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Questions and Answers
Which hormone is primarily responsible for initiating milk production?
Which hormone is primarily responsible for initiating milk production?
During parts of labor, which phase is characterized by the actual birth of the fetus?
During parts of labor, which phase is characterized by the actual birth of the fetus?
What hormonal changes occur with menopause?
What hormonal changes occur with menopause?
Which hormone, secreted by the placenta, is highest in early pregnancy?
Which hormone, secreted by the placenta, is highest in early pregnancy?
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What role does oxytocin play during lactation?
What role does oxytocin play during lactation?
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What triggers the secretion of renin?
What triggers the secretion of renin?
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What is formed when renin converts Angiotensinogen?
What is formed when renin converts Angiotensinogen?
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Which system is activated as a result of low blood volume and pressure?
Which system is activated as a result of low blood volume and pressure?
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How does constriction of the afferent arteriole affect renal hemodynamics?
How does constriction of the afferent arteriole affect renal hemodynamics?
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What is the formula for calculating net filtration pressure in the kidney?
What is the formula for calculating net filtration pressure in the kidney?
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Which of the following would increase due to aldosterone secretion?
Which of the following would increase due to aldosterone secretion?
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Which of the following correctly describes the relationship between GFR and creatinine levels?
Which of the following correctly describes the relationship between GFR and creatinine levels?
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What happens to the filtration fraction (FF) when both RPF and GFR decrease?
What happens to the filtration fraction (FF) when both RPF and GFR decrease?
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What role does the arcuate nucleus play in energy homeostasis?
What role does the arcuate nucleus play in energy homeostasis?
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What does a positive IBS-D diagnostic test indicate?
What does a positive IBS-D diagnostic test indicate?
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How does CCK affect gastric motility?
How does CCK affect gastric motility?
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What can excessive levels of VIP lead to?
What can excessive levels of VIP lead to?
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What is the primary function of bicarbonate in the gastrointestinal system?
What is the primary function of bicarbonate in the gastrointestinal system?
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Which of the following hormone classes would typically have the longest half-life?
Which of the following hormone classes would typically have the longest half-life?
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What metabolic action is primarily associated with glucagon?
What metabolic action is primarily associated with glucagon?
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Which class of hormones is known to lead to shorter half-lives generally?
Which class of hormones is known to lead to shorter half-lives generally?
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What is the primary substance filtered at the glomerulus at approximately 100%?
What is the primary substance filtered at the glomerulus at approximately 100%?
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Which transporter is known for enhanced sodium reabsorption in the proximal tubule during reduced extravascular volume?
Which transporter is known for enhanced sodium reabsorption in the proximal tubule during reduced extravascular volume?
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Which mechanism is primarily responsible for the reabsorption of proteins like albumin?
Which mechanism is primarily responsible for the reabsorption of proteins like albumin?
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What happens when plasma glucose levels exceed the transport maximum of renal glucose transporters?
What happens when plasma glucose levels exceed the transport maximum of renal glucose transporters?
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Which of the following substances is primarily reabsorbed in the proximal tubule?
Which of the following substances is primarily reabsorbed in the proximal tubule?
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Which of the following is NOT a way that water reabsorption is enhanced in the proximal tubule?
Which of the following is NOT a way that water reabsorption is enhanced in the proximal tubule?
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What is the average transport maximum (Tm) for renal glucose transporters?
What is the average transport maximum (Tm) for renal glucose transporters?
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Which of the following transporters contributes to the modulation of acid-base balance in the proximal tubule?
Which of the following transporters contributes to the modulation of acid-base balance in the proximal tubule?
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What is the primary regulated step in the synthesis of calcitriol?
What is the primary regulated step in the synthesis of calcitriol?
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Which hormone is known as the 'phosphate trashing hormone'?
Which hormone is known as the 'phosphate trashing hormone'?
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Which condition results from calcium-sensing receptor mutations leading to hypercalcemia?
Which condition results from calcium-sensing receptor mutations leading to hypercalcemia?
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What effect does calcitonin have on blood calcium levels?
What effect does calcitonin have on blood calcium levels?
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How does PTH influence calcium reabsorption in the kidneys?
How does PTH influence calcium reabsorption in the kidneys?
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Which of the following stimulates the activity of 1α-hydrolylase?
Which of the following stimulates the activity of 1α-hydrolylase?
