Q & A: Physiology (Endocrinology)

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Physiology - Endocrinology Questons & Answers

Q: A 21-Beta-hydroxylase deficiency will result in what hormone deficiencies/excesses?
A: Decreased cortisol and mineralocorticoids (hypotension, hyperkalemia)
A: Increased sex hormones (masculinization)

Q: A deficiency of 17-alpha hydroxylase will result in an decrease in what hormone(s)?
A: Decreased sex hormones and cortisol

Q: A deficiency of 17-alpha hydroxylase will result in an increase in what hormone(s)?
A: Aldosterone
A: Produces hypertension, hypokalemia

Q: A dopaminergic antagonist would be expected to have what effect prolactin secretion?
A: Stimulates prolactin secretion

Q: A maturing graafian follicule can be found at what stage of the menstrual cycle?
A: During the proliferative phase (Around Day 7)

Q: Angiotensin II has what effect on the adrenal cortex?
A: Stimulates aldosterone production by enhancing the activity of aldosterone synthase

Q: Calcitonin's actions (synergize/oppose) the actions of PTH.
A: Oppose. Calcitonin acts faster than PTH to decrease serum Ca2+ levels.

Q: Decreased cortisol levels as in any of the congenital adrenal hyperplasias will have what effect on ACTH?
A: ACTH levels will be increased contributing to increased skin pigmentation

Q: Decreased phosphate will have what effect on Vit D?
A: Increased activated Vit D.

Q: During the 2nd and 3rd trimester, one would expect the corpus luteum to be?
A: Degenerated.
A: Shortly after the first trimester, the placenta makes estriol and progesterone.

Q: Estradiol is converted from what precursor by what enzyme?
A: Aromatase converts Testosterone to Estradiol.

Q: Estrogen is produced in what 4 locations in the body?
A: Corpus luteum, placenta, adrenal cortex, and testes

Q: Estrogen levels are low/med/high during the just before the peak of the LH surge?
A: High.
A: Estrogen switches to positive feedback of LH from negative so both increase.

Q: Estrogens have what effect of LH secretion?
A: Complex effects.
A: Early on estrogen has a negative effect that switches to positve just before the LH surge.

Q: Estrogens have what effect of the follicle?
A: Estrogens stimulate growth of the follicle

Q: Failure of brain maturation due to lack of thyroid hormone is known as?
A: Cretinism

Q: Finasteride inhibits what step in testosterone metabolism?
A: Converstion of testosterone to DHT by 5-alpha reductase

Q: Follicular growth is fastest during what part of the menstrual cycle?
A: During the second week od the proliferative phase (Days 7-14)

Q: FSH stimulates what cells in the male?
A: Sertoli cells (spermatogenesis)

Q: Hypocalcemia will have what effect on Vit D metabolism?
A: Decreased Ca2+ will increase PTH which will stimulate the kidney to produce more activated Vit D.

Q: In addition to peripheral conversion, DHT is also produced in the?
A: Prostate

Q: In what organ is Vitamin D3 produced?
A: The skin. Vit D requires sun exposure (UV light and heat)

Q: Is testosterone considered to be anabolic or catabolic overall?
A: Anabolic

Q: LH levels would be low/med/high at the time of ovulation (Day 14)
A: Low.
A: The LH surge has already declined

Q: LH stimulates what cells in the male?
A: Leydig cells (testosterone synthesis)

Q: Name the two primary insulin independent organs?
A: Brain and RBC's take up glucose independent of insulin

Q: Order the following with the most potent first: testosterone, androstenedione. DHT
A: DHT > testosterone > androstenedione

Q: Order the following with the most potent first: estrone, estradiol, estriol.
A: Estradiol > estrone > estriol

Q: Phosphate reabsortion in the kidneys is inhibited by what hormone?
A: PTH

Q: Progesterone has what effect on body temperature?
A: Increases body temperature

Q: Progestorone is used in combination with estrogen for what reason?
A: To decrease the risk of endometrial cancer associated with unopposed estrogen therapy

Q: Prolactin has what effect on ovulation?
A: Prolactin inhibits ovulation by inhibiting the release/synthess of GnRH from the hypothalamus

Q: PTH causes increased calcium reabsorption in what part of the kidney?
A: DCT

Q: PTH is produced by what cell type?
A: Chief cells of the parathyroid glands

Q: Sertoli cells stimulate spermatogenesis by producing what 2 factors in response to FSH?
A: Androgen-binding protein (ABP) - concentrates testosterone in the seminiferous tubules
A: Inhibin - inhibits FSH secretion fro the ant pit

Q: T/F - Glycolisis is promoted by the thyroid hormones
A: False. Thyroid hormones increase blood glucose levels by stimulating glycolgenolysis and gluconeogenesis.

