Renal 23 Kidney & Ca Word Scramble
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Question | Answer |
Serum Ca stores | Ionized Ca (~50%) -Biologically active Protein-bound (~40%) Complexed to anions (~10%) |
Ca homeostasis is primarily regulated by | Parathyroid Hormone (PTH) -mobilize form bone Vitamin D -absorb from instetines |
What couples with free Ca? | Phosphate |
How does PTH effect phosphate levels? | Acts in the kidney to ↑phosphate excretion and ↓ reabsorption |
What primary signals does PTH respond to? | Absolute [Ca] Rate of fall of [Ca] |
Effects of PTH in the kidney | + Ca reabsorption - Phosphate reabsorption + primary hydolysis (responsible for activating Vit D. |
Majority of phosphate is reabsorbed... | In the proximal tubule |
What mechanism is responsible for the increase in phosphate excretion in the presence of PTH? | PTH inhibits the phosphate transporter from working and marks it be degraded by the lysosomes |
Where along the nephron is what percent of Ca reabsorbed. | Proximal tubule ~60% Thick ascending limb ~25% Distal convoluted tubule ~5% Collecting duct ~10% |
Effect of PTH on Vitamin D and Ca uptake in the distal tubule | PTH increase activity of an apical Ca channel Inside the cell Ca binds to Vit D which transports it cross cell Ca pumped out by Na/Ca exchange and Ca ATPase |
How does Vitamin D affect PTH? | Vitamin D feeds back to the parathyroid and decreases PTH secretion |
Vitamin D and intestinal absorption of Ca. | Vit D increases the synthesis of Ca binding proteins which grab Ca form the brush boarder side |
How does elevated PTH cause hypercalciuria? | PTH effect on bone resorption causes increased fluid levels of Ca These levels are higher than what hte kidney can absorb |
Elevated PTH can cause _____ (phosphate) | Hyperphosphaturia -↓resorption, ↑excretion |
What would you expect to see with Ca in acidosis? | ↓ renal Ca absorption ↓ protein binding to Ca thus ↑ionized[Ca] Promotes degradation of bone |
What would you expect to see with Ca in alkalosis | ↑ renal reabsorption of Ca ↑ protein binding to Ca so ↓ionized[Ca] |
True/False Loop diuretics may decrease Ca excretion | False It increases Ca excretion |
Created by:
bcriss
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