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What is the major second messenger system activated by the V2 receptor in response to ADH?
What is the major second messenger system activated by the V2 receptor in response to ADH?
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What are the expected effects on blood and urine levels in a case of Familial Hypocalciuric Hypercalcemia?
What are the expected effects on blood and urine levels in a case of Familial Hypocalciuric Hypercalcemia?
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What physiological condition is characterized by increased pH due to hyperventilation?
What physiological condition is characterized by increased pH due to hyperventilation?
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What does the pKₐ value represent in the context of weak acids?
What does the pKₐ value represent in the context of weak acids?
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Which of the following accurately describes metabolic acidosis?
Which of the following accurately describes metabolic acidosis?
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Which condition can lead to a high anion gap acidosis?
Which condition can lead to a high anion gap acidosis?
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How is the release of antidiuretic hormone (ADH) primarily regulated in response to blood pressure changes?
How is the release of antidiuretic hormone (ADH) primarily regulated in response to blood pressure changes?
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What is the physiological role of bicarbonate ions in the blood?
What is the physiological role of bicarbonate ions in the blood?
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Which of the following is a cause of respiratory acidosis?
Which of the following is a cause of respiratory acidosis?
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What is the primary effect of ADH on the kidneys?
What is the primary effect of ADH on the kidneys?
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Study Notes
Renal Physiology - Lectures 33-45
- Fluid distribution compartments: 60% of total body weight is water; 40% is intracellular fluid (ICF), 20% is extracellular fluid (ECF), 15% is plasma, and 5% is interstitial fluid.
- Extracellular fluid measurement: Amount/concentration (e.g., 1 ml of 1,000 mg/ml solution, final concentration 0.3 mg/ml, V=3,000 ml)
- SIADH (Syndrome of Inappropriate Antidiuretic Hormone): Increases water in both ECF and ICF, decreasing osmolarity, and causing volume expansion (water gain).
- Starling forces: Hydrostatic pressure pushes water and solutes out of plasma into urine. Dialysis is driven by a pressure gradient. No capillary osmotic pressure in Bowman's capsule (lack of albumin).
- RAAS (Renin-angiotensin-aldosterone system): Plasma volume impacts RAAS activity. Renin release is stimulated by low blood pressure, decreased sodium delivery, and increased sympathetic tone. Renin converts angiotensinogen to angiotensin I. ACE converts angiotensin I to angiotensin II. Angiotensin II causes vasoconstriction and increases Na reabsorption.
- Other renal functions: Kidney constricts glomerular efferent arteriole and increases Na+/H+ exchanger activity. Posterior Pituitary releases ADH (reabsorption of free water and urea). Vascular smooth muscle causes hypotension. Hypothalamus stimulates thirst. Adrenal Cortex releases aldosterone (increases Na reabsorption).
Renal Blood Flow and Glomerular Filtration Rate
- Afferent arteriole constriction decreases renal plasma flow (RPF) and glomerular filtration rate (GFR), but filtration fraction (FF) does not change.
- Efferent arteriole constriction increases GFR and decreases RPF, increasing filtration fraction (FF).
- Increased plasma oncotic pressure decreases GFR and does not affect RPF, but increases FF.
- Glomerular hydrostatic pressure (60 mmHg) - Bowman's capsule pressure (18 mmHg) - glomerular oncotic pressure (32 mmHg) = net filtration pressure (10 mmHg).
- GFR = (creatinine in urine x flow volume) / creatinine in blood.
- GFR = 125 ml/min. Creatinine is higher in urine than blood. Creatinine is endogenous.
Reabsorption and Secretion
- Proximal tubule reabsorbs Na+, Cl-, Ca2+, PO43-, bicarbonate (85-90%of HCO3- as CO2 and water on apical side), amino acids, glucose, water and urea passively.
- Transporters in proximal tubule help in response to reduced extravascular volume.
- When plasma glucose exceeds the transport maximum (Tm) of renal glucose transporters, excess glucose is not reabsorbed and is excreted in the urine. Average Tm is 375 mg/min.
- Proteins (albumin, immunoglobulins) and peptide hormones such as insulin are reabsorbed through endocytosis.
- Countertransport mechanisms (e.g., Na+/H+) are involved in reabsorption.
- Splay phenomena occurs due to variable saturation thresholds among nephrons.