Q: T/F - PTH stimulates both osteoclasts and osteoblasts?
A: True

Q: T/F - Testosterone is the most active androgen in males and females?
A: False. 5-alpha reductase activates testosterone to DHT which is the most active androgen.

Q: Testosterone acts as a negative inhibitor on what hormone from the brain?
A: GnRH

Q: Testosterone is synthesized in what two locations?
A: Testis
A: Adrenal Cortex

Q: The hormone with the highest concentration during the secretory phase is?
A: Progesterone

Q: The key inhibitor of prolactin release is?
A: Dopamine secreted from the hypothalamus
A: Bromocriptine (Dopamine agonist has the same effect)

Q: The parathyroid glands come from what embryonic structures?
A: The 3rd and 4th pharyngeal pouches

Q: The primary estrogen produced by the ovary is?
A: Estradiol

Q: The primary estrogen produced by the placenta is?
A: Estriol

Q: Thick mucous production is the result of what sex hormone?
A: Progesterone
A: Decreases sperm entry into the uterus

Q: Throid Stimulating Immunoglobulin results in what disease?
A: Graves Disease (hyperthroidism)

Q: Thyroid hormones acts synergistically with what hormone with respect to bone growth?
A: GH

Q: TRH is produced in what region of the brain?
A: Hypothalamus

Q: TSH levels in a hypothroid patient would be? Free T4?
A: Elevated TSH
Decreased free T4
A:
Q: Unlike estrogen, what effect does progesterone have on the myometrium?
A: Progesterone decreases myometrial excitability to help maintain the pregnancy/facilitate fertilization

Q: Vit D deficiency in kids cause what disease? Adults?
A: Rickets in kids
A: Osteomalacia in adults

Q: What 2 conditions other than pregnancy increase hCG?
A: Hydatidiform moles in women or choriocarcinoma

Q: What adrenergic effects do the thyroid hormones have?
A: Beta-adrenergic effects

Q: What are the symptoms of menopause?
A: HAVOC
A: H = Hot flashes
A: A V = Atrophy of the Vagina
A: O = Osteoporosis
A: C = Coronary Artery Disease

Q: What cells produce calcitonin?
A: Parafollicular cells (C cells) of the thyroid

Q: What does an elevated progesterone level indicate?
A: Ovulation

Q: What effect do androgens have on growth of long bones.
A: During puberty, testosterone stimulates bone growth but eventually causes closure of the ephyseal plates

Q: What effect do estrogens have on the endometrium? Myometrium?
A: Stimulate endometrial proliferation
A: Increase myometrial excitability

Q: What effect do estrogens have on the liver?
A: Increase hepatic synthesis of transport proteins

Q: What effect do the thyroid hormones have on cardiac output? Heart rate? Contractility? Stroke Volume? Respiratory Rate?
A: Thyroid hormones increase:
A: CO
A: HR
A: SV
A: contractility and
A: RR

Q: What effect does Ca2+ have on bone?
A: Stimulates bone resorption of calcium.

Q: What effect does progesterone have on FSH? On LH?
A: Progesterone is inhibitory to both gonadotrophins

Q: What effect does progesterone have on the endometrium?
A: Progesterone stimulates the endometrial glands to become secretory and increases spiral artery development

Q: What effect does PTH have on bone?
A: Increases bone resorption of Ca2+ and phosphate

Q: What effect does thyroid hormone have on lipolysis?
A: Lipolysis is stimulated

Q: What effect will low serum phosphate have the kidney?
A: The kidney will produce more 1-25-OH2 Vit D which will increase phosphate release from bone matrix and increase Ca2+ and phosphate absorption in the GIT

Q: What enzyme deficiency will produce BOTH hypertension and masculinization of females?
A: 11-Beta hydroxylase deficiency
A: 11-deoxycorticosterone will act as a mineralocorticoid

Q: What enzyme in the kidney is stimulated that affects vitamin D metabolism?
A: PTH stimulates 1-alpha-hydroxylase cause increased production of 1,25-(OH)2 vitamin D.

Q: What happens to the corpus lutem if progesterone levels fall without fertilization?
A: The corpus luteum regresses and menstration occurs

Q: What happens to the corpus lutem if progesterone levels with fertilization?
A: The corpus luteum is maintained by hCG acting like LH which maintains both estrogen and progesterone levels.

