Renal 2A

Question 0

What is the definition of hyperkalemia?

Answer 0

serum K > 5.0 mEq/L

Question 1

What are two ways to drive K into cells?

Answer 1

a. insulin increases K uptake in cells

b. beta-agonists drive K into cells.

Question 2

What is the definition of hypokalemia?

Answer 2

serum K < 3.6 mEq/L

Question 3

Does hypokalemia make cells more or less excitable? Why?

Answer 3

Less. Resting membrane potential is more negative, hence the cells are less excitable.

Question 4

What are some common causes of hyperkalemia?

Answer 4

a. renal failure
b. trauma (crush injuries, marathon running)
c. diabetes bc the pt is resistant to insulin, so K can’t leave the blood (aka- enter the cell)

Question 6

What are some causes of hypokalemia?

Answer 6

a. excess insulin
b. alkalosis
c. diuretics (loop or thiazide)
d. vomiting/diarrhea
e. increased aldosterone levels

Question 7

What can cause an anion gap acidosis?

Answer 7

Methanol
Uremia
Dka
Phenformin, paraldehyde
Iron, infection
Lactic acidosis
Ethylene glycol, ethanol
Salicylates

Question 8

What can cause a nongap acidosis (hyperchloremic)?

Answer 8

Hyperalimentation
Acetazolamide (carbonic anhydrase inhibitor)**
Renal tubular acidosis**
Diarrhea**
Ureteroenteric shunt
Pancreatic fistula

Question 9

Does a high flow rate increase or decrease K+ excretion?

Answer 9

Increase.

Question 10

Does an increase in lumenal anions increase or decrease K+ excretion?

Answer 10

Increase. The charge attracts the K+.

Question 11

Which intercalated cell is an aldosterone target, alpha or beta?

Answer 11

Beta.

Question 12

What does Winter’s fomula tell you? What is it?

Answer 12

It tells you what the pCO2 should be for a metabolic acidosis.

1.5(HCO3) + 8 +/- 2

Question 13

What does it mean if delta AG &laquo_space;delta HCO3?

Answer 13

AG metabolic acidosis and non-gap acidosis.

Question 14

What does it mean if delta AG&raquo_space; delta HCO3

Answer 14

AG metabolic acidosis and metabolic alkalosis

Question 15

Where is ADH made? Where is it stored/released?

Answer 15

Made: hypothalamus

Stored/Released: posterior pituitary

Question 16

Are AQP2, AQP3, and AQP4 found on the apical or basolateral side of the cells in the collecting duct?

Answer 16

AQP2: apical side

AQP3/4: basolateral

Question 17

Tell me 3 things about Fanconi Syndrome.

Answer 17

a. defect in PCT
b. metabolic acidosis (RTA)
c. reabsorption problem: AA, glucose, HCO3, PO4

Question 18

Tell me about 5 things about Bartter Syndrome.

Answer 18

a. reabsorption problem with TAL
b. metabolic alkalosis
c. affects Na/K/2Cl transporter
d. hypokalemia
e. hypercalciuria

Question 19

Tell me 6 things about Gitelman Syndrome.

Answer 19

a. affects DCT
b. reabosorption problem with NaCl
c. hypokalemia
d. metabolic acidosis
e. hypercalciuria
f. like a more mild Bartter

Question 20

Tell me 6 things about Liddle Syndrome.

Answer 20

a. increase Na absorption in CD
b. HTN+
c. hypokalemia
d. metabolic alkalosis
e. decrease in aldosterone
f. treat with amiloride

Question 21

What is the fear when correcting chronic hyponatremia?

Answer 21

Central pontine myelinolysis. Restore at 12mEg/L first 24 hours and 8mEq/L afterwards.