Which of the following directly caused Lauren's weight gain?
answer
increased absorption of water in the digestive system and an increased reabsorption of water by the collecting duct
question
Which of the following statements best describes the condition (hyponatremia) that Lauren was diagnosed with?
answer
There is a low sodium content in the extracellular fluid.
question
What will happen to the osmotic pressure of the extracellular fluid in the body under a hyponatremia state and how could this affect the size and shape of your cells?
answer
Osmotic pressure will decrease; cells will swell.
question
Which of the following organ systems will be most negatively affected by the hyponatremic state?
answer
brain
question
How would you expect aldosterone and vasopressin levels to change if a person had also run a race and had not taken in any water and produced a copious amount of sweat of 10 mEq/L
answer
Vasopressin would increase while aldosterone would decrease.
question
Starvation would cause which of the following acid-base conditions? Also, determine what type of compensation (metabolic or respiratory) there would be.
answer
metabolic acidosis with respiratory compensation.
*this is known as a ketosis (due to the breakdown of fat for metabolism), and the respiratory system would increase respiration to compensate for the excess hydrogen ions.
question
A patient is admitted to the hospital with the following plasma values: pH = 7.2, pCO2 = 55 mmHg, and HCO3¯ = 30 mEq/L. What is the acid base imbalance?
answer
respiratory acidosis with metabolic compensation
question
A patient is admitted to the hospital with the following plasma values: pH = 7.5, pCO2 = 45 mmHg, and HCO3¯ = 30 mEq/L. What is the acid-base imbalance?
answer
metabolic alkalosis with no compensation
question
A patient is admitted to the hospital with the following plasma values: pH = 7.2, pCO2 = 25 mmHg, and HCO3¯ = 18 mEq/L. What is the acid base imbalance?
answer
metabolic acidosis with respiratory compensation
question
Diarrhea can lead to which acid/base disturbance? Assuming compensation, would it be a metabolic or respiratory compensation?
answer
metabolic acidosis with respiratory compensation
question
Emphysema can lead to which acid/base disturbance? What would be the compensation?
answer
respiratory acidosis; kidneys will retain more HCO3 and excrete H+.
* a patient with emphysema would retain CO2, leading to a respiratory acidosis. The kidneys would compensate by retaining HCO3 and excreting H+.
question
What is the mechanism of action of vasopressin?
answer
insertion of AQP-2 into the apical membrane of distal tubule cells
question
Which of the following statements about aldosterone is NOT correct?
answer
Aldosterone increases sodium reabsorption by increasing the number of Na+-K+ ATPase pumps in the luminal membrane of the proximal tubule.
* CORRECT-
- Aldosterone is produced in the adrenal cortex.
- Aldosterone increases the number of passive sodium channels in the luminal membrane of the distal tubule and collecting duct, thus aiding sodium reabsorption
- Aldosterone is stimulated by decreased plasma sodium levels and increased plasma potassium levels.
question
Which of the following statements about ADH (antidiuretic hormone) is correct?
answer
ADH is released by the posterior pituitary gland.
question
What is the osmolarity of the filtrate at the end of the proximal tubule?
answer
isotonic - 300 mOsm
question
In overhydration, what would be the levels of ADH (high, normal, or low) and what would be the osmolarity of the urine?
answer
ADH - low; 100 mOsm (urine)
question
In severe dehydration or blood loss, what would be the levels of ADH and what would be the urine flow rate?
answer
ADH - high; low urine flow rate (0.25 ml/min)
question
What is the primary stimulus for natriuretic peptide release?
answer
`myocardial cell stretch
question
What is the effect of countercurrent multiplier in the loop of Henle?
answer
Water is reabsorbed in the descending loop of Henle.
question
What is the site and mechanism of the early response phase of aldosterone action?
answer
increased Na+/K+-ATPase activity in P cells of the distal nephron epithelium
question
Why is maintaining osmolarity so important to the body?
answer
The membranes of most cell types are freely permeable to water.
question
Which is NOT an important route of water loss from the body?
answer
Metabolic breakdown of water molecules
question
Most cell types are ________ permeable to water. An exception is cells of the ________, which can be either impermeable or permeable, depending upon the absence or presence of ________.
answer
very; distal nephron; aquaporins
question
The ________ limb of the loop of Henle is permeable only to ________, which is reabsorbed all along the length because the fluid outside is ________ concentrated deeper in the medulla.
answer
descending; water; more
question
Which process causes insensible water loss?
answer
respiration
question
If a patient had damage to the posterior pituitary that resulted in decreased secretion of vasopressin, which of the following would you expect to happen?
answer
increased urine output and decreased blood volume
question
What would cause osmoreceptors in the hypothalamus to shrink and what effect would that have?
answer
high plasma osmolarity, release of vasopressin
question
Where does the reabsorption of ions occur in the nephron to produce a hyposmotic solution in the tubules?
answer
ascending limb of the loop of Henle
question
Which of the following is the correct classification of vasopressin?
answer
neurohormone
question
Which of the following structures is the site of release for vasopressin?
answer
posterior pituitary
question
Which of the following best describes the direct effect of vasopressin?
answer
increases water reabsorption at the collecting duct of the kidney
question
Vasopressin Reflex Pathway:
answer
* Stimulus:
-Increased blood osmolarity
-Decreased stretch of the atria
-Decreased blood pressure
* Sensors:
-Carotid baroreceptors
-Atrial stretch receptors
-Osmoreceptors
* Integrating Center:
-Hypothalamus
*Efferent Signal:
-Vasopressin (released by the posterior pituitary)
* Target
-Collecting duct of kidney
* Response at Tissue:
-Insertion of aquaporins on apical surface.
