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202 Cards in this Set
- Front
- Back
Water accounts for _____ -_____% of total body weight depending on age and body fat content. |
50-75 |
|
What are the two compartments that make up water in the body? |
Intracellular Fluid and Extracellular fluid |
|
What percentage of water is in intracellular fluid? |
67 |
|
What percentage of water is in extracellular fluid? |
33 |
|
Plasma and interstitial fluid are part of what water compartment in the body? |
Extracellular Fluid |
|
Percentage of water goes _____ for obese people. |
down |
|
True or False: muscle cells have less water in them than fat cells. |
False |
|
True or false: Older people have less water in their bodies than younger people. |
True |
|
True or False: Water distribution in the intracellular fluids is controlled by filtration and reabsorption forces. |
False. It is the extracellular fluids |
|
The _______ force moves water from plasma (blood vessels) to interstitial fluid. |
Filtration Force |
|
Filtration force is determined by ______ pressure. |
Hydrostatic |
|
The ________ force moves water from interstitial fluid to plasma. |
Reabsorption |
|
Reabsorption force is determined by ______ pressure. |
osmotic pressure |
|
This type of pressure is caused by the pumping of the heart |
hydrostatic pressure |
|
This type of pressure is caused by large proteins present in the plasma |
osmotic pressure |
|
_______ is the protein that drives osmotic pressure. |
Albumin |
|
Which two organs are responsible for regulation of extracellular water osmolarity and volume? |
Hypothalamus, Kidney |
|
________ is the main signal to regulatory factors responsible for maintenance of fluid balance. |
osmolarity |
|
Which hormone, stimulated by increased blood pressure stretching the heart, functions to inhibit sodium reabsorption to promote sodium excretion? |
ANP (Atrial natriuretic peptide) |
|
Increased blood pressure triggers the release of what two hormones that relate to osmolarity. |
ANP, BNP
|
|
Decreased blood pressure triggers the release of what two hormones that relate to osmolarity. |
RAAS and ADH |
|
RAAS and ADH increase during low blood pressure and stimulate Na and H2O (Retention or Excretion?)
|
Retention |
|
ANP and BNP increase during high blood pressure and stimulate Na and H20 (Retention or Excretion?) |
Excretion |
|
Vasopressin is also referred to as _____ |
ADH |
|
Which hormone stimulates the movement of aquaporins in the distal convoluted tubule to increase the kidney's permeability to water? |
ADH (Vasopressin) |
|
ADH is synthesized in the ________ but stored in and secreted by the _________. |
hypothalamus Posterior pituitary |
|
This is secreted when there is an increase in extracellular osmolarity or decreased intravascular volume. (When you are dehydrated). |
ADH (Vasopressin) |
|
Where does ADH (Vasopressin) act on the kidney? |
distal convoluted tubule |
|
ADH(Vasopressin) increases permeability of the distal convoluted tubule to water by stimulating the movement of _________. |
Aquaporins (water channels) |
|
ADH (Vasopressin) increases or decreases Na absorption. |
Increases. ADH stimulates H20 retention, and in turn, increase Na retention. |
|
True or False ADH (Vasopressin) and RAAS have the same function. |
False They both, in turn, stimulate H20 retention and Na reabsorption, but they do not have the same function to make this happen |
|
True or False: Angiotensin I stimulates the release of ADH. |
False, Angiotensin II stimulates the release of ADH |
|
Where does aldosterone function in the kidney? |
Distal ascending loop of Henle |
|
True or False: Aldosterone main function is to excrete H20 and Na |
False Functions to increase H20 and Na absorption |
|
Aldosterone works in the distal ascending loop of Henle and collecting ducts to: |
Stimulate sodium absorption and potassium excretion |
|
Which hormone, mediated by the enzyme renin, is primarily responsible for active reabsorption of sodium ions in the distal and collecting tubules? |
Aldosterone |
|
Aldosterone regulates ____% of filtered Na |
8 |
|
What is the functional unit of the kidney? |
nephron |
|
What is the major system that controls sodium retention and potassium excretion? |
RAAS (Renin-Angiotensin-Aldosterone System) |
