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Physiology · USMLE Step 1

USMLE Physiology: Renal and Acid-Base Regulation

Nephron transport mechanisms, tubuloglomerular feedback, and acid-base compensation concepts tested on USMLE Step 1.

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Where in the nephron does SGLT2-mediated Na+/glucose cotransport primarily occur?
Early proximal convoluted tubule
Approximately what percentage of filtered Na+ is reabsorbed in the proximal tubule?
About 65 to 70 percent
What percentage of filtered bicarbonate is reabsorbed in the proximal convoluted tubule?
About 80 to 90 percent
Which enzyme allows the proximal tubule brush border to convert CO2 and H2O for bicarbonate reabsorption?
Carbonic anhydrase
Which transporter mediates Na+, K+, and Cl- reabsorption in the thick ascending limb?
Na-K-2Cl cotransporter (NKCC2)
Loop diuretics act on which nephron transporter?
The Na-K-2Cl cotransporter (NKCC2) in the thick ascending limb
Is the thick ascending limb permeable to water?
No, it is impermeable to water
Which transporter mediates Na+ and Cl- reabsorption in the distal convoluted tubule?
Na-Cl cotransporter (NCC)
Thiazide diuretics act on which nephron transporter?
The Na-Cl cotransporter (NCC) in the distal convoluted tubule
In the collecting duct, what is the main function of principal cells?
Reabsorb Na+ and secrete K+
In the collecting duct, what is the main function of intercalated cells?
Regulate acid-base balance by secreting H+ or HCO3-
Which hormone increases Na+ reabsorption and K+ secretion by principal cells?
Aldosterone
Which channel does aldosterone upregulate in principal cells to increase Na+ reabsorption?
Epithelial sodium channel (ENaC)
Which hormone increases water permeability of the collecting duct?
ADH (vasopressin)
Which water channel does ADH insert into the luminal membrane of collecting duct cells?
Aquaporin-2 (AQP2)

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