Q: What hormonal changes are seen with untreated menopause with respect to estrogen, FSH, LH, GnRH?
A: Decreased estrogen
A: Increased FSH (Greatly)
A: Increased LH (No surge)
A: Increased GnRH

Q: What hormone predominates during the secretory phase of the menstrual cycle?
A: Progesterone

Q: What is the key regulator of PTH secretion?
A: Decrease in free serum Ca2+ increases PTH secretion. Increased Ca2+ feedback inhibits PTH secretion.

Q: What is the key regulator that increases Calcitonin secretion?
A: Increased serum Ca2+

Q: What is the most common cause of congenital adrenal hyperplasia?
A: 21-Beta hydroxylase deficiency

Q: What is the physiologic source of hCG?
A: The syncytiotrophoblasts of the placenta

Q: What is the primary organ that converts Vit D to 25-OH Vit D?
A: Liver

Q: What is the primary source of androstenedione?
A: Adrenal glands

Q: What is the role of calcitonin in normal calcium homeostasis?
A: Probably not important as PTH is the primary regulator of calcium homeostasis.

Q: What is the VERY first molecule in the pathway for the synthesis of Aldosterone? Cortisol? Adrenal androgens?
A: Cholesterol

Q: What is thought to be the cause of menopause?
A: Cessation of estrogen production due to decline in the number of follicles

Q: What overall effects does PTH have on body electolytes?
A: PTH increases serum Ca 2+, decreases serum phosphates, increases urine phosphates

Q: What signal from the body decreases TRH secretion?
A: Thyroid hormones, T3

Q: What substance is used by the brain for energy during starvation?
A: Ketone bodies

Q: What will the levels of Ca2+, phosphate, and alkaline phosphatase be in hyperparathyroidism?
A: Increased Ca2+, decreased phosphate, increased alkaline phosphatase

Q: What will the levels of Ca2+, phosphate, and alkaline phosphatase be in osteoporosis?
A: No changes in Ca2+, phosphate, or alkaline phosphatase

Q: What will the levels of Ca2+, phosphate, and alkaline phosphatase be in Paget's disease of bone?
A: Alkaline phosphatase increased with normal Ca2+ and phosphate

Q: What will the levels of Ca2+, phosphate, and alkaline phosphatase be in renal insufficiency?
A: Decreased Ca2+, increased phosphate, and alkaline phosphates WNL

Q: What will the levels of Ca2+, phosphate, and alkaline phosphatase be in Vit D intoxication?
A: Increased Ca2+ and phosphate with alkaline phosphatase WNL

Q: Which ducts (Mullerian or Wolfian) are promoted by androgens?
A: Wolfian ducts are differentiated into the internal gonadal structures.

Q: Why is hCG so useful for detecting pregnancy?
A: It is detectable in the blood and urine 8 days after successful fertilization.

Q: Why is hormone replacement therapy used in postmenopausal women?
A: Decrease hot flashes and decrease bone loss.
A: Decreased risk of heart disease could be on the boards but is no longer true (2001).

Q: Will most steroids in the blood be bound or unbound?
A: Bound to specific binding globulins
A: Steroids are lipophilic

Q: You would expect the body temperature of a patient with hyperthroidism to be?
A: Elevated
A: Thyroid hormone increases Na/K ATPase activity => increased consumption of O2 => increased temp
PHYSIO_GI TRACT
Q: Exocrine secretion of zymogens by secretory acini is stimulated by what?
A: -Acetylcholine
A: -CCK

Q: Five effects of Parasympathetic GI Innervation:
A: 1. Increase production of saliva
A: 2. Increase gastric H+ secretion
A: 3. Increases pancreatic enzyme and HCO3- secretion
A: 4. Stimulates evteric nervous system to creat intestinal peristalsis
A: 5. Relaxes sphincters

Q: Five main components of gastric secretions and their sources?
A: -Mucus (Mucous cell)
A: -Intrinsic factor (Parietal cell)
A: -H+ (Parietal cell)
A: -Pepsinogen (Chief cell)
A: -Gastrin (G cell in antrum and duodenum)

Q: Four categories of drugs that inhibit/decrease secretion of gastric acid:
A: 1. Proton pump inhibitors (omeprazole)
A: 2. H2 receptor antagonists (Rantidine, Cimetidine, Famotidine)
A: 3. Anticholinergics
A: 4. Prostaglandin receptor antagonists (Misoprostol)

Q: Four effects of Sympathetic GI Innervation:
A: 1. Increase production of saliva
A: 2. Decreases splanchnic blood flow in fight-or-flight response
A: 3. Decreases motility
A: 4. Constricts Sphincters

Q: Four functions of H+ secreted in the stomach?
A: -Kills bacteria
A: -Breaks down food
A: -Lowers pH to optimal range for pepsin function (conversion of pepsinoget)
A: -Sterilizes chyme

Q: Four functions of Samatostatin?
A: 1. Inhibits Gastric acid and pepsinogen secretion
A: 2. Inhibits pancreatic and small intestine fluid secretion
A: 3. Gallbladder contraction
A: 4. Release of both insulin and glucagon

Q: From what cells is bile secreted?
A: hepatocytes

Q: Function of Gastrin secreted in the stomach?
A: Stimulates secretion of HCl, IF, and pepsinogen (also stimulates gastric motility)

Q: Function of Intrinsic factor secreted in the stomach?
A: Binding protein required for vitamin B12 absorption (in terminal ileum)

Q: How do you treat Pancreatic Insufficiency?
A: -Limit fat intake
A: -Monitor for signs of fat-soluble vitamin (A,D,E,K) deficiency

Q: How does jaundice manifest in the body?
A: yellow skin and sclerae

Q: How much urobilinogen is secreted per day?
A: 4mg

Q: In what form is bilirubin secreted by the kidney?
A: urobilirubin

Q: In what form is bilirubin secreted in the feces?
A: stercobilin

Q: Name as many Pancreatic enzymes as you can:
A: -alpha-amylase
A: -lipase
A: -phospholipase A
A: -colipase
A: -proteases (trypsin, chymotrypsin, elastase, carboxypeptidases)
A: -trypsinogen (trypsin)

Q: Name the major product of heme metabolism that is actively taken up ty hepatocytes:
A: Bilirubin

Q: Name the organ and enzyme family involved in the production of bilirubin?
A: Nonerythroid enzymes in the liver

Q: Name the three salivary secretory glands:
A: -Parotic
A: -Submandibular
A: -Sublingual

Q: Name two potent stimulators of Gastrin:
A: 1. Phenylalanine
A: 2. Tryptophan

Q: Secretin's nickname?
A: Nature's antacid

Q: SEE PICTURE ON LAST PAGE OF GI PHYSIOLOGY!!!
A: SEE PICTURE ON LAST PAGE OF GI PHYSIOLOGY!!!

Q: Three main functions of CCK?
A: 1. Stimulates gallbladder contraction
A: 2. Stimulates pancreatic enzyme secretion
A: 3. Inhibits gastric emptying

Q: Two functions of Secretin?
A: 1. Stimulates pancreatic HCO3 secretion
A: 2. Inhibits gastric acid secretion

Q: Two functions of the mucus secreted in the stomach?
A: -Lubricant
A: -protects surface from H+

Q: What activates all the proteases?
A: trypsin

Q: What are the products of oligosaccharide hydrolase action?
A: Monosaccharides (glucose, galactose, fructose)

Q: What are the products of starch hydrolysis by pancreatic amylase?
A: Oligosaccharides, maltose and maltotriose

Q: What are the products of the hydrolysis of carbohydrate alpha-1,4 linkages by salivary amylase?
A: maltose, maltotriose and alpha-limit dextrans

Q: What are the three main functions of saliva?
A: 1. Begin starch digestion
A: 2. Neutralize oral bacterial acids which maintains dental health
A: 3. Lubricate food

Q: What are the two main sources of bilirubin in the body?
A: -Hepatic production by nonerythroid enzymes
A: -Metabolism of heme from red blood cells (120 day life span) and incomplete or immature erythroid cells

Q: What causes pain to worsen in Cholelithiasis?
A: Eating fatty foods which cause CCK release

Q: What component of GI secretion is 'not essetial for digestion?'
A: Gastric acid

Q: What condition results from elevated bilirubin levels?
A: Jaundice

Q: What disease is commonly associated with pancreatic insufficiency?
A: Cystic Fibrosis

Q: What do pancreatic ducts secrete when stimulated by secretin?
A: -mucus
A: -alkaline fluid

Q: What does inadequate gastric acid cause?
A: Increased risk of Salmonella infections

Q: What enzyme converts trypsinogen to trypsin?
A: enterokinase (a duodenal brushborder enzyme)

Q: What enzyme hydrolyzes starch?
A: Pancreatic amylase

Q: What enzyme is involved in the rate-limiting step in carbohydrate digestion?
A: Oligosaccaride hydrolases

Q: What enzyme starts digestion and hydrolyzes alpha-1,4 linkages?
A: Salivary Amylase

Q: What form are the proteases secreted in?
A: proenzyme form

Q: What form is Alpha-amylase secreted in?
A: active form

Q: What hormone decreases absorption of substances needed for growth)
A: Somatostatin

Q: What inhibits the release of gastrin and secretin?
A: Somatostatin

Q: What is pancreatic amylase in highest concentration?
A: In the duodenal lumen

Q: What is the composition of bile? (5)
A: -bile salts
A: -phospholipids
A: -cholesterol
A: -bilirubin
A: -water