|
True or False: Renin is secreted in the response to a decrease in blood pressure. |
True |
|
Where is renin secreted? |
by the afferent arteriole of glomerulus |
|
What is the major function of Renin? |
To hydrolyze Angiotensinogen into Angiotensin I |
|
Angiotensinogen is synthesized by what? |
The liver |
|
Angiotensin is converted to Angiotensin II by what enzyme? |
ACE (Angiotensin-Converting Enzyme) |
|
Where is ACE synthesized? |
In the Lungs |
|
What is the main function of ACE? |
To convert Angiotensin to Angiotensin II |
|
Aldosterone is released by the ________ _________ in response to the stimulation by what hormone? |
Adrenal cortex Angiotensin II |
|
Angiotensin II stimulates the release of what two hormones? |
Aldosterone and ADH (Vasopressin) |
|
____________ is a potent vasoconstrictor, stimulates the release of ADH and the thirst center of the hypothalamus. |
Angiotensin II |
|
How do you measure the anion gap? |
Measured Cations (Na+)-Measured Anions (Cl-+HCO3-) |
|
Which of the following is not a cation present in the extracellular fluid. Sodium, Potassium, Calcium, Bicarbonate |
Bicarbonate It is an anion, not a cation |
|
_______ _______ is the clinical parameter for establishing metabolic diseases that can alter electrolyle balance. |
Anion Gap |
|
True or False: the anion gap is the concentration of unmeasured cations and anions |
True |
|
What specifically does the anion gap measure? |
It measures organic acids, negatively charges proteins, phosphates, and sulfates |
|
The family of drugs called ACE-Inhibitors is prescribed to patients with high blood pressure. What is the mechanism of action of these drugs? |
They inhibit the conversion of angiotensin I into Angiotensin II Arikawa Answer: Inhibits angiotensin converting enzyme and prevents breakdown of bradykinin, which causes vasodilation and potentiates the action of ACE inhibitors |
|
Where do ACE inhibitors act? |
In the lungs. ACE is synthesized in the lungs |
|
What is the mechanism of action of loop diuretics? |
Arikawa Answer: Inhibit the sodium- chloride-potassium cotransporter in the thick ascending limb of the loop of Henle, leading to less reabsorption (25% of sodium). It is the most potent of the diuretics. |
|
What is the most potent of the diuretics? Loop, Thiazide, Potassium-sparing? |
Loop diuretics |
|
What is the mechanism of actions of potassium sparing diuretics? |
Arikawa Answer: 1.Some of these drugs don’t act directly on sodium transport but on aldosterone receptors in the collecting duct. 2.Others inhibit sodium channels associated with aldosterone-sensitive sodium pump, which spares potassium |
|
<5 mg Na per serving |
Sodium Free |
|
<35 mg Na per serving but greater than 5mg |
Very low sodium |
|
<140 mg Na per serving but greater than 35mg |
Low Sodium |
|
At least 25% less Na per serving compared to regular product |
Reduced or Less Sodium |
|
What are the three major pathways of absorption of sodium? |
1. Na/Glucose Cotransport System SGLT1 2. Na/Cl Cotransport system 3. Electrogenic Na Absorption |
|
Regardless of the mechanism of absorption of sodium into the enterocyte, transport across the basolateral membrane is mediated by |
Sodium/Potassium ATPase Pump |
|
In the Na/Cl cotransport system, Na and Cl enter the cell while _____ and _____ leave the cell. |
H+ and Bicarbonate |
|
McCarron paper, What is the overall idea of the paper? |
1. public policy cannot change sodium intake because the intake is set by human physiology. 2. Decreased sodium intake would lead to an increase in renin and angiotensin, which could contribute to the further progression of the disease. |
|
True or false: The mean sodium intake across the globe seem to fall in the range of 2000 to 4000 mg per day. |
True |
|
________ are the primary tissue for excretion of potassium. |
kidneys |
|
True or False: The same hormones that affect Na+ excretion affect potassium excretion in the same direction. |
False, in the opposite direction |
|
Which is the following is not a mechanism by which potassium lowers blood pressure Increase in smooth muscle relaxation Increase in renin secretion Reduction of urinary excretion of Ca and Mg Stimulate sodium excretion |
Increase in renin secretion Explain: Renin increases Na absorption and decreases potassium which would increase blood pressure, not lower it. |
