Jan4 M1-Water balance Flashcards

1
Q

ref phgy individual weight and body water

A

70kg. 60%. 42L

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2
Q

how much fluid goes IV if give 1L water in IV compartment

A

83ml. 1/12

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3
Q

body fluid compartments and values

A

IC: 8/12
IS: 3/12
IV: 1/12

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4
Q

daily water intake and output value

A

2550 mL

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5
Q

daily urine output and insensible losses

A

1500 mL urine. 900 mL insensible losses

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6
Q

water in the PCT

A

(67%) NaK ATPase drives Na movement. Water follows (tight junctions and aquaporins)

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7
Q

normal ECF osmolality (or osmolarity same thing)

A

275-290 mOsm/kg

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8
Q

osmolality equation (blood)

A

Nax2 + urea + glucose = 275-290

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9
Q

urea and alcohol osmotically active or inactive + def of that

A

urea: inactive (crosses cell membrane)
alcohol: active. add to equation if present

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10
Q

ADH type of hormone + produced where and released where

A

peptide. group of hypothalamic neurons. released from posterior pituitary

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11
Q

ADH acts how (exact names of receptors and proteins)

A

binds to V2 receptors in the collecting duct to stimulate the insertion of aquaporin-2 channels in the luminal membrane

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12
Q

2 stimuli to ADH release and sensed where

A

hypertonicity, sensed by osmoreceptors in the hypothalamus

hypovolemia, sensed by carotid sinus. signals hypothalamus

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13
Q

osmolality threshold for ADH release

A

290 or more

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14
Q

how much water reabso at CD when no ADH and consequence

A

none. water diuresis. CD is impermeable to water

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15
Q

diabetes insipidus pathophgy

A

malfunction of ADH system. ADH not released or doesn’t bind receptor. urine high in water

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16
Q

DI can happen when

A

head injury or post neuro procedure

17
Q

2 main components of water regulation

A

permability to CD to water via ADH

high osm of medullary interstitium

18
Q

osmolality of the filtrate in Bowman’s space

A

same as blood (275-290)

19
Q

what nephrons do the high osm in the medullary interstitium and % they represent

A

juxtamedullary glomeruli (or corpuscules)

20
Q

% of juxtamedullary glomeruli vs not and loop of Henle in each

A

20% juxtamedullary: loop of Henle is in medulla + vasa recta with it
80% short loop of Henle and is in the cortex

21
Q

max urine osms

22
Q

osms in diff parts of the nephron when ADH active vs when inactive

A
PCT: 300
DL: 600 to 1200
AL: 1200 to 100
DCT: 100
CT and CD: 300 to 1200. if no ADH, osm of 50 in CT and CD.
23
Q

tDL and TAL: what they are permeable to (most importantly)

A

tDL: water and not salt
TAL: salt and not water

24
Q

filtrate osms as enters DCT

A

100 mosm/L

25
how filtrate osms goes from 1200 to 100 in AL
Na-Cl cotransporters pull Na and Cl into interstitium
26
function of vasa recta and why the shape
take extra water and solutes back in the blood | shape avoids losses of solute gradient from interstitium
27
2 portions of vasa recta and osms in them
descending limb of vasa recta: 300 to 1200 | ascending limb of vasa recta: 1200 to 300
28
vasa recta: what is the net reabsorption
only the water and solute net abso by the medullary tubules
29
water reabso in %
67% PCT 15% tDL 0% in TAL and DCT ADH for the rest in CT (CCD) and CD (MCD)
30
furosemide site of action
inhibits Na-K-2Cl cotransporter in TAL by binding Cl site
31
medullary interstitium and urine osmolality in patients on furosemide
300
32
osms in different parts of the nephrons when on furosemide with ADH and without ADH
with and without ADH: 300 in all tubules
33
why osms don't increase in tDL when on furosemide
no osmotic gradient to pull water in interstitium