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Urology > Regulation of ECF > Flashcards

Regulation of ECF Flashcards

1
Q

what are the major ECF osmoles?

A

> sodium

> chlorine

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2
Q

what are the major ICF osmoles?

A

potassium

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3
Q

what are the immediate effects of increased slat and water loss from vomiting and diarrhoea?

A 
decreased:
> peripheral volume
> venous pressure
> venous return
> atrial pressure
> end diastolic volume
> systolic volume
> cardiac out put
> blood pressure
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4
Q

what is the effect of decreased atrial pressure and decreased carotid sinus baroreceptor inhibition of sympathetic discharge on osmolarity?

A

hypoosmolarity occurs due to the increase in ADH

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5
Q

what is the effect of decreased carotid sinus baroreceptor inhibition of sympathetic discharge?

A

> increased ADH
increased sympathetic vasoconstriction
increased total peripheral resistance
increased blood pressure

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6
Q

what is the effect of angiotensin 2 on na+ reabsorption?

A

increased Na+ reabsorption from the proximal tubule

due to greater reabsorpative forces in the peritubular capillaries

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7
Q

true or false:

angiotensin 2 decreases the peritubular capillary hydrostatic pressure

A

true

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8
Q

true or false:

increase in aldosterone causes an decrease in distal tubule reabsorption

A

false it causes and increase

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9
Q

where are juxtaglomerular cells found?

A

the smooth muscle of the media of the afferent arteriole just before it enters the glomerulus

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10
Q

describe juxtaglomerular cells

A

large epithelial cells filled with granules

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11
Q

what do juxtaglomerular cells produce?

A

renin

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12
Q

what forms the juxtaglomerular apparatus?

A

> juxtaglomerular cells

> macula dense

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13
Q

where are macula densa found?

A

loop of the distal tubule

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14
Q

what Is the rate limiting step in the rennin-angiotensin-aldosterone system?

A

angiotensinogen being converted into angiotensin 1 on the plasma

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15
Q

what converts angiotensin 1 into angiotensin 2?

A

angiotensin converting enzyme

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16
Q

what 4 things does angiotensin 2 act on?

A

> arterioles
cardiovascular control centre in the medulla oblongata
hypothalamus
zona glomerulosa

17
Q

how does angiotensin 2 cause an increase in blood pressure?

A

> vasoconstriction

> increased cardiovascular response

18
Q

what effect does angiotensin 2 have on the hypothalamus?

A

> increase ADH secretion

> increased thirst

19
Q

what is the effect of angiotensin 2 on the zona glomerulosa?

A

> increased aldosterone release

20
Q

how does angiotensin 2 increase volume and osmolarity?

A

> increased ADH
increased thirst
Increased Na+ reabsorption

21
Q

where in angiotensin converting enzyme found?

A

in vascular endothelium

22
Q

what increases renin release?

A

> decrease in NaCl delivery
increase in sympathetic nerve activity
decrease in pressure in afferent arteriole at the level of the juxtaglomerular cells

23
Q

what causes a decrease in renin release?

A

> feedback of angiotensin 2
ADH (inhibits renin release)
increased NaCl delivery

24
Q

how does tubuloglomerular feedback contribute to GFR consistency?

A

> GFR increases so the flow through the tubule increase
flow past the macula densa increases creating paracrine effects from the macula densa to the afferent arteriole
the afferent arteriole then constricts decreasing the GFR

25
Q

what are the opposing inputs to ADH secretion in a patient who drinks 2L of pure water after losing 3l of salt and water?

A

> decrease in ECF osmolarity causes inhibition of ADH via osmoreceptors
increase in ECF volume causes increase in ADH via baroreceptors

26
Q

what is corrected first osmolarity or ECV?

A

ECV as an emergency mechanism to save brain perfusion

27
Q

what does atrial natriuretic peptide promote?

A

Na+ excretion

28
Q

what is known as aldosterone escape?

A

volume expansion due to aldosterone stimulates ANP from atrial cells causing a loss of Na+ and H20

29
Q

what does aldosterone continue to cause even after ANP kicks in?

A

K+ Secretion

30
Q

in Conn’s syndrome primary hyperaldosteronsim leads to what effect of potassium and sodium?

A

> potassium depletion

> no Na+ change

31
Q

what is the effect of atrial stretch of ANP?

A

increased secretion

32
Q

what is the effect of ANP on the hypothalamus?

A

less ADH

33
Q

what is the effect of ANP on the kidney?

A

> increased GFR
increased NaCl and H20 excretion
decreased renin

34
Q

what is the effect of ANP on the adrenal cortex?

A

less aldosterone

35
Q

how does ANP affect blood pressure?

A

decreases it

Urology (9 decks)

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