Physio 2 Flashcards
PTH - Affects what part of Nephron? Function?
1) PCT - inhibits Na/phosphate cotransport (P excerted)
2) DCT increases Ca/Na exchange - increases Ca resorption
ATII - Affects what part of Nephron? Function?
PCT and DCT. increases Na/H exchange, increases HCO3 - can cause alkylosis.
TAL of nephron - resorbs?
Mg and Ca
Na, K, Cl
ALDO- Affects what part of Nephron? Function?
Collecting tubules - inserts Na channels
ADH - Affects what part of Nephron? Function?
collecting ducts - inserts aquaporins on luminal surface
Renin released in response to? By what cells?
decreased BP (JG cells) decreased NA (Macula Densa cells) increased SNS (B1 receptors)
ATII converted by enzyme produced by?
Lungs/kidney
ACE - function other than AT conversion?
inhibits bradykinin
ATII acts where? (6)
1) AT receptors in SMC (vasoconstriction increases BP)
2) Constricts EA of kidney (up FF, but WITH compensatory Na resorption)
3) Adrenal gland (produced ALDO)
4) Post Pit (release of ADH)
5) PCT (increases Na/H activity)
6) Hypothal - thirst
Mech for molecule released in response to increased volume?
ANP: increases cGMP in SMC, which will relax renal arteries, increasing GFR and decreasing renin (increasing GFR means increasing Na filtration without increasing Na resorption - loss of Na)
Primarily regulates osmolarity?
ADH
Primarily regulates volume?
ALDO
EPO released by?
intersitial cells in the peritubular capillary bed
Name and Location of enzyme that convert 25-OH Vit D to 1,25 VitD?
1a-hydroxylase. PCT cells.
Fuctions in the kidney to vasodilate the AA to increase GFR?
Prostaglandins.
Can cause acture renal failure by constriction of AA?
NSAIDs - inhibit prostaglandins
Shifts K out of Cells?
Digitalis, hyperOsmolarity, Insulin deficiency, Lysis of cells Acidosis, B-adrenergic antagonist
DO insulin LAB
Insulin - affect on K?
pushes it into cells (INsulin INto cells)
U waves and Flattened T-waves on EKG? Suspect?
low K; Flatttened T waves because of impaired repol
Wide QRS and peaked (huge) T waves
hyperK
Pt with tetany and seizures?
HypoCa
Pt with tetany and arrhythias?
hypoMg
Pt with bone loss and increased osteoid. Electrolyte disturbance?
hypoPO4 (from not enough vit D)
Pt with Stupor with nausea and malaise?
HypoNa
Pt with stupor and irritability?
hyperNa
Pt with bone pain, anxiety, altered mental status, and abdominal pain?
hyperCa (stone, bones, groans, and psychiatric overtones)
Pt with decreasedDTRs, bradycardia, hypotension, hypoCa going into cardiac arrest?
hyperMg
Pt with hypoCa and metastatic cacifications with renal stones?
HyperPO4
Henderson-Hasselbalch?
pH = 6.1 +log(HCO3/.03Pco2)
Predicted respiratory compensation for a simple met acidosis?
Pco2 = 3/2 (HCO3)+8
Anion gap?
Na-Cl-HCO3
pH<7.4 and Pco2>40; Causes?
Respiratory Acidosis
Hypoventilation (lung disease, opioids, weak muscles, obstruction)
pH<7.4, anion gap over 12; causes?
Met Acidosis - MUDPILESS Methanol (formic acid) Uremia DKA Propylene glycol Iron tablets/INH Lactic acidosis Ethylene glycol Salicylates (later) Shock/infarction
pH<7.4, anion gap of 10; causes?
Met Acidosis - HARDASS Hyperalimentation Addison's disease Renal tubular acidosis Diarrhea Acetazolamide Spirolactone Saline
pH>7.4 and Pco2<40; causes?
Respiratory Alk - SHH
early salicylates, Hyperventilation, high altitude,
pH>7.4 and Pco2>40
Met Alk - LAVA Loop Diuretics Antacid Vomiting AyperALDO
Pt has Urine pH>5.5, hypoK. Defect? Risk of?
Distal Renal tubular acidosis - cannot excrete H.
Risk of CaPO4 stones and bone resorption
Urine pH<5.5. HypoK. Defect? Risk of?
Proximal RTA. Defect in HCO3 resorption (drags out k). Increased risk for hypophosphatemic rickets
pt with Fanconi’s. May develope (re: kidneys)
Proximal tubles RTA (cant resorb HCO3)
Pt with Low Mg : causes?
Alcoholism, diarrhea, aminoglycosides, diuretics
pt with hyperK and low urine pH?
RTA from hypoALDO.
