discontinuation?

    <p>The braking phenomenon</p> Signup and view all the answers

    Which electrolyte's renal handling is directly influenced by loop diuretics in addition to sodium, potassium, calcium, and magnesium according to the text?

    <p>Chloride</p> Signup and view all the answers

    How do loop diuretics primarily impact the renal hemodynamics in terms of regulating the body's fluid volume?

    <p>Increase renal blood flow (RBF) and glomerular filtration rate (GFR)</p> Signup and view all the answers

    Which part of the nephron is identified as the primary site of action for loop diuretics?

    <p>Thick ascending limb of the loop of Henle</p> Signup and view all the answers

    What term describes a slight increase in the fractional excretion of a particular substance facilitated by loop diuretics?

    <p><strong>Natriuretic response</strong></p> Signup and view all the answers

    How do loop diuretics primarily impact the fractional excretion of sodium (Na+)?

    <p><strong>Increase it</strong></p> Signup and view all the answers

    What is the primary site of action for diuretics that are inhibitors of Na+-K+-2Cl- symport?

    <p>Thick ascending limb</p> Signup and view all the answers

    Which class of diuretics affects the renal handling of cations and anions, as well as uric acid, without significant volume depletion?

    <p>Osmotic diuretics</p> Signup and view all the answers

    What is the primary renal hemodynamic effect of loop diuretics?

    <p>Increase in glomerular filtration rate</p> Signup and view all the answers

    Which electrolyte's handling is typically altered by loop diuretics in addition to K+, H+, Ca2+, and Mg2+?

    <p>Chloride (Cl-)</p> Signup and view all the answers

    What is the main excretory effect of diuretics acting on the thick ascending limb by inhibiting Na+-K+-2Cl- symport?

    <p>Decreased potassium excretion</p> Signup and view all the answers

    How do loop diuretics primarily adjust the renal handling of cations and anions?

    <p>By inhibiting sodium reabsorption</p> Signup and view all the answers

    What phenomenon occurs when renal compensatory mechanisms bring Na+ excretion in line with Na+ intake?

    <p>Diuretic braking</p> Signup and view all the answers

    Which of the following is NOT mentioned as a compensatory mechanism during diuretic braking in the text?

    <p>Decreased arterial blood pressure</p> Signup and view all the answers

    Which process is primarily responsible for bringing Na+ excretion in line with Na+ intake after continued diuretic administration?

    <p>Diuretic braking</p> Signup and view all the answers

    What is the role of loop diuretics in the context of extracellular volume and body weight?

    <p>Reduce extracellular fluid volume</p> Signup and view all the answers

    Which of the following is a common compensatory mechanism activated during diuretic braking?

    <p>Increased arterial blood pressure</p> Signup and view all the answers

    In the context of diuretics, what is the main consequence of renal compensatory mechanisms like diuretic braking?

    <p>Maintenance of Na+ excretion balancing Na+ intake</p> Signup and view all the answers

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