NBME 20 Answers : Block 4 : #16 = An investigator wishes to determine the ...

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NBME 20 Answers

nbme20/Block 4/Question#16

An investigator wishes to determine the ...

Ductal ion reabsorption is more efficient at low flow rates

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submitted by masonkingcobra(67),

https://drawittoknowit.com/pop-quizzes/anatomy-physiology/at-a-high-flow-rate-how-does-saliva-compare-to-plasma

+2 upvote downvote
submitted by usmleuser007(113),

Salivary secretion 1. At low flow = High concentration of potassium; low concentrations of sodium, bicarb, & chloride 2. at high flow = low concentration of potassium; high concentrations of sodium, bicarb, & chloride

sherry That's exactly what I was thinking when I was taking the test. But I was sidetracked by same HCO3 level. Can somebody explain this part to me?? +

smc213 @sherry https://pcwww.liv.ac.uk/~petesmif/petesmif/salivary%20secretion/bicarbonate%20secretion.htm +1

charcot_bouchard Because salivary duct removes Na & Cl while secrete K & Hco3 in lumen. In low flow rate HCO3 & K inc because duct is doing its thing for more time. At high flow rate K slightly dec (as cant be secrted as much) but HCO3 stays almost same. the reason is high flow indicates higher metabolism & higher bicarb production. +

cienfuegos Regarding the bicarb (via BRS Physiology, which explains flow rate as coming down to "contact time" where slow flow allows more reabsorption of NaCl): The only ion that does not “fit” this contact time explanation is HCO3−; HCO3− secretion is selectively stimulated when saliva secretion is stimulated. +1

+2 upvote downvote
submitted by sinforslide(9),

Overview of Saliva production:

Acinar cells secrete initial saliva, which is isotonic to plasma.
Ductal cells modify initial saliva, causing reabsorption of Na+, Cl- and secretion of K+ and HCO-. -> higher K+ and HCO- concentrations, lower Na+ Cl- concentrations in saliva. In this process, MORE NaCl is reabsorbed, meaning that saliva ends up being hypotonic to plasma.

Ductal reabsorption process is hindered in high-flow states, which causes isotonic saliva