Endocrinology Flashcards
What hormones is most concered with the regulation of body fluid?
Where is this hormone made?
ADH
Hypothalamus: Supraoptic nucleus
Which of the followingwould trigger the release of ADH? Bonus: change the incorrect ones so that they’re all correct
A. Increase in BP
B. Increase in blood volume
C. Increase in osmolality
D. decrease in angiotensin II
Increase in osmolality
- Decrease BP*
- Decrease in blood volume*
- Increase in angiotensin II*
Which of the following receptors does ADH target to increase water reabsorption by the kidneys?
A. V1
B. V2
C. alpha-1
D. Beta-1
V2
T/F: ADH makes you thirsty
True
Which of the following is true under conditions of hypoosmolality?
A.Increased release of ADH
B. Reabsorption of water
C. Urine becomes more dilute
D. None of the above
Urine becomes more dilute
- we decrease the amount of ADH released, remove more water from the blood and see a more dilute urine
Which of the following disorders causes a lack of effect of ADH on the collecting duct?
A. Central Diabetes Insipidus
B. Peripheral Diabietes Insipidus
C. Nephrogenic Diabetes Insipidus
D. SIADH
Nephrogenic Diabetes Insipidus
In which of the following disorders do you see an increase in ADH and water retention, even during periods of hypoosmolality?
A. Central Diabetes Insipidus
B. Peripheral Diabietes Insipidus
C. Nephrogenic Diabetes Insipidus
D. SIADH
SIADH
What are the affects of aldosterone on potassium?
K+ secretion
A decrease in mean arterial pressure would be addressed by the release of ______
Renin
Which of the following describes what one might see in a primary adrenal insufficiency?
A. Both cortisol and aldosterone levels are decreased despite high levels of renin
B. Decrease in cortisol but normal levels of aldosterone and renin
C. Both cortisol and aldosterone levels are increased while renin is decreased
D. All of the above are made up
Both cortisol and aldosterone levels are decreased despite high levels of renin
Where would we find BNP?
What is the affect of this peptide?
VEntricular myocytes
Decrease NaCl and water reabsorption by the collecting duct
Urodilatin and ANP are encoded by the same gene, but differ in where they are secreted. Where is urodilatin secreted, and what is its mechanistic goal?
Distal Tubule and Collecting Duct
Inhibits NaCl and water reabsorption across the medullary portion of the collecting duct
All of the following is true of the actions of ANP, except?
A. inhibit renin, aldosteron, and ADH secretion
B. Vasoconstriction of afferents and vasodilation of efferents
C. Increase GFR and filtered NaCl
D. Vasodilation of afferents and vasoconstriction of efferents
Vasodilation of afferents and vasoconstriction of efferents
Release of which of the following from sympathetic nerves stimulate reabsorption of NaCl in all of the following locations, EXCEPT?
A. Proximal Tubule
C. Thin ascending limb
D. Thick ascending limb
E. Distal Tubule
F. Collecting Duct
Thin ascending limb
Select all of the scenarios that are true regarding effectively decreasing Na+ reabsorption at the collecting duct or proximal tubule.
A. Decrease of sympathetic activity causes dilation of afferent arterioles increasing GFR
B. Increase in ANP which will constrict efferent arterioles and increase GFR
C. Decrease in osmotic capillary pressure
D. Decrease in RAAS
E. All of the above are correct
All of the above are correct
All of the following can cause K+ to shift INTO the cells leading to kypokalemia except?
A. Insulin
B. B2-adrenergic AGONIST
C. alkalosis
D. a-adrenergic AGONIST
E. Hyposmolarity
a-adrenergic AGONIST
an a-adrenergic antagonist would shift K+ into cells
Which of the following correctly explains how insulin stimulates the K+ uptake by the cells?
A. Increases activity of ENaC
B. Increases the activity of Na/K ATPase
C. Increases activity of NKKC2
D. None of the above
Increases the activity of Na/K ATPase
Hyperkalemia stimulates the release of _________, while hypokalemia reduces its production.
Hyperkalemia stimulates the release of aldosterone, while hypokalemia reduces its production.
The following all cause HYPOkalemia, and we will see high ECF or high BP. However, select all of the following where you would see low renin and low aldosterone?