|
What is the major intracellular cation? |
Potassium |
|
____% of K is reabsorbed from glomerular filtrate with hormonal influence. |
8 |
|
Deficiency of potassium is most commonly seen in which situations? |
With use of certain blood pressure medication Excess vomiting Excess Diarrhea |
|
Thiazides and loop diuretics are major medications that can waste what micronutrient? |
potassium |
|
True or False: Potassium deficiency is related to deficiency of the eye. |
False It is related to muscles |
|
True or False: Nervous irritability, glucose intolerance, and mental disorientation are all symptoms of potassium deficiency |
True |
|
True or False: A deficiency in potassium could lead to excessive levels of calcium in the urine (hypercalciuria) |
True |
|
Both hyperkalemia and hypokalemia lead to: |
cardiac arrhythmias |
|
True or False: A potassium deficiency can lead to lower blood pressure, slowed bone turnover and low levels of calcium in the urine. |
False (Potassium deficiency is associated with elevated blood pressure, abnormal bone turnover and elevated calciuria) |
|
What is the major function of chloride? |
Maintenance of gastric acidity Another way to phrase: Formation of hydrochloric acid in the stomach |
|
Which micronutrient is used by white blood cells to destroy foreign substances? |
Chloride |
|
What is the major role of chloride in the red blood cells? |
To maintain a neutral charge |
|
The chloride shift is an exchange between ______ ions and _______ ions in red blood cells which allows for transport of CO2 and O2. |
Chloride and Bicarbonate |
|
True or False: Na is positively correlated with blood pressure while potassium is negatively correlated with blood pressure. |
True |
|
True or False: Effect of K supplementation on BP is more pronounces in Hispanics and those who are salt sensitive. |
False (African Americans, not Hispanic) |
|
True or False: Na is correlated with insulin resistance. |
True |
|
True or False: Calcium and Magnesium have a strong correlation with the levels of blood pressure.
|
False, they have weak connections. |
|
Which is the following is not a characteristic of the DASH diet? 3g Na 8-10 servings of fruits and vegetables Limit red meats Decreased consumption of Nuts and seeds |
Decreased consumption of Nuts and seeds |
|
How many mg of K are required on the DASH diet? |
4500 mg |
|
True or False: Alcohol is ok to consume on the DASH diet? |
False |
|
What two proteins can absorb Manganese (Mn2+)? |
DMT1 AND ZIP14 |
|
How is manganese homeostasis maintained in the body? |
It is maintained by control of intestinal absorption and urinary excretion. |
|
True or False: Manganese absorption is very limited and it is absorbed typically in its more reduced form. |
True |
|
What protein is bound to manganese when it is transported to the liver? |
Alpha-2 Macroglobulin |
|
Once manganese is transported to the liver by alpha-2 macroglobulin, what are the 3 main ways it can leave? |
1. Free Mn2+ 2. Bound to proteins (albumin, a-2 macroglobulin, B-globulin or Y-globulin) 3. Oxidized by ceruloplasmin to Mn3+ and bound to transferrin |
|
True or False: Iron and Manganese share some commonalities as far as transport goes? |
True (They are both transported out of the liver by being oxidized by ceruloplasmin and bound to transferrin for transport) |
|
True or False: Most of the manganese is bound to transferrin for transport. |
False, more is bound to other proteins (albumin, and globulins) |
|
What are the 5 things that inhibit manganese absorption and transport? |
1. Fiber 2. Phytic acid 3. Oxalic acid 4. Iron (competes for DMT1) 5. Copper |
|
What are the 3 things that stimulate manganese absorption and transport? |
LMW Ligands Histidine Citrate |
|
Although manganese can be replaced by magnesium in several enzymatic reactions, one reaction that requires manganese for activation is: |
The synthesis of glycosaminoglycans by glycosyl transferase |
|
What micronutrient acts as the enzyme activator for glycosyl transferase? |
Manganese |
|
glycosyl transferase is important for: |
connective tissue synthesis |
|
True or False: Manganese is a cofactor for the enzyme superoxide dismutase. |
True |
|
