endocrine

Question 1

how does ADH influence the kidneys

Answer 1

causes it to reabsorb water

Question 2

how does aldosterone influence the kidneys

Answer 2

increases Na absorption

Question 3

how does ANP influence the kidneys

Answer 3

Decreases Na absorption and increases H20 excretion

ANP MAKES YOU PEE

Question 4

what is renin

Answer 4

• hormone produced by kidney

- raises BP by vasoconstriction

Question 5

serum creatinine

Answer 5

0. 5-1.2 mg/dL
   - impaired renal function is the only thing that elevates this
   - 60% of renal function is lost before this # even elevates

Question 6

BUN

Answer 6

10-20 mg/dL

• byproduct of protein breakdown
• indicates liver or renal impairment

Question 7

24 hr creatinine clearance urinalysis

Answer 7

good indicator of renal function

-how well is the protein being cleared in the blood

Question 8

changes to renal function with CKD

Answer 8

cant filter blood so fluid & electrolytes are retained

• fluid overload
• increased K
• decreased Ca (low activated VitD)
• metabolic acidosis (kidneys cant absorb HCO3 or excrete H)

-overall decline

Question 9

CKD on acid/base

Answer 9

• metabolic acidosis
• cant excrete H
• cant reabsorb HCO3
• kussmal breathing

Question 10

CKD on fluids/electrolytes

Answer 10

10-20% increase in ECF

• risk for fluid overload
• hyponatremia early
• hypernatremia & hyperkalemia later
• hypocalcemia

Question 11

CKD on renal system

Answer 11

nephrons larger/work harder

• work sufficiently until 80% function lost
• kidneys shrivel
• BUN increases
• UO decreases & concentration increases

Question 12

CKD on cardiac

Answer 12

fluid overload

• HTN (lack of RAAS)
• peripheral edema
• uremia (urine in blood)
• CHF
• atherosclerosis

Question 13

CKD on respiratory

Answer 13

pulmonary edema

• pleuritis
• metabolic acidosis
• crackles/SOB/low SPO2

Question 14

CKD on hematological

Answer 14

bleeding/bruising

• platelets in toxic environment
• uremia
• anemia (low RBC)
• low EPO production
• Low RBC survival time

*can give EPO injection if super super low

Question 15

CKD on GI

Answer 15

anorexia (no appetite)

• taste uremia bc vascular mouth
• build up of ammonia in GI tract
• ulcers bc no prostaglandins
• GI bleeds
• malnutrition

Question 16

CKD on immune

Answer 16

urea in blood disrupts WBC production

• decreased immunity
• risk for infection
• generalized inflammation (body cant do anything about bc prostaglandins aren’t produced)

Question 17

CKD on integumentary

Answer 17

uremic frost (overload of uremia)

• decreased platelets so bruising
• dry skin
• terrible itching
• yellow/grey color skin

Question 18

HHS

Answer 18

glucose >600

• ketones absent of low
• severe cellular dehydrated
• onset several days

-give fluids and insulin

Question 19

DKA

Answer 19

-excess glucose
->300
metabolic acidosis
-sudden onset
-glucose levels very high from stress and infection

-give fluids and insulin

Question 20

kussmaul breathing

Answer 20

deep rapid labored breathing

Question 21

Hypothyroidism

Answer 21

High TSH; Low T3 and T4
intolerance to cold
weight gain
constipation
bradycardia
thick tongue
dry skin
slowed speech

myxedema coma
hypercalcemia

Question 22

hyperthyroidism

Answer 22

Low TSH; High T3 and T4
intolerance to heat
weight loss
diarrhea 
tachycardia
facial flushing
bulging eyes
localized edema

thyroid storm
graves disease