5 Written Questions

1. (1) Na-H
   (2) Na-glucose/ Na-aa
   (3) reab 50-55% filtered sodium
2. (1) yes
   (2) can be due to renal also
3. (1 ) Na delivery to the Collecting duct
   (2) aldosterone action
   ** both are essential for secreting potassium
4. (1) aortic arch
   (2) cartoid sinus (elastic region of the internal carotid)
5. (!) BNP

5 Matching Questions

1. What is the excellent clinical marker for reduced effective circulating volume, in the absence of diuretics?
2. What are some diuretics?
3. What is the mxn of aldosterone on the CCT?
4. How do you assess volume status?
5. How are the arterial baroreceptors activated?

1. a (1) physical exam findings
   (2) no lab tests
   **assessment for sodium
   ... can be ifnoremd by elevated BUN:Cr ratio, low urinary na+ concetnration, high hemoconcentratino
2. b (1) loss of stretch which activates the symapthetic nervous system via IX and X
3. c (1) reduced urinary sodium (Una<20)
4. d (1) osmotic diuretic (glucose, mannitol)
   (2) diuretic drugs
5. e (1) works on the apical sodium channel permits sodium entry from lumen
   (2) Na pumped out of the cell into the systemic circulation via Na/K- ATPase
   (3) electroneutrality maintained via K+ efflux into lumen (or via paracellular chl- entry, if avail)

5 Multiple Choice Questions

1. (1) systemic vasoconstrictor
   (2) influences GFR
   (3) ang II inc tubular sodium reab
   1. What are the JG cells?
   2. What cleaves angI to angII?
   3. What are the actions of angII?
   4. What are the affects of angII?
2. (1) inc Na+ uptake in the principal cells of the CORTICAL COLLECTING TUBULE by promoting the synthesis of the APICAL SODIUM CHANNELS
   (2) binds to a specific nuclear receptor regulating gene transcriptoin
   (3) "last chance" to regulate Na_ reab b4 glomerular filtration exits the nephron
   (4) praimry mxn for K+ loss
   1. What does aldosterone do?
   2. Where is aldosterone made?
   3. What does amiloride inhibit?
   4. What does the JGA do?
3. (1) responds to systemic osmolality
   (2) severe decrease in ECF (i.e. hemorrhage) --> NON-OSMOTIC RELEASE OF ADH
   (3) increases water reab in CT (poor vol expander)
   (4) inc vascular tone via vasoconstricting
   1. What does aldosterone do?
   2. What does the JGA do?
   3. What does ADH (aka arginine vasopressin) do?
   4. What does the SNS do?
4. (1) sodium retention
   (2) vasoconstriction
   1. Where are the arterial baroreceptors located?
   2. What happens when the arterial baroreceptors are activated?
   3. How are the venous baroreceptors activated?
   4. How are the arterial baroreceptors activated?
5. (1) Senses the extracellular fluid volume in two ways
   (2) sensed via Baroreceptors in the wall of the afferent arteriole (renin-secreting JG cells)--dec pressure releases renin
   (3) sensed via solute (cl-) delivery to the DCT (macula densa)--communicate with JG cells to release renin when cl drops
   (4) Also SNS results in renin release from JG cells b/c directly innervated (by arterial and venous baroreceptors)
   1. What triggers renin?
   2. What are the volume sensors?
   3. What does aldosterone do?
   4. What does the JGA do?

5 True/False Questions

1. What is the blood pressre and ECF fluid volume a refleciton of the level of what important cation? → (1) sodium
   **Bp is the body's highest priority

   True        False

2. What are the effectors of sodium balance? → (1) systemic vasoconstrictor
   (2) influences GFR
   (3) ang II inc tubular sodium reab

   True        False

3. How is renin secretion regulated? I.e... ECF is sensed by.... → (1) baroreceptors in afferent arteriole wall: activated be decreased renal perfusion
   (2) macula densa: sense luminal Cl (NOT PRESSURE)
   (3) SNS: activated by hypotension and hypovolemia via Central (arterial and venous) baroreceptors

   True        False

4. what happens when the venous baroreceptors are activated? → (1) increases renal sodium reabsorption directly (in prox tubule)
   (2) indirectly via renin to aldo
   (3) influences release of atrial natriuretic peptide
   (4) neural and humoral effectors

   True        False

5. What are the effectors of sodium balance or hypovolemia → (1) arterial ("high pressure") baroreceptors
   (2) venous ("low pressure") baroreceptors
   (3) juxtaglomerular apparatus of the nephron

   True        False