What is the function of superoxide dismutase? |
to prevent lipid peroxidation by superoxide radicals by catalyzing the removal of superoxide radicals. |
|
True or False: Superoxide dismutase is a hydroxylase metalloenzyme
|
False, it is an oxido-reductase |
|
Where would you find a superoxide dismutase metalloenzyme which has a cofactor of manganese? |
Mitochondria |
|
Which of the following minerals is not a component of the enzyme superoxide dismutase? Manganese Zinc Selenium Copper |
Selenium |
|
True or False: Copper must be reduced in order for it to be absorbed. |
True |
|
True or False: Before tissue uptake copper must be oxidized |
False, It must be reduced |
|
What chaperone is related to Willson's disease? |
ATP7B |
|
True or False: Free copper can enter the cell without causing any damage. |
False, Free copper can damage cells. It must be bound to a chaperone such as a histidine, cysteine, glutathione, or others. |
|
What 3 things can happen to copper once it enters the enterocyte? |
1. Stored in the enterocyte 2. Used by the enterocyte 3. Transported across the enterocyte for entry into blood by ATPase ATP7A |
|
What protein, located in the basolateral membrane of the intestine, helps transport copper out of the enterocyte and into the circulation? |
ATPase ATP7A |
|
Menke's disease is a mutation in what protein? |
ATPase ATP7A |
|
What is the primary circulating form of ceruloplasmin?
|
Copper |
|
Homeostasis of ______ is regulated by absorption of GI tract secretion which contains high amounts of this micronutrient. |
Copper |
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What protein chaperones copper for insertion into ceruloplasmin in the liver and for bile duct excretion?
|
ATP7B |
|
When copper is outside the enterocyte it needs a chaperone. What are the 3 main chaperones of copper outside the cell? |
1. Ceruloplasmin (60-70%) 2. Albumin 3. a-2-macroglobulin 2&3 make up 30-40% |
|
What are the 2 enzymes (that we need to know) in which copper is a cofactor for? |
1. Superoxide Dismutase 2. Lysyl oxidase |
|
Lysyl oxidase requires what micronutrient as a cofactor? |
copper |
|
What are the 2 functions of lysyl oxidase? |
1. catalyzes the removal of an amino group from lysine or hydroxylysine of collagen. 2. Oxidizes the terminal end of an aldehyde to form cross-links |
|
True or False: Lysyl oxidase is an amino oxidase |
True |
|
True or False: When copper is inside of the cell and needs to be stored is can be bound to methionine |
False, it is bound to metallothionein |
|
What two micronutrients are commonly bound to metallothionein? |
Copper and Zinc |
|
Copper can be stored in the intestinal cells and liver cells by binding to: |
metallothionein |
|
Where is copper mainly stored? |
In the liver |
|
Copper and Zinc-dependent superoxide dismutase is located where in the body? |
In the plasma or other compartments of the cell, which are NOT THE MITOCHONDRIA! |
|
______ is at the active site of superoxide dismutase. |
copper |
|
True or False: Superoxide dismutase functions differently when it is bound to manganese rather than copper and zinc. |
False, its activity is the same. It is just located in a different area of the cell. |
|
True or False: Copper and Zinc deficiency leads to a decreased activity of superoxide dismutase. |
False, only copper deficiency will lead to its decreased activity. |
|
Which mineral is critical for oxidizing iron to be bound to transferrin for delivery to the tissues from the gut and liver? |
Copper |
|
True or False: Wilson's disease is a mutation in the ATPase ATP7A gene |
False, ATP7B gene |
|
Wilson's disease is characterized by a genetic defect in the gene encoding for ATP7B protein which leads to |
impaired excretion of copper into the bile |
|
Molybdenum is used to treat cancer and a genetic disorder, both related to molybdenum's interaction with: |
Copper (molybdenum enhances copper excretion, exploited in treatment of Wilson's disease) |
|
What occurs inside the enterocyte before retinol/retinal enters the circulation? |
Esterification to palmitate |
|
True or False: Vitamin A and Carotenoids are metabolized in the same way |
False |
|
What are the three types of carotenoids that have vitamin A function? |
Beta Carotene, Alpha Carotene, Beta Cryptoxanthin |
|
Which carotenoid has the greatest provitamin A activity? |
B-Carotene |
|
When retinol is esterified it is incorporated into __________ for transport. |
chylomicrons |
|
What protein bind to esterified retinol or esterified retinal and directs them to the cell for metabolism? (This can also happen to carotenoids) |
CRBPII (Cellular Retinol-Binding Protein) |
|
Retinol released into the circulation from the liver can be bound to either albumin or RBP/TTR whereas beta-carotene is mostly transported by |
lipoproteins |
|
Retinol may be stored in the liver in specialized cells called: |
stellate cells and parenchymal cells |
|
50% of beta-carotene is stored in what type of lipoprotein? |
LDL |
|
Retinol is stored in the |
Liver |
|
Carotenoids are stored in the |
liver and adipose tissue |
|
What is SR-B1 |
Protein that helps absorb vitamin A into the enterocyte |
|
What protein binds to retinoic acid to direct it to the nucleus of cells so it can function in gene expression |
CRABP |
|
What is the function of LRAT? |
Esterifies a fatty acid (palmitate) onto the CRBPII-bound retinol to form CRBPII-retinylpalmitate |
|
Within the nucleus, all-trans retinoic acid and/or 9-cis retinoic acid binds to nuclear retinoic acid receptors to: a. Direct differentiation of keratinocytes b. increase the synthesis of gap junction proteins c. increase glycoprotein synthesis to induce cell adhesion (stimulate differentiation) d. All of the above |
D. All of the above |
|
What form of vitamin A needed for the visual cycle? |
11-cis retinal |
|
11-cis retinal is also referred to as: |
rhodopsin |
|
True or False: When light hits the eye, trans-retinal is converted into cis-retinal |
False, cis-retinal is converted into trans-retinal |
|
what makes rhodopsin |
opsin and cis-retinal |
|
What is the function of carotenoids? |
They function as antioxidants because they possess the ability to react with and quench free radical reactions in lipid membranes or compartments and possible in solution. |
|
Which micronutrient deficiency interferes with vitamin A metabolism by reducing retinol-binding protein? |
Zinc. Zinc is needed for the synthesis of retinol-binding protein |
|
True or False: Excess Vitamin A interferes with Vitamin D absorption. |
False, Vitamin K absorption |
|
True or False: High B-carotene intake may decrease plasma Vitamin E |
True |
|
How is iron metabolism interrelated with both carotenoids and vitamin A?
|
1.Required for conversion of B-Carotene to Vitamin A 2. Vitamin A deficiency may be associated with iron-deficiency anemia |
|
What is RAE? |
Retinol Activity Equivalents |
|
How many times B-carotene is needed for 1 ug of retinol? |
12 |
|
Xerophthalmia and Bitot's spot are classical signs of: |
Vitamin A Deficiency |
|
From the liver; only one form of vitamin E is incorporated into VLDL for transport in the blood, which is also the most biologically active form, named: |
alpha-tocopherol |
|
This micronutrient is mainly found in plant-derived foods, particularly vegetable oil |
Vitamin E |
|
From the enterocyte, vitamin E gets transported via: |
chylomicrons |
|
True or False: Vitamin A and E are both transported via chylomicrons |
True |
|
True or False: Supplementation of Vitamin E does not provide any extra benefits and in some cases may increase mortality. |
True |
|
_________ is thought to act synergistically with ________ to inhibit lipid peroxidation. |
Beta-carotene, vitamin E |
|
True or False: selenium requires digestion |
False |
|
1. methionine and cysteine are what type of amino acids? 2. What is the different between selenomethionine and regular methionine |
1. sulfur amino acids 2. The sulfur is replaced by a selenium |
|
Which of the following bests describes the function of vitamin E? a. maintenance of membrane integrity b. prevention of lipid peroxidation c. destruction of singlet molecular oxygen d. all of the above |
D. all of the above |
|
soil concentrations of ______ deeply affect the levels of this micronutrient in foods? |
selenium
|
|
What two things are needed to make endogenous selenocysteine |
selenophosphate and serine |
|
Selenophosphate can be made from all other forms of selenium by the enzyme: |
Selenophosphate synthetase II |
|
True or False: dietary selenocysteine can be used as a cofactor for Se-dependent enzymes (as part of tRNA during protein synthesis). |
False, only endogenously made selenocysteine |
|
Although dietary selenocysteine cannot be used by the body to synthesize seleno-dependent proteins, it is important for the synthesis of _______ which is used to make endogenous selenocysteine |
selenophosphate
|
|
Selenium may be found in foods in its organic form or inorganic form. The organic forms correspond to: a. selenomethionine b. selenocysteine c. selenoglutathione d.both a and b e. all of the above |
d. Both a and b |
|
What are the inorganic forms of selenium? |
Selenide, selenite, selenate |
|
One of the common features of several seleno-cysteine dependent protein/enzymes is their role in: |
antioxidant activity |
|
Whole blood glutathione peroxidase activity may reflect long-term status of which micronutrient? |
selenium (glutathione peroxidase requires selenium in their structure) |
|
Metabolism of selenium in the liver involves the synthesis of which protein which also serves as the main transport protein of selenium in blood? |
Selenoprotein P |
|
Which of the following is required for iodine metabolism a. Copper b. Manganese c. Chromium d. Selenium |
selenium (Selenium deficiency impairs thyroid hormone metabolism by inhibiting the synthesis and activity of the iodothyronine 5'- deiodinases, which convert T4 to T3. ) |
|
True or False: Thioredoxin reductase, the enzyme that functions in cellular redox state maintenance, requires selenium in its structure. |
True |
|
Most animals synthesize their own ascorbic acid from ________ |
glucose |
|
Why can't we make vitamin C? |
Humans, rats and other primates lack the enzyme gulonolactone oxidase |
|
Which of the following nutrients can be absorbed via GLUT transporters in its oxidized form? |
Vitamin C (it is synthesized from glucose!) |
|
The four H's characterized by hyperkeratosis, hematologic abnormalities, hemorrhagic signs, and hypochondriasis are manifestations of: |
Vitamin C deficiency |
|
Which of the following molecules synthesized with the help of vitamin C underscores the importance of vitamin C to fat metabolism? Tyrosine Collagen Carnitine Lysine |
Carnitine (vitamin C it required for carnitine synthesis which is critical for LCFA metabolism) |
|
Vitamin C works as an antioxidant to reduce all of the following except a. Iron b. Copper c. Zinc d. dihydrobiopterin |
Zinc |
|
Intake of ascorbic acid aids in absorption of |
non-heme iron |
|
Vitamin C acts as a cofactor in collagen synthesis by |
maintaining iron in its reduced state |
|
True or False: Three hydroxylation reactions, using vitamin C, enable the collagen molecule to cross-link |
True |
|
Which of the following best describes the interaction between vitamin C and vitamin E |
Vitamin C reduces vitamin E that has been oxidized |
|
Which of the following compounds does not contribute to the regeneration of vitamin C that has been oxidized? a. Niacin b. Glutathione c. Thioredoxin d. dihydrolipoic acid e. Carnitine |
e.carnitine |
|
Which protein is primarily responsible for the transport of zinc in the body? |
Albumin or ZIP4 |
|
The mutation of what transporter leads to acrodermatitis enteropathica?
|
ZIP4 (related to zinc) |
|
Maintenance of Zinc homeostasis is done primarily by binding zinc to _______ which prevents its transport into the blood. |
Metallothionein |
|
What are the three main functions of metallothionein? |
1. Regulatedistribution and transfer of Zn to enzymes 2. Scavengefree hydroxyl radicals 3. Synthesisincreases under acute phase response |
|
True or False: Metallothionein would be a good indicator of zinc under metabolic stress |
False, Synthesis increases under acute phase response which would not be a good reflection of zinc stores. |
|
Which of the following are metalloenzymes which require zinc to function? a. Carboxypeptidases b. Superoxide dismutase c. alcohol dehydrogenase d. Carbonic Anhydrase e. All of the above |
e. all of the above |
|
The role of zinc in gene expression is attributed to the formation of |
Zinc fingers |
|
Growth retardation, skeletal abnormalities, wound healing, dermatitis , Alopecia- loss of hair ,Impaired immune function , and decreased taste acuity (hypogeusia) are all common symptoms of what: |
a deficiency in zinc |