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Endocrine > 1 - PUPD > Flashcards

1 - PUPD Flashcards

1
Q

Normal drinking value

A

Less than 40 - 60 mL/kg/d

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2
Q

What are contributors to body water hemostasis

A

Plasma osmolality, vascular volume, kidneys, pituitary gland

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3
Q

Osmolality

A

Concentration osmotically active particles in solution , # particles in 1 kg solvent

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4
Q

Osmolality is calculating what 2 factors

A

Size and number

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5
Q

Osmolarity

A

particles per 1 L solvent

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6
Q

If your body wants to lower osmolality will ADH increase or decrease

A

ADH will increase

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7
Q

Increasing ADH causes what

A

Increase in thirst and increase in withholding water

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8
Q

Where is the thirst center

A

Hypothalamus

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9
Q

The hypothalamus has what 2 receptor

A

Osmoreceptors and baroreceptors

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10
Q

Triggers for thirst

A

Hyper osmolality and decreased vascular volume

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11
Q

ADH aka

A

Vasopressin

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12
Q

ADH is produced

A

Hypothalamus

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13
Q

ADH is storages

A

Posterior pituitary

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14
Q

What does ADH effect

A

Reabsorbs water and concentrate urine

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15
Q

Plasma osmolality primarily determined by

A

NA

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16
Q

Where are the ADH receptor

A

Distal renal tubule

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17
Q

Thirst center mediated primarily by

A

Hypothalamic osmoreceptor

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18
Q

Decreased renal perfusion activates

A

RAAS

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19
Q

Polydipsia

A

Greater than 100 mL/kg/d

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20
Q

Polyuria

A

Greater than 50 mL/kg/d

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21
Q

With PUPD will you have an increase or decrease in volume

A

Increase

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22
Q

Common pretenders of PUPD

A

Pollakiuria, incontience, behavioral

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23
Q

What USG be with PUPD

A

Persistently less than fully concentrated

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24
Q

What does USG measure

A

Urine osmolality

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25
Q

Plasma osmolality in dogs and cats

A

290 - 310 moms

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26
Q

Hyposthenuria

A

1.00 - 1.007

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27
Q

What is the osmolality of hyposthenuria

A

Urine is less than plasma

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28
Q

Isothenuria

A

1.008 - 1.012

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29
Q

Minimally concentrated

A

Dogs - 1.013 - 1.030 Cats - 1.013 - 1.040

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30
Q

What is the osmolality of minimally concentrated

A

Urine is greater than plasma

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31
Q

Wet cat food will cause minimally concentrated or concentrated?

A

Minimally concentrated

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32
Q

What do you need to make concentrated urine

A

Functioning nephrons, hypertonic medullary gradient, ADH, and responsiveness to ADH

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33
Q

What percent of functioning nephrons needs to be parent to concentrate

A

1/3 present

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34
Q

Hypertonic medically gradient depend on what two components

A

Na and urea

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35
Q

80 - 90% of fluid filtered at the glomerulus is reabsorbed in teh

A

Proximal tubule

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36
Q

Hyposthenuric urine at

A

Distal nephrons

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37
Q

What is the most common cause of PUPD

A

Primary polyuria

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38
Q

What can cause primary polyuria

A

Osmotic diuresis, decreased ADH production, decreased ADH receptor function, medically washout

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39
Q

Causes of osmotic diuresis

A

Presence of poorly reabsorbed solutes and excessive salt intake

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40
Q

What are examples of portal reabsorbed solutes

A

Mannitol, urea, glucose

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41
Q

ADH production and receptor function is decreased signals for

A

Diabetes insipidus

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42
Q

If there is a decrease in ADH production what is the primary DI coming from

43
Q

With what type of diabetes insipidus is there NO ADH produced

44
Q

Obligate water drinker is ign of

A

Primary nephrogenic DI

45
Q

What is the mot common cause of DI in dogs/cat

A

Acquired nephrogenic DI

46
Q

What can interfere with the ADH receptor

A

Cortisol, endotoxin, electrolytes - CA

47
Q

DDAVP

A

Vasopressin used for treatment of CDI

48
Q

RAAS

A

Regulates blood pressure and volume

49
Q

CDI

A

Lack of ADH production from the pituitary

50
Q

nephrogenic diabetes insipidus

A

Lack of ADH receptors in the kidney or decreased response of the ADH receptors

51
Q

Insensible loss

A

Water loss primarily due to evaporative respiratory loss

52
Q

Vasopressin acts on receptors in the

A

Distal tubule - aquaporins

53
Q

Thirst center can be stimulated by

A

Increases in Extracellular osmolality or decreases in the intravascular volume

54
Q

Do cat on canned diet drink more or less

55
Q

Primary polydipsia is often a

A

Behavioral problem

56
Q

When Na is selectively reabsorbed this makes the urine

A

Hyposthenuric

57
Q

What are some disease that cause PU through osmotic diuresis mechanism

A

DM, primary renal glucose Rita, Fanconi’s Syndrome, CKD, post obstructive diuresis

