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Renal 8 Flashcards

1
Q

Effects of Angiotensin 2

A

Increased Cardiac output
Increased Na+ Reabsorbtion
Thirst
Increased vasopressin secretion
Increased peripheral vasoconstriction
Stimulus: Low blood pressure

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2
Q

Thirst is controlled by

A

Hypothalamus

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3
Q

What are the sources of increasing thirst

A

Increased blood osmolarity
Decreased blood volume
Decreased blood pressure
Dry mouth

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4
Q

Behavioural mechnaisms for salt intake

A

increased aldosterone
increased angiotensin 2

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5
Q

Avoidance behaviours

A

Helps prevent dehydration

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6
Q

CV system responds

A

To blood volume and blood pressure

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7
Q

Renal responds to

A

Blood volume and blood osmolarity

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8
Q

increase osmolarity and increase blood volume

A

When eating salty popcorn. Ingesting more salt than water. Ingestion of hypertonic saline

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9
Q

How do kidneys resolve increase osmolarity and increased blood volume

A

By excreting hyperosmotic urine

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10
Q

Increased volume and no change in osmolarity

A

If salt and water are ingestes equally to isotonic solution

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11
Q

Increase volume and decreased osmolarity

A

Simply drinking pure water
Kidneys cannot excrete pure water

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12
Q

No volume increased osmolarity

A

Kidneys created concentrated urine
Thirst is triggered
Eating salt without drinking water, increases ECF osmolarity

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13
Q

No change in volume decreased osmolarity

A

if you are sweating. can lead to hypokalemia or hyponatremia

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14
Q

Decrease volume Increased osmolarity

A

Dehydration. due to excessive excersie or sweating or diarrhea
Can result in inadequate perfusion (decreased blood volume) and cell dysfunction
You want to increase water intake

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15
Q

Decrease volume no chnage osmolarity

A

Hemorrhage
Need blood transfusion

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16
Q

Decrease volume Decrease dehydration

A

May be due to incomplete dehydration

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17
Q

Dehydration is due to

A

Decreased blood pressure and increased osmolarity

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18
Q

Dehydration is restored by

A
  1. Conserving fluid to prevent additional loss
  2. Trigger cardiovascular reflexes to incrase blood pressure
  3. Stimulate thirst so normal fluid volume and osmolarity can be restored
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19
Q

ANP release in stimulated by

A

Increased blood volume

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20
Q

Renin - angiotensin is stimulated by

A

Decreased blood volume

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21
Q

Increase in osmolarity

A

Inhibits aldosterone release

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22
Q

What senses dehydration in CVVCC

A

Cartoid and aortic baroreceptors

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23
Q

how does CVCC respond to dehydration

A

Heart rate goes up as SA node controls shifts from parasympathetic to sympathetic.
2. Force of ventricular contraction increases from sympathetic stimulation
3. Sympathetic input to arterioles increases peripheral resistance (Vasoconstriction)
4. Sympathetic vasoconstriction of afferent arterioles in kidney decreses GFR, coserving fluid
5. Increased sympathetic activity at granular cells increases renin seretion

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24
Q

Direcr responses of Low blood pressure

A

Decreases blood pressure directly decreases GFR
Paracrine feedback at macula densa cells causees granular cells to release renin
Granular cells respond to decreased blood pressure by releasing renin
Decreased blood pressure, and increased osmolarity and increased ang 2 stimulate vasopressin and the thirst centers at hypothalamus
ANG 2 reinforces CV response

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25
Results of blood pressure mechanisms
1. Rapid attmept by the CVCC to maintain blood pressure 2. Restoration of volume by water conservation and fluis intake 3. Restoration of normal osmolarity by decreased na+ reabsorbtion and increased water reabsorbtion and intake
26
pH of solution
Is a measurement of H+ Concentration
27
pH of 7
Neutral
28
A Change of 1 pH represents
10 fold change in H+ concentration
29
Normal pH
in ECF is 7.38-7.42
30
pH chnages can
Denature proteins
31
low pH
Acidosis (CNS depression, cofusion and coma)
32
High pH
Alkalosis (Hykerexcitability) Sustained respiratory muscle contracttion
33
Body is exposed
To more acid than base
34
The largest source of acid is
Production of CO2 from aerobic metabolism
35
pH homeostasis depends on 3 mechanisms
1. Buffers (First line of defence) 2. Vnetilation (handles 75% of disturnamces) 3. Renal regulation of H+ and HCO3 (lowest)
36
Intracellular buffers
Hemoglobin
37
Major extracellular buffer
HCO3 itself
38
Which of the following occurs during dehydration
Decreased aldosterone release Increased vasopressin release Increased ANG II released Increased Sympathetic Decreased ANC
39
Buffer systems include
Proteins, phosphate ions and HCO3 -
40
Intracellular buffer
Hemoglobin
41
most important extracellular buffer system
Bicarbonate
42
Increased CO2
Equilibrium shifts to right It creates one hydrogen and one bicarbonate
43
Increased hydrogen
Bicarbonate acts as a buffer creating carbonic acid. Function within a narrow range.
44
Increased in CO2
Hypoventilation (Right Shift)
45
Decrease CO2
Hyperventilation (Left shift)
46
Rate of breathing increases when
Decreases plasma H+ and increased plasma CO2
47
Kidneys respond to disturbances
Slowly Directly Indirectly
48
how do you do it directly
By altering excretion or reabsorbtion of H+
49
How do you do it indirectly
By changing the rate at which HCO3- buffer is reabsorbed or secreted
50
Hydrogen is not
Filteres
51
The proximal tubule
secretes H+ and reabsorbs HCO3-
52
Glutamine
Metabolizes to ammonium and HCO3
53
The distal nephron
Controls acid secretion and initial portion of the collecting duct
54
Type A intercalated cells
During acidosis There is excess hydrogen and co2 Goal is to secrete hydrogen Also result in hyperkalemis
55
Type B interclated cells
During Alkalosis HCO3 and K+ is secreted Hypokalemia
56
Acidosis
More acidic
56
Types of Acid/base disturbances
Respiratory Metabolic
56
Collecting duct
Plays a significant role in the fine regulation of acid base balance
56
Alkalosis
More basic
57
Respiratory acidosis
Increased CO2 and H+ Occurs in Alveloar hypoventilation results in CO2 retention and elevated plasma CO2
58
What causes acidosis
Pulmonary fibrosis Skeletal muscle disorders Muscle dystrophy
59
How is respiratory acidosis fixed
Must occur via Renal mechanisms
60
Respiratory alkalosis
Decreased CO2 Decreased H+ Less commON Result of hyperventilation
61
Metabolic acidosis
Excessive acid intake Excessive metabolic production of hydrogen Can be due to ketoacidosis Excessive Bicarbonate loss (Diarrhea)
62
Metabolic Alkalosis
Excessive vomiting of acidic stomach contents or excessive ingestion of bicarbonate ccontaining antacids

BMSC208 (20 decks)

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