Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CV Anesthesia, plus renal (Skuta) > Diuretics > Flashcards

Diuretics Flashcards

1
Q

Natriuretic Peptides are involved in:

A

long-term regulation of sodium and water balance, blood volume and arterial pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

2 Major Actions of Natriuretic Peptides

A
  1. Vasodilator effects (directly dilate veins and arteries)
  2. Decrease Renin release, which decreases circulating levels of angiotensin II and aldosterone. This leads to further natriuresis and diuresis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Natriuretic Peptides serve as acounter-regulatory system for the:

A

renin-angiotensin-aldosterone system.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ANP is produced by:

A

atrial myocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Functions of ANP

A

Relax smooth muscle
Promote NaCl and water excretion by kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ANP: Stimuli for release

A

Atrial stretch (increased Extra Cellular Volume)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Actions of ANP:

A

Inhibit Renin release
Inhibits aldosterone secretion
Acts directly on the collecting duct to decrease NaCl reabsorption (fine tuning urine)
Inhibits ADH release from the posterior pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Elevated levels of ANP are found during _____ states such as occurs in___ ____.

A

hypervolemic
Heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

BNP (brain natriuretic peptide) is synthesized in the _____ and ____ and is released by the same mechanisms as _____ with similar physiological actions.

A

ventricles and brain
ANP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ANP and BNP will _____GRF by _____ the afferent arteriole and _____ the efferent arteriole.

A

increase
dilating
constricting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cardiovascular and RenalActions of Natriuretic Peptides

A

Natriuresis and Diuresis
Improve glomerular filtration rate & filtration fraction
Inhibit renin release-
↓ circulating angiotensin II
↓ circulating aldosterone
Systemic vasodilation
Arterial hypotension
Reduced venous pressure
Reduced pulmonary capillarywedge pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Diuretics will ______ the rate of sodium reabsorption from the ______ which causes sodium output to increase (naturiesis) and results in diuresis.

A

decrease
tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Although many diuretics work within minutes this effects will…..
what are they end results?

A

decreases over the next few days with chronic use

Decreasse ECF , decrease MAP, decrease GFR, INCREASE Renin and Angiotensin II (override effects of diuretics)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Osmotic diuretics (urea and mannitol) will……and work at the _____ _____.

A

draw fluid into the tubules
proximal tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Loop Diuretics: Action and location

A

inhibit the Na-2Cl-K co-transporter in the TAL of Henle’s loop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The most used diuretic

A

Thiazide Diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Thiazide Diuretics: Action and location

A

inhibit sodium chloride reabsorption in the early distal tubule.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Thiazides: Increase sodium reabsorption in exhancege for _____ and _____ ions

A

potassium and hydrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Carbonic Anhydrase Inhibitors example:

A

acetazolamide (Diamox)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Carbonic Anhydrase Inhibitors: Action and location

A

Reduce reabsorption of Na+ in the proximal convoluted tubule by decreasing bicarbonate reabsorption.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Disadvantage with Carbonic Anhydrase Inhibitors

A

causes acidosis through bicarbonate loss in the urine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Carbonic Anhydrase Inhibitors main use?

A

glaucoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Aldosterone Antagonists example

A

Example: spironolactone (Aldactone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Spironolactone: Action and location

A

Potassium-sparing diuretics:
Decreases reabsorption of Na+ and decreases K+ secretion by competing for aldosterone binding sites in the distal segment of the distal tubule.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Aldosterone Antagonists are often used in conjunction with thiazide or loop diuretics to help prevent _______.

A

hypokalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Other diuretics that spare potassium?

A

Na+ Channel Blockers
Examples: amiloride and triamterene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Osmoticdiuretics (mannitol)

A

Mainly proximal tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Loopdiuretics (furosemide, bumetanide)

A

Thick ascending loop of Henle

29
Q
A
30
Q

Thiazidediuretics (hydrochlorothiazide, chlorthalidone)

A

Early distal tubules

31
Q

Carbonic anhydrase inhibitors (acetazolamide)

A

Proximal tubules

32
Q

Aldosterone antagonists (spironolactone, eplerenone)

A

Collecting tubules

33
Q

Sodium channel blockers (triamterene, amiloride)

A

Collecting tubules

34
Q

______ is the leading cause of end-stage renaldisease(ESRD), followed by hypertension.

A

Diabetes Mellitus

35
Q

Pre- Renal Failure definition and example:

A

Kidney not getting enough blood flow and therefore becomes ischemic

Examples: heart failure, hypovolemia

36
Q

Intra- Renal Failure definition and example:

A

Damage to the kidney itself

Examples: Toxins, infections, autoimmune disease, direct renal injury

37
Q

Post- Renal Failure definition and example:

A

Obstruction of the collecting system

Examples: Stones, urethral valves, tied off ureter, kinked Foley

38
Q

CKD: Symptoms often do not occur until the number of functioning nephrons decreases to at least ____% below normal.

