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Renal I Final > Regulation of Body Fluid: Regulation of Water Balance (L) > Flashcards

Regulation of Body Fluid: Regulation of Water Balance (L) Flashcards

1
Q

What condition describes fluid leaving the loop of henle?

A

Hypotonic

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2
Q

What is the maximum osmolarity of the interstitium?

A

1200-1400 mOsm

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3
Q

What condition describes tubular fluid entering the Proximal convoluted tubule?

A

Isotonic

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4
Q

What is the concentration difference always between the ascending loop of henle and the interstitium?

A

200 mOsm

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5
Q

What are the functions of the vasa recta?

A
  1. Supply blood, oxygen, and nutrients to the Medulla.

2. Remove water and solutes that get added to the interstitium

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6
Q

What is the effect of an increase in blood flow through the vasa recta?

A

Decrease in medullary gradient
- Decreases salt and solute transport by nephrons
(“medullary washout”)

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7
Q

Where are UT-A1 and UT-A3 located in the nephron?

A

Inner medullary Collecting Duct
UT-A1 is on the apical side
UT-A3 is on the basolateral side

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8
Q

Where is the UT-A2 receptor located?

A

Thin Ascending Loop of Henle

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9
Q

How is urea recycled throughout the nephron?

A

Urea can be reabsorbed through the collecting duct via UT-A1 and UT-A3 receptors. It is then taken back up into the ascending loop of henle via UT-A2.

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10
Q

In which part of the nephron does ADH influence the permeability of water

A

Collecting duct

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11
Q

Where is ADH produced?

A

Hypothalamus

Supraoptic Nuclei and Paraventricular nuclei

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12
Q

Where is ADH secreted?

A

Posterior pituitary

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13
Q

What two responses are initiated by osmoreceptors?

A
  1. ADH release (happens quicker than #2)

2. Increased thirst

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14
Q

What is the net effect of ADH on principle cells?

A

Reabsorption of water, Cl-, and Na+

Secretion of K+

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15
Q

What receptors does ADH have an effect on?

A

Na-K ATPase: Reabsorption of Na and secretion of K

Aquaporin 2 channels: Reabsorption of water

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16
Q

Where are AQ-2 channels located?

A

Apical side of principle cells

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17
Q

What is the net effect of ADH on Intercalated cells?

A

Increase K+ reabsorption

H+ secretion

18
Q

What effect does Aldosterone have on intercalated cells?

A

Increases H+ secretion via H-ATPase

19
Q

Where is Aldosterone secreted?

A

Adrenal cortex

20
Q

What is aldosterone secreted in response to?

A

AGT II
Increased plasma K+ concentration
Decreased Na+ plasma concentration

21
Q

What happens during Neurogenic Diabetes Insipidus?

A

Pt can’t produce ADH

**Buzzword = head injury

22
Q

What happens during Nephrogenic Diabetes Insipidus

A

Kidneys fail to respond to ADH, OR Countercurrent multiplier fails to establish a osmotic gradient

23
Q

Tx for Neurogenic Diabetes Insipidus

A

Desmopression

(ADH analog, acts on V2 receptors) –> results in rapid response

24
Q

How do you distinguish between Neurogenic and Nephrogenic DI in a patient?

A

Administer Desmopression:

If there is a rapid response: Neurogenic
If there is no rapid response: Nephrogenic

25
Q

What two drugs can also lead to nephrogenic DI?

A

Lithium and Tetracyclin

26
Q

What are 4 effects of an increased ECF that happens in patients with SIADH?

A
  1. Reduced plasma osmolarity
  2. Dilutional hyponatremia
  3. Diminished aldosterone secretion
  4. Elevated GFR
27
Q

Urine output:

DI vs. SIADH

A

DI: Increased urine output
SIADH: Decreased Urine output

28
Q

ADH Levels:

DI vs. SIADH

A

DI: Low ADH
SIADH: High ADH

29
Q

Natremia:

DI vs. SIADH

A

DI: Hypernatremia
SIADH: Hyponatremia

30
Q

Hydration:

DI vs. SIADH

A

DI: Dehydration
SIADH: Overhydration

31
Q

Fluid Loss or Retention

DI vs. SIADH

A

DI: Fluid Loss
SIADH: Fluid Retention

32
Q

Polyuria

A

Excessive urine production

Greater than 2.5 L/day

33
Q

Oliguria

A

Too little urine production

Less than 300-500 ml/day

34
Q

Causes of polyuria

A 
Diabetes mellitus
Diabetes insipidus
Caffee and alcohol
Diuretics
Sickle cell anemia
35
Q

Causes of Oliguria

A

Dehydration
Blood loss
Diarrhea
Cardiogenic shock

36
Q

Anuria

A

Basically no urine production

Less than 50 mL/ day

37
Q

Causes of Anuria

A

Kidney failure
Kidney stones/ tumors
Obstructions
Englarged prostate

38
Q

Normal urine production

A

1-2 L/day

39
Q

Causes of Hyponatremia

A 
Volume depletion
Circulated depletion
SIADH
H2O Intoxication
Low solute intake
40
Q

Causes of Hypernatremia

A 
Water depletion
Osmotic diuresis
Diabetes insipidus
Salt intoxication
Impaired thirst

Renal I Final (7 decks)

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