Sodium and Potassium Balance
- 67% of Na+ reabsorption and 67% of K+ reabsorption is in the proximal convoluted tubule.
- 25% of Na+ reabsorption is in the thick ascending limb.
- 5% of Na+ reabsorption is in the distal convoluted tubule.
- 3% of Na+ reabsorption is in the inner medullary collecting duct
- No energy is required for 67% of water reabsorption in the proximal convoluted tubule.
- Aldosterone blockade results in natriuresis (increased Na+ excretion) and hyperkalemia (increased K+ retention).
Calcium and Phosphate Balance
- Parathyroid hormone (PTH) inhibits sodium-phosphate cotransport in the proximal tubule, decreasing the maximum transport rate (Tm).
- PTH increases Ca2+ reabsorption in the distal convoluted tubule.
- Calcitriol (Vitamin D3) increases Ca2+ and phosphate absorption in the intestines and kidneys..
- Elevated phosphate levels lead to decreased Ca2+ levels.
Acid-Base Chemistry
- Acid-base variables: pH, pKa, [A-], [HA].
- Examples of variables include blood pH (~7.4), concentration of carbonic acid (H2CO3) in blood ([HA]), and bicarbonate ions (HCO3-) in blood ([A-]).
- Metabolic acidosis is caused by decreased HCO3-.
- Respiratory acidosis is caused by increased CO2.
Water Balance
- Diabetes insipidus results in inability to concentrate urine, with high serum and urine osmolality.
- ADH (antidiuretic hormone) release is stimulated by hyperosmolarity and inhibited by hypotension.
Other Topics
- GI Structure and Function: Differentiate sympathetic and enteric nervous systems in digestive function. Distinguish regional innervation of the esophagus. Recognize dysphagia and recall regulatory mechanisms of lower esophageal sphincter opening. Determine likely cause of GI symptoms and role of somatostatin. Predict effect of vagus associated compounds on gastrin release.
- GI Accessory Secretory Organs: Recall pancreatic fluid synthesis and sequence for aqueous component. Recall ionic composition of pancreatic fluid and how it is affected by flow rate.
- GI symptoms and diseases. Describe biliary cancer symptoms and causes. Recall the role of the arcuate nucleus in appetite regulation. Explain insulin's and glucagon's major metabolic actions. Define anion gap.
- Endocrine and Reproductive Physiology: Describe the four classes of hormones. Interpret a change in a dose-response curve. Explain insulin's and glucagon's major metabolic actions. List the physiological effects of insulin administration. Describe how vitamin D3 is synthesized, stored, secreted, and regulated.
Hypothalamic-Pituitary-Gonadal Axis
- Sex steroids are synthesized from cholesterol via enzymatic steps.
- Hypothalamus releases GnRH, stimulating pituitary to release LH and FSH, which regulate gonadal function.
- Distinguish primary and secondary pathologies related to hyper- and hypogonadism.
- Identify and discern how sex steroids (testosterone, estrogen, progesterone) are synthesized, stored, secreted, and regulated.
Sexual Differentiation
- Presence of SRY gene causes testes development, producing anti-müllerian hormone and testosterone, which lead to male external genitalia development.
- Improper sexual differentiation can alter gonadal and internal/external genitalia development due to abnormal hormone production.
Female Reproduction
- Recognize and interpret hormonal changes during ovarian cycles.
- Describe steps in follicle maturation and follicle development.
- Reproductive hormones (e.g., estrogen, progesterone, FSH, LH) roles in follicle and ovum development, ovulation, and hormonal regulation.
- Recall and interpret hormonal control of mammary gland development, lactogenesis, and control of lactation.
- Recognize hormonal changes during/after menopause.
Physiology of Pregnancy and Parturition
- Three stages of parturition (dilation, expulsion, placental) are hormonally controlled.
- Estrogen and oxytocin have influences on uterine contractions during pregnancy.
- Placenta is a transient endocrine organ producing hormones such as estrogen, progesterone, relaxin, human chorionic gonadotropin (hCG), and human placental lactogen.
- Understand fertilization, implantation, early embryonic development, and placenta development.
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Description
Dive into the complexities of renal physiology with this quiz covering Lectures 33-45. Explore fluid distribution, the role of SIADH, Starling forces, and the RAAS system in maintaining homeostasis. Perfect for students looking to test their understanding of kidney function and fluid balance.