Q: What is the fate of pepsinogen?
A: Broken down to pepsin (a protease) by H+

Q: What is the function (fxn) of Pepsin?
A: Begins protein digestion (optimal pH = 1.0 - 3.0

Q: What is the function of Alpha-amylase?
A: starch digestion

Q: What is the function of proteases?
A: protein digestion

Q: What is the function of VIP?
A: -pancreatic HCO3- secretion
A: - intibition of gastric H+ secretion

Q: What is the function on Nitrous Oxide?
A: Causes smooth muscle relaxation

Q: What is the major stimulus for secretion of enzyme-rich fluid by pancreatic acinar cells?
A: Cholecystokinin

Q: What is the major stimulus for zymogen release, but a poor stimulus for bicarbonate secretion?
A: Acetylcholine

Q: What is the only types of carbohydrate that is absorbed?
A: Monosacharides

Q: What is the primary location over bacterial conversion or conjugated bilirubin to urobilinogen?
A: Colon

Q: What is Zollinger-Ellison syndrome? What is the main manifestation?
A: 1. Hypersecretion of Gastrin
A: 2. Peptic ulcers

Q: What manifestations are seen in pancreatic insufficiency?
A: -malabsorption
A: -stratorrhea (greasy, malodorous stool)

Q: What regulates bicarbonate secretion?
A: Stimulated by secretin, potentiated by vagal input and CCK

Q: What regulates CCK secretion?
A: Stimulated by fatty acids and amino acids

Q: What regulates Gastrin secretion?
A: -Stimulated by stomach distension, amino acids, peptides, and vagus
A: -Inhibited by secretin and stomach acid pH less than 1.5

Q: What regulates secretion of secretin?
A: Stimulated by acid and fatty acids in lumen of duodenum

Q: What regulates secretion of Somatostatin?
A: -Stimulated by acid
A: -Inhibited by vagus

Q: What special characteristic do bile salts possess?
A: They are amphipathic (contain both hydrophilic and hydrophobic domains)

Q: What special characteristic does the conjugated form of bilirubin possess?
A: It is water soluble.

Q: What substance stimulates ductal cells to secrete bicarbonate-rich fluid?
A: Secretin

Q: What three enzymes aid in fat digestion?
A: 1. Lipase
A: 2. Phospholipase A
A: 3. Colipase

Q: What trasport is utilized in glucose absorption across cell membrane?
A: Sodium-glucose-coupled transporter

Q: What two conditions are caused be autoimmune destruction of parietal cells?
A: -Chronic Gastritis
A: -Pernicious Anemia

Q: What type(s) of innervation stimulate salivary secretion?
A: BOTH Sympathetic and Parasympathetic

Q: Where are the oligosaccharide hydrolase enzymes located?
A: At the brush border of the intestine

Q: Where does bilirubin conjugation take place?
A: Liver

Q: Where does glucose absorption occur?
A: Duodenum and proximal Jejunum

Q: Where does heme catabolism take place?
A: In the Reticuloendothelial System

Q: Where is bicarbonate secreted and what does it do?
A: -Surface mucosal cells of stomach and duodenum
A: -Neutralizes acid
A: -Present in the unstirred layer preventing autodigestion

Q: Where is Cholecystokinin (CCK) secreted?
A: I cells of duodenum and jejunum

Q: Where is Secretin secreted?
A: S cells of duodenum

Q: Where is Somatostatin secreted?
A: D cells in pancreatic islets and GI mucosa

Q: Where is Vasoactive Intestinal Peptide (VIP) secreted
A: Smooth muscle nerves of the intestines

Q: Which component of bile makes up the greatest percentage?
A: Water (97%)

Q: Which component of bile solubilizes lipids in micelles for absorption?
A: Bile salts

Q: Which component of saliva begins starch digestion?
A: Alpha-amylase (ptyalin)

Q: Which component of saliva lubricates food?
A: Mucins (glycoproteins)

Q: Why do we need alkaline pancreatic juice in the duodenum?
A: To neutralize gastric acid, allowing pancreatic enzymes to function
PHYSIO_KIDNEY
Q: At what concentration is the transport mechanism for glucose saturated?
A: 300 mg/dL

Q: Define effective renal plasma flow.
A: ERPF = U (PAH) x V/P (PAH) = C (PAH)

Q: Define filtration fraction.
A: FF = GFR/ RPF

Q: Define free water clearance.
A: C(H2O) = V- C(osm)

Q: Define GFR.
A: GFR = U(inulin) x V/P (inulin) = C (inulin)
A: GFR also equals the difference in (osmotic pressure of the glomerular capillary minus Bowman's space) and (hydrostatic pressure of the glomerular capsule minus Bowman's space).