* Systemic Response:
-Increased reabsorption of H2O
question
Vasopressin Release :
Place each of the following events associated with vasopressin synthesis and release in the correct sequential order.
answer
1. Vasopressin is produced by cell bodies in the hypothalamus.
2. Synaptic vesicles are transported along the axon of the neuron. 3. Synaptic vesicles are stored in the posterior pituitary.
4. Stimulus is received by the brain 5. Vasopressin is released by the axon terminals found in the posterior pituitary.
5. Vasopressin travels through the blood to its target tissue.
question
Sally goes to the emergency room (ER) seeking treatment for mild dehydration. The ER nurse mistakenly gives Sally an IV bag of solution that is very hypotonic to normal cells.
Which of the following statements about the release of vasopressin reflects what would occur as a result of this mistake?
answer
There is decreased release of vasopressin.
question
ADH is produced in the _______.
answer
hypothalamus
question
The secretion of aldosterone is directly stimulated by _______.
answer
angiotensin II
question
The secretion of ADH is directly stimulated by _______.
answer
a change in body fluid osmolarity
question
Aldosterone secretion increases in response to ________ and causes ________.
answer
increased angiotensin II; sodium reabsorption
question
Which two mechanisms cause an increase in extracellular fluid volume with salt ingestion?
answer
vasopressin secretion and thirst
question
When aldosterone causes sodium reabsorption, why doesn't water automatically follow?
answer
The distal nephron epithelium is impermeable to water without vasopressin.
question
How does angiotensin II (ANGII) directly affect the kidneys?
answer
It increases sodium reabsorption in the proximal tubule
question
How does angiotensin II (ANG II) directly affect the kidneys?
answer
It increases sodium reabsorption in the proximal tubule.
question
A decrease in fluid osmolarity may result from ingesting too much water. What mechanism exists to counteract the drinking of too much water?
answer
salt appetite
question
The ion imbalance known as ________ initially leads to ________ in excitable cells.
answer
hyperkalemia; depolarization
question
Dehydration leads to ________ blood volume, ________ blood pressure, and ________ osmolarity.
answer
decreased; decreased; increased
question
During severe dehydration, the adrenal cortex receives two competing stimuli: high plasma osmolarity and decreased volume. In response to this, aldosterone is not released. Why is this beneficial?
answer
Aldosterone would increase sodium retention, leading to shrinkage of cells throughout the body.
question
Change in homeostasis of ________ has a bigger impact on acid-base balance than the other options presented in this question.
answer
potassium ions
question
Which system helps control pH by eliminating H+ from the body?
answer
Urinary
question
Which of the following is a similarity between respiratory acidosis and respiratory alkalosis?
answer
Changes in pH are the result of changes in the amount of carbon dioxide in the body.
question
What is the most important extracellular buffer system?
answer
bicarbonate produced from CO2
question
Of the three buffering mechanisms in the body, which is the strongest?
answer
renal system
question
The bicarbonate buffer system is one of the chemical buffer systems of the body. How would the bicarbonate buffer system work if sodium hydroxide were added to a solution?
answer
A hydrogen on carbonic acid would dissociate and join the hydroxyl group on the base to form water and sodium bicarbonate.
question
The respiratory system is one of the three systems that regulate acid-base balance in the body. How does it work to decrease an acidosis?
answer
Carbonic acid is broken down into water and CO2; the CO2 is then exhaled
question
In a respiratory acidosis the kidney would do which of the following?
answer
The kidney would reabsorb bicarbonate and secrete hydrogen ions.
question
Ingesting too much antacid would cause which of the following acid-base disturbances?
answer
metabolic alkalosis
question
Vomiting will cause which type of acid-base disturbance?
answer
metabolic alkalosis
question
Severe anxiety would cause which type of acid-base disturbance? What would be the compensation?
answer
respiratory alkalosis; kidneys would excrete HCO3
question
Which of the following is NOT one of the body's chemical buffering systems?
answer
hydrochloride
* PART of it-
phosphate
protein
bicarbonate
question
Which of the following has the greatest capacity for pH change in the body?
answer
renal system
question
Respiratory alkalosis is a result of _______.
answer
too little carbon dioxide in the blood
question
Hyperventilation is defined as ______
answer
an increase in the rate and depth of breathing
question
How do the kidneys compensate for acid-base imbalances?
answer
by reabsorbing H+
by excreting bicarbonate ion
by excreting H+
by reabsorbing bicarbonate ion
question
Which of the following have the same effect on plasma pH?
answer
reabsorption of bicarbonate and excretion of H+
question
The movement of fluid and solutes from the peritubular capillary to the renal tubule is referred to as _______.
answer
tubular secretion
question
The nephron is responsible for maintaining _______.
answer
-electrolyte balance in the body
-acid-base balance in the body
-fluid balance in the body
question
Excessive diarrhea results in which of the following?
answer
loss of bicarbonate, metabolic acidosis
question
Ingestion of too much alcohol results in which of the following?
answer
gain of acid, metabolic acidosis
question
Which of the following does NOT result in metabolic alkalosis?
answer
hyperventilation
*DOES-
decrease in food intake
lowered body temperature
constipation
question
Ketoacidosis is usually a result of _______.
answer
uncontrolled diabetes mellitus
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