Reference no: EM133311189
Topic: Electrolyte Balance and Acid-Base Balance
Question:
1. Explain the importance of maintaining sodium balance.
2. Know the level of regulation for sodium balance in the kidneys.
3. Describe all the mechanisms involved in sodium reabsorption in the renal tubules, knowing the differences between the proximal and distal tubules and the differences between the apical and basolateral surfaces.
4. a. Know where the majority of sodium reabsorption occurs,
b. where it is regulated, and whether this is overall an active or passive process.
5. a. Describe the effects of aldosterone on principal cells in the late distal tubule and collecting duct.
b. Understand how this hormone promotes more sodium reabsorption, and how this leads to increased blood pressure.
6. Explain the renin-angiotensin-aldosterone system and know what conditions in the kidneys lead to its activation.
7. Describe the various stimuli for renin release from granular juxtaglomerular cells.
8. Describe the actions of angiotensin II and understand how they increase mean arterial pressure.
9. Describe the overall effects of ANP and the three ways it increases sodium excretion in urine.
10. Explain the importance of maintaining potassium balance.
11. Know the level of regulation for potassium balance in the kidneys.
12. Know the terms hyperkalemia and hypokalemia.
13. a. Describe all the mechanisms involved in potassium reabsorption in the renal tubules
b. know the differences between the proximal and distal tubules and the differences between the apical and basolateral surfaces.
14. a. Describe the effects of aldosterone on potassium in the kidneys.
b. Understand how plasma potassium can directly affect aldosterone secretion, and how this hormone promotes more potassium secretion.
15. Understand how aldosterone affects sodium and potassium simultaneously.
16. Describe glucose reabsorption and the effects of exceeding the Tm (transport maximum) of the sodium-glucose co-transporters.
17. Know the normal arterial pH and the reasons why this variable is so tightly controlled.
18. Describe how the urinary and respiratory systems work to maintain acid-base balance.
19. a. Understand the normal ratio of bicarbonate ions to carbon dioxide that must be maintained to maintain normal arterial pH.
b. Understand how changes in this ratio will affect pH and acid-base balance.
20. Describe the inputs and outputs for hydrogen ions in the blood.
21. a. Describe how metabolic disturbances differ from respiratory disturbances in acid-base balance.
b. Describe the various causes of metabolic acidosis and metabolic alkalosis.
22. a. Explain the three defense mechanisms against acid-base disturbances
b. Understand their major differences and how they work together to defend against pH changes in the blood.
23. a. Describe the role of a buffer and understand their advantages and limitations.
b. Know the main buffers in the ECF and ICF.
24. Understand the role of respiratory compensation and how changes in ventilation lead to changes in arterial pH.
25. Explain the role of renal compensation and what mechanisms the kidneys can perform to increase or decrease blood pH.
a. Know the mechanisms of hydrogen ion secretion and bicarbonate ion reabsorption in the proximal tubule. Understand where this bicarbonate comes from and the reactions that must take place in the tubular fluid and proximal tubule epithelial cells to produce H+ and bicarbonate.
b. Know the mechanisms of renal compensation used in the intercalated cells of the late distal tubule and collecting duct. Understand where the bicarbonate ion comes from and the significance of this.
c. Describe the process of glutamine catabolism and when this mechanism can be useful in renal compensation.
26. Describe the compensation mechanisms for respiratory acidosis and respiratory alkalosis.
27. Describe the compensation mechanisms for metabolic acidosis and metabolic alkalosis.