A. Increased ENaC: Liddle Syndrome
B. Decreased B-hydroxysteroid Dehydrogenase
C. Adrenal Tumor or hypoplasia
D. Congenital Adrenal hyperplasia
E. Renin-secreting tumor
A. Increased ENaC: Liddle Syndrome
B. Decreased B-hydroxysteroid Dehydrogenase
The following all cause HYPOkalemia, and we will see high ECF or high BP. However, select all of the following where you would see low renin and high aldosterone?
A. Increased ENaC: Liddle Syndrome
B. Decreased B-hydroxysteroid Dehydrogenase
C. Adrenal Tumor or hypoplasia
D. Congenital Adrenal hyperplasia
E. Renin-secreting tumor
C. Adrenal Tumor or hypoplasia
D. Congenital Adrenal hyperplasia
The following all cause HYPOkalemia, and we will see high ECF or high BP. However, select all of the following where you would see high renin and high aldosterone?
A. Increased ENaC: Liddle Syndrome
B. Decreased B-hydroxysteroid Dehydrogenase
C. Adrenal Tumor or hypoplasia (
D. Congenital Adrenal hyperplasia(17-hydroxylase deficiency)
E. Renin-secreting tumor
Renin-secreting tumor
The following can cause HYPERkalemia. Which of the following would we see high renin and high aldosterone with low or normal BP?
A. Decreased ENaC
B. Hypoaldosteronism (adrenal insufficiency)
C. Hyporenin-Hypoaldosteronism (beta-blockers)
Decreased ENaC
The following can cause HYPERkalemia. Which of the following would we see high renin and low aldosterone?
A. Decreased ENaC
B. Hypoaldosteronism (adrenal insufficiency)
C. Hyporenin-Hypoaldosteronism (beta-blockers)
Hypoaldosteronism (adrenal insufficiency)
The following can cause HYPERkalemia. Which of the following would we see low renin and low aldosterone?
A. Decreased ENaC
B. Hypoaldosteronism (adrenal insufficiency)
C. Hyporenin-Hypoaldosteronism (beta-blockers)
Hyporenin-Hypoaldosteronism (beta-blockers)
A decrease in plasma concentration of Ca2+ causes a direct increase in which of the following hormones?
A. Aldosterone
B. Active Vitamin D
C. Vasopressin
D. PTH
PTH
Which of the following would you see in acidemia in regards to calcium?
A. Increase in free ionized calcium
B. Decrease in free ionized calcium
C. No change in calcium
Increase in free ionized calcium
- this happens because in low pH less Ca2+ is bound to albumin
Which of the following type of acid base abnormalities are you most liekly to see accompanied by hypocalcemia?
A. Acidemia
B. Alkalemia
Alkalemia
T/F: Low extracellular calcium (hypocalcemia) reduces the threshold for sodium channels to evoke an AP, thus increasing membrane excitability
True
T/F: To maintain calcium balance the kidneys must excrete the same amount of calcium that the GI tract absorbs
True
T/F: Calcium and phosphate are directly proportional because their extracellular concentrations are regulated by two different hormones
False; inversely proportional - same hormones
Overall the affect of PTH is to increase calcium reabsorption and decrease urinary calcium excretion. In what location along the nephron does PTH enact its influence?
Thick Ascending Limb of LOH
Familial Hypocalciuric Hypercalcemia (FHH) is an autosomal dominant disorder that causes inactivation of CaSR in the parathyroid glands, as well as parallel Ca2+ receptors in ascending limb of the kidney. Which of the following accurately portays the results of this disorder?
A. PTH: decrease, Serum Ca2+: Increase, Urine Ca2+: decrease, Phosphate: Normal, Vitamin D: Normal
B. PTH: N/increase, Serum Ca2+: decrease, Urine Ca2+: decrease, Phosphate: Normal, Vitamin D: Normal
C. PTH: N/increase, Serum Ca2+: Increase, Urine Ca2+: decrease, Phosphate: decrease, Vitamin D: decrease
D. PTH: N/increase, Serum Ca2+: Increase, Urine Ca2+: decrease, Phosphate: Normal, Vitamin D: Normal
D. PTH: N/increase, Serum Ca2+: Increase, Urine Ca2+: decrease, Phosphate: Normal, Vitamin D: Normal
