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Organ Systems- Renal > Body Water Balance > Flashcards

Body Water Balance Flashcards

1
Q

Plasma Osmolarity =

A

= 2 x [Na] + [ Glucose/18 ] + [ BUN / 2.8 ]

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2
Q

What are the two Osmoreceptors in the hypothalamus ?

A

Supraoptic and Paraventricular

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3
Q

Where is vasopressin released from ?

A

The Hypothalamus

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4
Q

What is another name for vasopressin ?

A

Anti-Diuretic Hormone

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5
Q

What does Vasopressin do ?

A

It Increases the cAMP levels in the renal collecting duct epithelium causing Aquaporin-2 translocation to the lumen membrane.

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6
Q

What happens when your plasma osmolality hits 270 ?

A

Your thirst triggers will be stimulated. Vasopressin will be increasing H2O reabsorption in the distal tubule and collecting duct.

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7
Q

What do the osmoreceptors in the hypothalamus thirst center do ?

A

They drive the thirst behavior drive to increase water ingestion

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8
Q

What do the Osmoreceptors in the supraoptic nucleus of the hypothalamus do ?

A

Increase firing of nerve fibers with endings in the posterior pituitary releasing Vasopressin.

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9
Q

What triggers Osmoreceptors ?

A

Hyperosmotic plasma

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10
Q

How would you treat Hyponatremia due to GI fluid loss (Vomiting and Diarrhea), Why ?

A

Infusion of isotonic saline. The volume lost is isotonic so there will not be any flux between the ICV and

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11
Q

What are the adverse clinical effects of an increase in ECV ?

A

Increased cardiac filling, Jugular venous dissension, venous filling in the thorax,

Severe cases can cause pulmonary edema

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12
Q

When will GI fluid loss cause an abnormal increase in AVP ?

A

When the plasma volume is depleted. Infusion with isomolar or hypomolar saline will save the patient and lower AVP secretion. ds

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13
Q

How large of a depletion in ECFV must a patient sustain in order for AVP secretion to be activated ?

A

10-15 %

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14
Q

How do you calculate the concentration of the urine ?

A

Osmolar Clearance

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15
Q

Osmolar Clearance [ Cosm ] =

A

= Cosm =[ UF x Uosm ] / Posm

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16
Q

What is normal Cosm ?

A

2 +/- 0.5

17
Q

What is the concept of free water clearance ?

A

The ability to concentrate urine depends on the difference between osmolar clearance and clearance of water. This is the free water clearance

18
Q

Free Water Clearance = Ch20 =

A

= Ch2o= [ UF - Cosm ] = UF x [1 / [ Uosm / Posm ]]

19
Q

A positive Ch20 means what ?

A

Dilute Urine and an increase in plasma osmolality

20
Q

A negative Ch20 means what ?

A

Concentrated urine and a decrease in plasma osmolarity

21
Q

What does ADH do to the concentration of the corticopapillary osmotic gradient ?

A

It increases the concentrations and favors a concentrated urine formation.

22
Q

What is free water clearance used for ?

A

It is used to estimate the ability to concentrate or dilute the urine.

23
Q

What the hell is free water ?

A

It is solute free water that is produced in the diluting segments of the kidney where NaCl is reabsorbed and free water is left behind.

24
Q

What is the Free Water concentration in the presence of ADH ?

A

In the presence of ADO the solute free water is not excreted but is reabsorbed by the late distal tubule and collecting ducts. Ch2o is negative

25
Q

What is Urea’s job in countercurrent multiplication ?

A

Urea contributes to 40% of the osmolarity in medullary ISF.

26
Q

What mantains the medullary interstitial hyperosmolality ?

A

The medullary blood flow is low. The Vasa recta serves as a countercurrent exchanges

27
Q

What are the three things that can cause the Kidney’s ability to concentrate urine to diminish ?

A
  1. Defect in production or regulation of AVP secretion
  2. Inability of collecting ducts to respond to AVP
  3. Failure to form medullary osmolarity gradient
28
Q

What causes central diabetes insipidus ?

A

The pituitary gland fails to release AVP- the patients will get dehydrated really quickly

29
Q

What causes Nephrotic Diabetes insipitus ?

A

The collecting ducts do not respond to AVP.

30
Q

What are the 4 things that can cause a loss of medullary hyperosmolality ?

A
  1. Diuretics
  2. Excessive delivery of fluid into LOH
  3. Decreased urea production and decreased filtration of urea
  4. Age and renal failure- reduced number of functional nephrons
31
Q

What is the ionic exchange that takes place in the thick ascending portion of the proximal tubule ?

A

Active transport of Na+ out of collecting duct into ISF

32
Q

If your IT fluid has high plasma osmolarity how will the kidney respond ?

A

It will produce concentrated urine

Organ Systems- Renal (17 decks)

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