A

70%

39
Q

CKDis usually defined as the presence of kidney damage or decreased kidney function that persists for at least __ months.

A

3

40
Q

Refers to sclerotic lesions of smaller arteries, arterioles, and glomeruli:

A

Nephrosclerosis

41
Q

Glomerulonephritis:

A

Most caused by deposition of antigen-antibody complexes in glomerular membranes
Can be post-streptococcal infection
Lupus can also cause this
AKI following sugery

42
Q

A condition in which the bones are partially absorbed and, therefore, become greatly weakened:

A

Osteomalacia

43
Q

Kidney lesions which decrease water and sodium excretion promote _________.

A

hypertension

44
Q

Effective treatment of hypertension requires enhancing the kidneys’ capability to excrete _____ and _____.
How?

A

salt and water

Either by increasing GFR or by decreasing tubular reabsorption

45
Q

Drugs that vasodilate the kidneys and increase GFR

A

calcium channel blockers

46
Q

Dialysis: The rate of movement of solute across this membrane depends on:

A

-concentration gradient of the solute**
-permeability and surface area of the membrane
-length of time the blood and fluid remain in contact with the membrane.

47
Q

Usually there is about ____ cc of blood in the dialysis machine at any time

A

500

48
Q

Indications for Dialysis

A

Fluid overload
Hyperkalemia
Severe acidosis
Metabolic encephalopathy
Pericarditis
Coagulopathy
Refractory GI symptoms
Drug toxicity

49
Q

Normal BUN:

A

Normally 10-20 mg/dL

50
Q

Normal Creatinine:

A

0.8-1.3 mg/dL in men; 0.6-1.0 in women

51
Q

Creatinine concentration is directly related to body _____ _____ and is inversely related to _____.

A

muscle mass
GFR

52
Q

GFR _______ with age in most people (___% decline per decade after age 20)

A

decreases
5%

53
Q

Succinylcholine is safe in patients with K<____ mEq/L, will transiently increase K+ by almost ___ mEq/L

A

5
0.5

54
Q

Cis-atracurium as it is degraded by ______ ______.

A

Hoffman elimination

55
Q

Muscle relaxants to avoid with decreased renal function:

A

Pancuronium, pipecuronium, alcuronium, doxacurium as these are primarily dependent on renal excretion

56
Q

______ ______ are the most likely group of drugs used in anesthetic practice to produce prolonged effects in ESRD because of their dependence onrenalexcretion.

A

muscle relaxants

57
Q

Is Sugammadex excreted by the kidneys?

A

YES

58
Q

______ is not currently indicated in patients with renal failure, pediatrics, and ICU patients.

A

Sugammadex

59
Q

Fluids: best to avoid _____ as it has 4mEq/L of K+

A

LR

60
Q

If serum potassium is ≥ ____mEq/L,we generally dialyze the patient. ____ hours of hemodialysis will typically suffice to prepare a patient for surgery

A

5.5
2 hours

61
Q

Studies have shown that DDAVP ______ vWF–factor-VIII levels and _______ bleeding time within approximately 1 h after infusion or injection.

A

increase
decreases

62
Q

________ is a key factor in the causation of perioperative renal failure

A

Hypovolemia

63
Q

Post-op renal failure has a mortality of _____

A

~50%

64
Q

True or False: It is easier to treat the complications of fluid overload than it is to treat acute renal failure!

A

TRUE

65
Q

Most common type of kidney stone:

A

Calcium Oxalate Stones

66
Q

Most stones <____mmpass spontaneously

A

4

67
Q

More common where diet rich in protein, fat and alcohol

A

Gout

68
Q
A

CV Anesthesia, plus renal (Skuta) (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions