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Questions and Answers

What is a cause of acute hyperkalemia?

  • Acute renal failure (correct)
  • Excessive aldosterone production
  • Dehydration
  • Hyperventilation
  • Which of the following is a response to decreased plasma calcium levels?

  • Increased renal reabsorption of calcium
  • Increased secretion of calcitonin
  • Decreased secretion of parathyroid hormone
  • Increased activation of vitamin D (correct)
  • What is a key factor in magnesium homeostasis?

  • Cortisol levels
  • Renal excretion (correct)
  • Thyroid hormone
  • Insulin resistance
  • What is the normal range for ECF potassium (K+) concentration?

    <p>3.5-5.5 mEq/L</p> Signup and view all the answers

    What percentage of K+ is intracellular?

    <p>98%</p> Signup and view all the answers

    What is the typical fractional excretion of K+ (FEK) with normal dietary intake?

    <p>10-20%</p> Signup and view all the answers

    Where does 70% of K+ get reabsorbed?

    <p>Proximal tubule (PT)</p> Signup and view all the answers

    Which hormone primarily regulates K+ balance in the distal collecting duct?

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

    What effect does acidosis have on K+ secretion?

    <p>Decreases K+ secretion</p> Signup and view all the answers

    What is the plasma K+ level for hypokalemia?

    <p>&lt; 3.5 mEq/L</p> Signup and view all the answers

    Which medical treatment for acute hyperkalemia stabilizes cardiac membrane potential?

    <p>Calcium gluconate infusion</p> Signup and view all the answers

    What is the primary mechanism of action of β2 agonists in treating acute hyperkalemia?

    <p>Drive K+ into the ICF</p> Signup and view all the answers

    Which of the following stimulates aldosterone secretion in response to increased serum K+?

    <p>Increased plasma K+</p> Signup and view all the answers

    What is the primary effect of thiazide and loop diuretics on potassium balance?

    <p>Inhibit Na+ reabsorption upstream of cortical collecting duct</p> Signup and view all the answers

    What is the effect of insulin on potassium movement?

    <p>Stimulates K+ uptake by liver and skeletal muscle</p> Signup and view all the answers

    What is the main function of free ionized Ca++ in the body?

    <p>Acting as a vital second messenger for blood coagulation</p> Signup and view all the answers

    Which form of calcium is not filtered into the interstitial fluid or glomerulus?

    <p>Protein-bound Ca++</p> Signup and view all the answers

    What is the most common urinary calculi formed from calcium?

    <p>Calcium oxalate</p> Signup and view all the answers

    What stimulates calcium reabsorption from the distal tubule in response to low plasma calcium?

    <p>Parathyroid hormone (PTH)</p> Signup and view all the answers

    What is the primary role of parathyroid hormone (PTH) at the kidney in response to low plasma calcium?

    <p>Increasing calcium reabsorption from the distal tubule</p> Signup and view all the answers

    What is the percentage of calcium reabsorption regulated in the thick ascending limb (TAL)?

    <p>65%</p> Signup and view all the answers

    What effect do loop diuretics have on divalent cations such as calcium and magnesium?

    <p>Cause urinary loss of divalent cations</p> Signup and view all the answers

    What is the primary mechanism of compensatory response to low effective circulating volume in the renal system?

    <p>Activation of the renin-angiotensin-aldosterone axis</p> Signup and view all the answers

    What is the main function of free ionized magnesium in the body?

    <p>Acting as an essential cofactor in enzymatic reactions</p> Signup and view all the answers

    Where is approximately 65% of magnesium reabsorption regulated?

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

    In which form is approximately 50% of plasma magnesium present?

    <p>Free ionized magnesium</p> Signup and view all the answers

    What is the effect of loop diuretics on magnesium excretion?

    <p>Cause urinary loss of magnesium</p> Signup and view all the answers

    What is the primary effect of high tubular flow at the macula densa?

    <p>Stimulates nitric oxide synthase to produce Nitric Oxide (NO) for vessel relaxation/dilation</p> Signup and view all the answers

    What stimulates renin release in the kidneys?

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

    What is the primary response of the renin-angiotensin-aldosterone system and ADH to low effective circulating volume?

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

    What effect does angiotensin II have on renal perfusion pressure and extracellular fluid (ECF) volume?

    <p>Increases renal perfusion pressure and ECF volume</p> Signup and view all the answers

    What is the primary effect of aldosterone on water and potassium balance?

    <p>Causes H2O retention and K+ excretion</p> Signup and view all the answers

    What stimulates renin secretion in the kidneys?

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

    What is the primary mechanism by which the kidneys regulate blood pressure?

    <p>Affecting Na+ and H2O balance</p> Signup and view all the answers

    What activates nitric oxide synthase to produce Nitric Oxide (NO) in the kidneys?

    <p>High tubular flow</p> Signup and view all the answers

    What is the coupling factor for renin secretion in the kidneys?

    <p>Renal baroreceptor</p> Signup and view all the answers

    What is the primary role of the renin-angiotensin-aldosterone system and ADH in response to low effective circulating volume?

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

    What is the primary effect of angiotensin II on renal perfusion pressure and extracellular fluid (ECF) volume?

    <p>Increases renal perfusion pressure and ECF volume</p> Signup and view all the answers

    What is the primary effect of aldosterone on water and potassium balance?

    <p>Causes H2O retention and K+ excretion</p> Signup and view all the answers

    Study Notes

    Renal Regulation of Blood Pressure

    • Low effective circulating volume may not correspond to low total body volume
    • Examples of edema of varying etiologies: congestive heart failure, nephrotic syndrome, cirrhosis
    • With normal circulating volumes, activity of renin, angiotensin, aldosterone, and sympathetic nerves is generally low
    • Kidneys regulate blood pressure by affecting Na+ and H2O balance
    • Tubuloglomerular feedback stimulates renin release
    • High tubular flow is sensed at the macula densa
    • High tubular flow activates nitric oxide synthase to produce Nitric Oxide (NO) which leads to vessel relaxation/dilation
    • Renin secretion is coupled to the renal baroreceptor
    • Renin is released in response to low perfusion and low Na+
    • Renin-angiotensin-aldosterone system + ADH responds to low effective circulating volume
    • Angiotensin II increases renal perfusion pressure and ECF volume
    • Aldosterone causes H2O retention and K+ excretion

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    Description

    Test your knowledge of the renal regulation of blood pressure with questions on the role of renin, angiotensin, aldosterone, and other mechanisms involved in maintaining blood pressure balance in the body.

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