PODA OYEKAN Renal Sys

Question 1

Which 4 systems control neurohumoral response?

Answer 1

RAAS or renin-angiotensin aldosterone system

ADH

Renal sympathetic nerves

Natriuretic peptides

Question 2

Which hormones operate when there is a DECREASE in intravascular volume?

Answer 2

RAAS

ADH/Vasopressin

and

Renal sympathetic and nerves

Question 3

_________ operate when there is an increase in intravascular volume.

Answer 3

Natriuretic peptides

Question 4

_______ bind to high affinity to NPR-A

Answer 4

ANP and BNP

Question 5

TorF: CNP binds with low affinity to NPR-B

Answer 5

False. CNP binds with high affinity to NPR-B

Question 6

ANP stimulates ______________ which ___________cGMP and causes relaxation

Answer 6

ANP stimulates guanylate cyclase which INCREASES cGMP and causes relaxation

Question 7

TorF: Natriuetic peptides dilate afferent arteriole but constrict efferent arteriole

Answer 7

True. Dilate afferent arteriole but constrict efferent arteriole which INCREASES intraglomerular pressure and INCREASE GFR

Question 8

TorF: Vasopressin decreases water absorption in the collecting duct

Answer 8

False. INCREASE water reabsorption in the collecting duct by CONSTRICTION of arterioles

Question 9

V1 + Gq = CONSTRICTION of Arterioles

V2 + Gs = water REABSORPTION

which leads to

Answer 9

Gs: INCREASE cAMP

INCREASE PKA

INCREASE PHOSPHORYLATION OF AQUAPORIN-2 VESSELS

INCREASE REABSORPTION

Question 10

TorF: Renal sympathetic nerves increase intravascular volume

Answer 10

False. DECREASE VOLUME via renal nerves

Renin release leads to constriction of afferent arterioles which decreases GFR and DECREASE natriuresis

Question 11

Heart failure

Answer 11

↑preload (intravascular volume) ↑afterload (vascular resistance) —->↓Cardiac output, DECREASED renal blood flow —> CONGESTION

Question 12

Right heart failure—>

Answer 12

peripheral edema

Question 13

Left heart failure

Answer 13

pulmonary edema

Question 14

What are the RF for HF?

Answer 14

ischemic heart disease and hypertension

Question 15

Inability of the heart to provide adequate blood flow into the pulmonary circulation at a normal central venous pressure

Answer 15

RIGHT HEART FAILURE

Question 16

Inability of the heart to generate adequate cardiac output to perfuse vital tissues

Answer 16

Left heart failure

Question 17

What are the goals for heart failure?

Answer 17

Increase contractility

Reduce preload

Reduce afterload

Question 18

Standard therapy for HF =

Answer 18

ACEI, Loop diuretic +/- digoxin

Question 19

CIRRHOSIS

Answer 19

A disease caused by hepatic parenchymal fibrosis resulting from chronic inflammation or hepatotoxic insult

Question 20

Fibrosis

Answer 20

obstruction of venous outflow from the liver leading to increased hydrostatic pressure in the portal vein

Question 21

Hepatocellular injury

Answer 21

disturbed hepatic function =

• DECREASED albumin production
• DECREASED synthesis and secretion of peptide hormones
• DECREASED synthesis of coagulation factors—> increased bleeding

Question 22

Nephrotic Syndrome

Answer 22

• Excretion of 3.0 g or more of protein in urine

* Protein excretion as a result of glomerular injury

Question 23

Clinical manifestations of nephrotic syndrome

Answer 23

• Hypoalbuminemia
• Hypercholesterolemia
• Peripheral edema
• Prone to infection