Q: Define renal blood flow.
A: RBF = RPF/1 - Hct

Q: Define renal clearance.
A: Cx = UxV/Px
A: The volume of plasma from which the substance is cleared completely per unit time.

Q: Define urine flow rate.
A: V = urine flow rate
A: C (osm) = U(osm)V/P(osm)

Q: How are amino acids cleared in the kidney?
A: Reabsorption occurs by at least 3 distinct carrier systems, with competitive inhibition within each group.

Q: How do NSAIDs cause renal failure?
A: By inhibiting the production of prostaglandins which normally keep the afferent arterioles vasodilated to maintain GFR

Q: How high can the osmolarity of the medulla reach?
A: 1200-1400 mOsm

Q: How is ICF measured?
A: ICF = TBW - ECF

Q: How is interstitial volume measured?
A: Interstitial volume = ECF - PV

Q: How is PAH secreted?
A: Via secondary active transport

Q: How is PAH transport mediated?
A: Mediated by a carrier system for organic acids

Q: How much of the ECF is interstitial fluid?
A: Three-fourths

Q: How much of the ECF is plasma?
A: One-fourth

Q: How much of the total body water is part of intracellular fluid?
A: Two-thirds

Q: How much of the total body water is part of the extracellular fluid?
A: One-third

Q: If clearance of substance X is equal to GFR, what occurs?
A: There is no net secretion or reabsorption

Q: If clearance of substance X is greater than GFR, what occurs?
A: Net tubular secretion of X

Q: If clearance of substance X is less than GFR, what occurs?
A: Net tubular reabsorption of X

Q: T/F. Secondary active transport of amino acids is saturable.
A: TRUE

Q: What 3 layers form the glomerular filtration barrier?
A: 1. Fenestrated capillary endothelium
A: 2. Fused basement membrane with heparan sulfate
A: 3. Epithelial layer consisting of podocyte foot processes

Q: What actions does ADH have on the kidney?
A: -Increase water permeability of principle cells in collecting ducts
A: -Increase urea absorption in CD
A: -Increase Na/K/2Cl transporter in the thick ascending limb

Q: What actions does AII have on the kidney?
A: -Contraction of efferent arteriole increasing GFR
A: -Increased Na and HCO3 reabsorption in proximal tubule

Q: What actions does aldo have on the kidneys?
A: -Increased Na reabsorption in distal tubule
A: -Increased K secretion in DT
A: -Increased H ion secretion in DT

Q: What actions does ANP have on the kidney?
A: -Decreased Na reabsorption
A: -Increased GFR

Q: What actions does PTH have on the kideny?
A: -Increased Ca reabsorption
A: -Decreased phosphate reabsorption
A: -Increase 1,25-(OH)2 Vit D production

Q: What activates 1 alpha-hydroxylase?
A: PTH

Q: What are the 4 actions of angiotensin II?
A: 1. Vasoconstriction
A: 2. Release of aldo from adrenal cortex
A: 3. Release of ADH from posterior pituitary
A: 4. Stimulates hypothalamus to increase thirst

Q: What are the 4 endocrine functions of the kidney?
A: 1. EPO release
A: 2. Vitamin D conversion
A: 3. Renin release
A: 4. Prostaglandins release

Q: What are the consequences of a loss in the charge barrier?
A: -Albuminuria
A: -Hypoproteinemia
A: -Generalized edema
A: -Hyperlipidemia

Q: What competitively inhibits the carrier system for PAH?
A: Probenecid

Q: What constricts the efferent arteriole?
A: Angiotensin II

Q: What dilates the renal afferent arteriole?
A: Prostaglandins

Q: What do the collecting ducts reabsorb in exchange for K or H?
A: Na ions

Q: What does renin do?
A: Cleave angiotensinogen into angiotensin I

Q: What does the anterior pituitary secrete?
A: -FSH and LH
A: -ACTH
A: -GH
A: -TSH
A: -MSH
A: -Prolactin

Q: What does the beta subunit do?
A: The beta subunit determines hormone specificity

Q: What does the early distal convoluted tubule actively reabsorb?
A: -Na ions
A: -Cl ions

Q: What does the posterior pituitary secrete?
A: ADH and oxytocin

Q: What does the secretion of prostaglandins from the kidney do?
A: Vasodilates the afferent arterioles to increase GFR

Q: What does the thick ascending loop of Henle actively reabsorb?
A: -Na ions
A: -K ions
A: -Cl ions

Q: What does the thick descending loop of Henle indirectly reabsorb?
A: -Mg ion
A: -Ca ions

Q: What effect does constriction of the efferent arteriole have?
A: -Decreased RPF
A: -Increased GFR
A: -FF increases

Q: What effect does dilation of the afferent arteriole have?
A: -Increased RPF
A: -Increased GFR
A: - FF remains constant

Q: What enzyme converts 25-OH Vit D to 1,25-(OH)2 Vit D?
A: 1alpha-hydroxylase

Q: What happens to glucose in the kidneys when glucose is at a normal level?
A: Glucose is completely reabsorbed in the proximal tubule.

