WVSOM -- Flux of electrolytes and water
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| How much fluid enters small intestine? | 7-10L
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| How much fluid enters colon? | 600ml
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| Whow much fluid is excreted? | 100ml
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| Where is most of the water absorbed? | small intestine
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| In what is tehre a net absorption? | Na, Cl and water
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| What is there a net secretion of? | K and HCO3
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| What are the 5 mechanisms of Na reabsorption? | 1. co-transport with sugars or amino acids
2. thru Na channels (colon)
3. Co-transport with Cl-
4. Counter-transport with H
5. Solvent drag (significant in duodenum and jejunum); less so elsewhere
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| In the proximal bowel, what kind of transport predominates? | counter transport with H, and co-transport with solutes (sugars adn AA) predominates
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| How is Cl absorbed in teh ileum? | along the electrical gradient
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| What is Na co-transported with in the ileum? | Cl-
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| What kind of exhange occurs in the distal ileum and increases in the colon? | chloride/HCO3-
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| NA/H, Cl/HCO3 Counter transport | exchange occurs in the distal ileum and increases in the colon
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| How is K absorbed in the small inetestine? | by passive diffusion thru paracellular spaces
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| Where is there a net absorption and net secretion of K? | Net absorption in small intestine
Net secretion in colon
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| What is the primary mechanism of Na in the colon? | Na channels are under teh control of mineralocorticoids (aldosterone).
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| What happens to K in the colon? | can be absorbed or secreted depending on the luminal content.
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| What does aldosterone do? | Promotes Na absorption and K secretion. Increases Na channel activity, K channel activity and increases activity of the basolateral Na/K pump
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| What is K secretion dependent on? | increased flow rate increases K secretion as in diarrhea
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| Where is most water absorbed? | small intestine
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| What is the major source of water adn electrolytes in diarrheic stool | small intestine
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| Why does rpolonged diarrhea result in hypokalemic metabolic acidosis? | Because of teh secretion of K and the exchange of Cl for HCO3 in the colon
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| What does cAMP, cGMP, and CA++ do to K secretion? | increases K secretion
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| How do Epsom salt laxative work? | Hypertonic in the colon and thus draws water into the gut.
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| Name two conditions that could lead to an osmotic diarrhea and explain how this happens. | Lactase deficiency and protozan.
Things that will destroy the brush border and wipe out the enzymes needed for carbohydrate and protein digestion leaving the stuff in the gut lumen.
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| Give examples where cAMP, cGMP and Ca++ can open the Cl channel at the apical membranes. | CFTR
Prancreatic ductal Cl- channels
Cl- channels in colon
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| What are normal secretogues? | ACH (inc. Ca)
Secretin and VIP (inc. cAMP)
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| What are abnormal secretogues | Cholera (inc. cAMP)
E. coli (inc. cAMP)
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| Oral rehydration therapy | utilizes the co-transport of Na with solutes (sugar and AA) to increase water absorption in the small intestine.
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