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Physiology > Exam 4: Intro to Diuretics and Renal Disease > Flashcards

Exam 4: Intro to Diuretics and Renal Disease Flashcards

1
Q

What are diuretics used for?

A

Control ECF volume (hypertension and edema)
Increase urine volume output
Lower ECF volume

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2
Q

What are the different diuretic types?

A 
Osmotic
Loop blockers
Thiazide diuretics
Carbonic anhydrase inhibitors
Aldosterone antagonist
Na+ channel blocker
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3
Q

What do osmotic diuretics do?

A

Increase tubular osmolarity

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4
Q

What is an example of osmotic diuretics?

A

Mannitol

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5
Q

What do loop blockers diuretics do?

A

Inhibit Na, K, Cl cotransport

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6
Q

What is an example of loop blocker diuretics?

A

Furosemide

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7
Q

What does furosemide do?

A

Block concentration and diluting ability

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8
Q

What do thiazide diuretics do?

A

Inhibit Na and Cl cotransport

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9
Q

What is an example of thiazide diuretics?

A

Hydrochlorothiazide

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10
Q

What do carbonic anhydrase inhibitors do?

A

Inhibit H+ secretion and bicarb reabsorption thereby blocking Na reabsorption

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11
Q

What is an example of carbonic anhydrase inhibitors?

A

Acetazolamide

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12
Q

What do aldosterone antagonist diuretics do?

A

Block aldosterone receptor

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13
Q

What is an example of aldosterone antagonist diuretics?

A

Spironolactone

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14
Q

What do Na channel blocker diuretics do?

A

Block Na entry

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15
Q

What is an example of Na channel blocker diuretics?

A

Amiloride

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16
Q

What are the 2 reasons that loop diuretics raise urine output out of electrolytes?

A

They greatly increase the quantities of solutes derived to the distal parts of the nephrons, and these acts as osmotic agents prevent water reabsorption
They disrupt the countercurrent multiplier system by decreasing absorption of ions from the loop into the medullary interstitium, thereby decreasing the osmolarity of the medullary interstitial fluid

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17
Q

What happens with uremia?

A

Accumulation of nitrogenous waster products

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18
Q

What happens with hyperkalemia?

A

Arrhythmias and other neuromuscular dysfunction

19
Q

What does acidosis affect?

A

CNS function and all cell processes

20
Q

What causes acidosis?

A

Retention of hydrogen ions and organic acids, loss of bicarb

21
Q

What happens with hypertension or hypotension?

A

Failure to excrete or conserve Na and H2O
Failure to produce renin leading to no angiotensin
Edema or dehydration

22
Q

What hormone does anemia effect?

A

Renal erythropoietic factor

23
Q

What does osteomalacia effect?

A

Vitamin D

24
Q

What are subclinical renal disease signs?

A

None

25
Q

What are clinical renal disease signs?

A 
General malaise
Inappetence
Polyuria/polydipsia
Weight loss
Weak and lethargic
Hypertension
Edema
26
Q

What things are critical in the improvement of quality of life of chronic renal failure?

A

Control of hypertension

Anemia

27
Q

Describe prerenal disease

A

Diminished renal blood flow

28
Q

Is hypertension a common problem as a common cause of renal disease?

A

No, it is more a common result of renal disease

29
Q

What does uncontrolled hypertension do?

A

Worsen renal disease

30
Q

Is primary or secondary hypertension more common?

A

Secondary

31
Q

What are examples of postrenal disease?

A

Nephrolith-diminished filtration affected nephrons
Ureter-diminished filtration effected kidney
Urethra-diminished filtration both kidneys
Vessiculo-uretral reflux can result in pyelonephritis

32
Q

What is creatinine created by?

A

Metabolism

33
Q

What is creatinine filtered by?

A

Glomerulus

34
Q

Is creatinine reabsorbed?

A

No

35
Q

What happens with nephron loss?

A 
Decreased filtration capacity
Decreased overall creatinine clearance
Creatinine doubles in concentration
New equilibrium at high Cr concentration
Greater BP which lads to greater GFR
36
Q

How do you calculate Urine Prot/Cr ratio?

A

Ur_prot / Ur_Cr

37
Q

How do you calculate GGT/Cr ratio or LDH/Cr ratio?

A

Ur_GGT or LDH / (Ur_Cr x 0.01)

38
Q

How do you calculate the fraction excretion of electrolytes?

A

((P_Cr / U_Cr) x (U_x / P_x)) x 100

39
Q

How do you calculate creatinine clearance?

A

(U_Cr x V) / P_Cr

40
Q

What are the normal urine protein/creatinine ratios?

A

Dog’s is less than 0.5
Cat’s is less than 0.4
Horse’s is around 0.3

41
Q

What are the normal levels of GGT/Cr ratio?

A

0-25 IU GGT/g Cr

42
Q

What are the normal levels of LDH/Cr ratio?

A

Up to 12 IU LDH/g Cr

43
Q

What are the normal levels of the sodium fraction excretion?

A

Less than 0.8 to 1%

Physiology (70 decks)

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