Q: What hormones act on the kidney?
A: 1. ADH
A: 2. Aldosterone
A: 3. Angiotensin II
A: 4. Atrial natriurtic Peptide
A: 5. PTH

Q: What inhibits constriction of the efferent arteriole by AII?
A: ACE inhibitors

Q: What inhibits dilation of the afferent arteriole by prostaglandins?
A: NSAIDS

Q: What is an important clinical clue to diabetes?
A: Glucosuria

Q: What is angiotensin II's overall function?
A: To increase intravascular volume and increase blood pressure

Q: What is passively reabsorbed in the thin descending loop of Henle?
A: Water via medullary hypertonicity (impermeable to sodium)

Q: What is reabsorbed in the early distal tubule under the control of PTH?
A: Ca ions

Q: What is the function of the early proximal convoluted tubule?
A: Reabsorbs all of the glucose and amino acids and most of the bicarbonate, sodium, and water

Q: What is the oncotic pressure of Bowman's space?
A: Zero

Q: What is the thick ascending loop of Henle impermeable to?
A: Water

Q: What is the threshold for glucose reabsorption in the proximal tubule?
A: 200 mg/dL

Q: What may act as a 'check' on the renin-angiotensin system in heart failure?
A: ANP

Q: What part of the nephron secretes ammonia?
A: Early proximal convoluted tubule

Q: What part of the pituitary is derived from neuroectoderm?
A: Posterior pituitary

Q: What percentage of the body is water?
A: 0.6

Q: What regulates the reabsorption of water in the collecting ducts?
A: ADH

Q: What secretes renin?
A: JG cells

Q: What stimulates ADH secretion?
A: -Increased plasma osmolarity
A: -Greatly decreased blood volume

Q: What stimulates aldosterone secretion?
A: -Decreased blood volume (via AII)
A: -Increased plasma K concentration

Q: What stimulates angiotensin secretion?
A: Decreased blood volume (via renin)

Q: What stimulates ANP secretion?
A: Increased atrial pressure

Q: What stimulates EPO release?
A: Hypoxia

Q: What stimulates PTH secretion?
A: Decreased plasma ca concentration

Q: What stimulates renin release?
A: 1. Decreased renal arterial pressure
A: 2. Increased renal nerve discharge (Beta 1 effect)

Q: What subunit do TSH, LH, FSH and hCG have in common?
A: Alpha subunit

Q: What symptom is present once threshold is reached?
A: Glucosuria

Q: What type of tissue is the anterior pituitary derived from?
A: Oral ectoderm

Q: What value is used clinically to represent GFR?
A: Creatinine clearance

Q: What variables are needed to calculate free water clearance?
A: -Urine flow rate
A: -Urine osmolarity
A: -Plasma Osmolarity

Q: Where does ACE convert AI to AII?
A: Primarily the lung capillaries

Q: Where does secondary active transport of amino acids occur?
A: In the proximal tubule

Q: Where is EPO secreted?
A: Endothelial cells of the peritubular capillaries (kidney)

Q: Where is paraaminohippuric acid secreted?
A: Proximal tubule

Q: Which barrier is lost in nephrotic syndrome?
A: Charge barrier

Q: Which layer filters by negative charge?
A: Fused basement membrane

Q: Which layer filters by size?
A: Fenestrated capillary endothelium

Q: Why does the nephron secrete ammonia?
A: Acts As a buffer for secreted H ions

Q: Why is inulin sued to measure GFR?
A: Because it is freely filtered and is neither absorbed or secreted

Q: Why is PAH used to calculate RPF?
A: PAH is secreted and filtered
PHYSIO_LUNGS
Q: A decrease in PA O2 will have what effect on the pulmonary vasculature?
A: Causes hypoxic vasoconstriction that shifts blood awayfrom poorly ventilated regions

Q: A value of infinity for V/Q indicates?
A: Blood flow obstruction

Q: A ZERO value for V/Q indicates?
A: Airway obstruction

Q: Bicarbonate in the RBC is transported out of the cell in exchange for what ion?
A: Cl- by a HCO3-/Cl- antiport

Q: Cor pulmonale is the result of?
A: Pulmonary hypertension

Q: Cor pulmonale will lead to what condition of the heart?
A: Right ventricular failure (jugular venous distention, edema, hepatomegaly)

Q: Dissociation of CO2 from Hb upon oxygenation in the lungs is known as?
A: The Haldane effect

Q: Exercise (increased cardiac output) will have what effect on V/Q to the apex?
A: The V/Q will approach 1 (from 3) as a result of dilation of vessels in the apex.