58
Q

Can patient with CDI concentrate urine if given exogenous ADH

A

Yes because the receptors are functional

59
Q

Idk what medullary washout is

60
Q

If you need more water is your osmoality high or low

61
Q

What triggers thirst

A

Hyperosmoolality and decreased vascular volume

62
Q

What are the effects of ADH

A

Reabsorb water and concentrate urine

63
Q

Plasma osmoality is primarily determined by

64
Q

Where are the ADH receptors located

A

Distal renal tubule

65
Q

The thirst center is mediated by

A

Hypothalamic omoreceptors

66
Q

Polydipsia value

A

More than 100 mL/kg.d

67
Q

Polyuria values

A

More than 50 mL/kg/d

68
Q

What are common pretenders of PUPD

A

Pollakiuria, Incontience or behavioral

69
Q

What USG should you consider pUPD

A

Persistent less than fully concentrated

70
Q

What is USG measuring

A

Urine osmoality

71
Q

Isosthenuric values

A

1.008 - 1.012

72
Q

How can you concentrate urine

A

Functioning nephrons, hypertonic medullary gradient, ADH, response to ADH

73
Q

What two are important in hypertonic medullary gradient

A

Na and urea

74
Q

H20 is mostly permeable where

A

Descending tubule

75
Q

Na is mostly permeable where

A

Ascending tubule

76
Q

Urea recycling is maintained through

A

Selective reabsorption and recycling

77
Q

80 - 90% of fluid filtered at the glomerulus is reabsorbed in the

A

Proximal tubule

78
Q

Selective reabsorption of sodium happens where

A

Thick ascending loop

79
Q

After selective reabsorption sodium what happens to the urine

A

Hyposthenuric urine

80
Q

Where is hyposthenuric urine found

A

At distal nephrons

81
Q

Most common caues of primary polyuria

A

Osmotic dieresis, decreased ADH production, decreased receptor function, medullary washout

82
Q

What are some causes of osmotic dieresis

A

Excessive salt intake, DM , mannitol, lepto, jerky treats, Franconia, renal glucosuria

83
Q

If there is osmotic dieresis, where is the problem most likely

A

Proximal tubule - because it absorbs all the glucose usually

84
Q

What are causes of primary polyuria

A

Osmotic dieresis, reduced/ absent ADH production and receptor, and medullary washout

85
Q

If you have decreased ADH or decreased ADH receptor function, what is the problem

A

Diabetes Insipidus

86
Q

Decreased ADH production is indicative of

A

Central DI

87
Q

Decreased ADH receptor is indicative of

A

Nephrogenic DI

88
Q

What are primary nephrongenic DI examples

A

No ADH receptors in the kidney, obligate water drinker

89
Q

What interferes with ADH receptors

A

Cortisol, endotoxin, calcium

90
Q

What can impair medically gradient

A

Increase flow urine or blood, decrease urea, decrease Na

91
Q

What can cause increase flow of urine or blood

A

Solute washout, impaired reabsorption Na or urea

92
Q

What can cause decrease in Urea

A

Liver insufficiency, low protein diet

93
Q

What can cause decrease in Na

A

Hypoadrenocorticism, loop diuretics, electrolytes los

94
Q

Low serum sodium can be indicative of

A

Primary polydipsia

95
Q

If you have PUPD in dog what are the main suspicions

A

Cushing, DM, CKD

96
Q

What is the main suspicion of PUPD in cats

A

DM, CKD, hyperthyroidism

97
Q

Can you consider PUPD with concentrated urine

98
Q

If you have dilute urine what is considered

A

DI and primary polydipsia

99
Q

If you have isosthenuria what is considered

A

CKD, secondary NDI, and partial CDI

100
Q

What test should you do when ther is normal to increased NA

A

Desmopressin trial

101
Q

If they can concentrated ADH given what do they have

102
Q

If they cannot concentrate when given ADH what do they have

A

Primary NDI

103
Q

What are the steps of the desmopressin trial

A

Measure water intake 2 -3 day, do USG, drops 5 -7 days, blah blah

Endocrine (7 decks)

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