Q: In the apex of the lung, V/Q should be >1, =1, or <1?
A: V/Q > 1. NL = 3 which indicates wasted ventilation.

Q: In the base of the lung, V/Q should be >1, =1, or <1?
A: V/Q < 1. NL = 0.6 which indicates wasted perfusion.

Q: In the perpheral tissue what factor helps unload oxygen by shifting the curve to the right?
A: Increased H+ (decreased pH) a.k.a. the Bohr effect

Q: Increased 2,3-DPG will cause a shift in what direction of the oxygen-Hb dissociation curve?
A: The curve will shift RIGHT.
A: This allows Hb to release more oxygen

Q: Increased erythropoietin levels as a response to high altitudes will have what affect on the blood?
A: Increase hematocrit and Hb

Q: Neonatal respiratory distress syndrome is due to a deficiency of what?
A: Surfactant (dipalmitoyl phosphatidylcholine, lecithin)

Q: Perfusion is greatest in what part of the lung?
A: Both ventilation and perfusion are greater at the base than at the apex.

Q: Recurrent TB grows best in what part of the lung? Why?
A: Apex because of high O2.

Q: Surfactant role in the lungs is to do what?
A: Decrease alceolar surface tension

Q: T/F - The pulmorary circulation is a high resistance, low compliance system.
A: F. It has low resistance and high compliance.

Q: The conversion of CO2 to H2CO3 (Carbonic acid) is catalyzed by what RBC enzyme?
A: Carbonic Anhydrase

Q: The kidneys would do what to compensate for respiratory alkalosis as a response to high altitude?
A: Excrete bicarbonate

Q: The predominant form of CO2 transport from the tissues to the lungs is?
A: HCO3- (bicarbonate) accounts for 90%, followed by Hb bound CO2 (5%) and dissolved CO2 (5%)

Q: TV+IRV+ERV = ? TV = tidal volume, IRV = inspirartory reserve volume, ERV = expiratory reserve volume
A: Vital capacity. VC is everything but the residual volume.

Q: Ventilation is greatest in what part of the lung?
A: Both ventilation and perfusion are greater at the base than at the apex.

Q: What 6 factors decrease O2 affinity to Hb/decrease P50? What direction does the O2-Hb dissociation curve shift?
A: Decrease metabolic needs, dcr PCO2, dcr temperature, increased pH, dcr 2,3-DPG, and Fetal Hb
A: The curve shifts LEFT.

Q: What are some potential side effects of ACE inhibitors?
A: Cough and angioedema due to decreased bradykinin

Q: What cellular change could you expect as a response to high altitude?
A: Increased mitochondria

Q: What enzyme in the lungs is a key enzyme in the renin-angiotensin system?
A: Angiotensin-converting enzyme (ACE) which converts Ang I to Ang II

Q: What is expiratory reserve volume?
A: Air that can still be breathed out after normal expiration

Q: What is FRC? How is it calculated?
A: FRC is the flume in the lungs after normal respiration and is the sum of RV +ERV.

Q: What is inspiratory reserve volume?
A: Air in excess of the tidal volume that moves into the lungs with maximum inspiration

Q: What is residual volume?
A: Air in the lung at maximal expiration

Q: What is the bodies acute reponse to a change from low to high altitude?
A: Increase in ventilation

Q: What is the difference between capacites and volumes in the lung?
A: Capacities are the sum of >= 2 volumes.

Q: What is the Total Lung Capacity? Normal Value?
A: IRV + TV + ERV + RV or VC + RV
A: Normal would be ~ 6.0 L

Q: What is tidal volume? What is a normal TV value?
A: Air that moves into the lung with each quiet expiration.
A: 500 mL is normal

Q: What would be the effect on the heart due to chronic hypoxic pulmonary vasoconstriction (High altitude)?
A: Right ventricular hypertrophy

Q: Would you expect acidosis or alkalosis due as a response to high altitude? Metabolic or Respiratory?
A: Respiratory alakalosis

[bharat]

well thanks bro. this is also really usefull. well keep up this sprit bro.
i want more ...hahah...........