Renal Labs Part 2

Question 1

What is the primary circulating cation? (extracellular cation)

Answer 1

Na

Question 2

What is the normal range for sodium?

Answer 2

136-145 mEq/L

Question 3

How does sodium indicate free body water?

Answer 3

When free water is increased, Na is diluted and Na levels decrease.
When free water is decreased, Na is concentrated and levels increase.

Question 4

What ion is a major contributor to plasma osmolality?

Answer 4

Na

Question 5

What is a normal serum osmolality?

Answer 5

280-295mOsm/kg H2O

Question 6

What hormone regulates body water and osmolality?

Answer 6

Antidiuretic hormone

Question 7

What stimulates ADH?

Answer 7

Increased osmolality
Hypovolemia
Thirst

Question 8

By what mechanism does ADH cause the body to hold onto water?

Answer 8

Increases the permeability in the collecting tubule allowing more water to be reabsorbed

Question 9

Name a few conditions that would cause increased serum osmolality.

Answer 9

Hypernatremia
Hyperglycemia
Ketosis
Dehydration
Diabetes insipidus

Question 10

Name 2 conditions that would cause decreased serum osmolality.

Answer 10

Overhydration

SIADH

Question 11

Common cause of SIADH?

Answer 11

Iatrogenic causes

Question 12

Diabetes insipidus is caused by?

Answer 12

Inadequate amount of ADH present

Question 13

Symptoms of diabetes insipidus

Answer 13

Increased thirst, polyuria, dilute urine

Question 14

What test evaluates the ability of the kidney to concentrate urine?

Answer 14

Urine osmolality

Question 15

Name 2 conditions that would increase urine osmolality?

Answer 15

SIADH

CHF

Question 16

Name 2 causes of decreased urine osmolality?

Answer 16

Diabetes insipidus

Excess fluid intake

Question 17

What is more worrisome, hyponatremia or hypernatremia?

Answer 17

Hyponatremia

Question 18

Serum sodium below ____ is hyponatremia?

Answer 18

136

Question 19

What are the two types of hyponatremia?

Answer 19

Sodium depletion

Dilutional

Question 20

Symptoms of hyponatremia typically are not seen until serum sodium below ____

Answer 20

120

Question 21

Symptoms of hyponatremia?

Answer 21

lethargy, nausea, muscle cramps, and the bad one: cerebral edema

Question 22

Serum sodium above ____ is hypernatremia.

Answer 22

145

Question 23

Causes of hypernatremia?

Answer 23

Impaired thirst (dementia, stroke), water loss without sodium loss (burns), and dehydration

Question 24

Treatment for hypernatremia?

Answer 24

Rehydration

Question 25

What test distinguishes between renal and nonrenal causes of hyponatremia?

Answer 25

Urine sodium

Question 26

What are the three categories of hyponatremia?

Answer 26

Isotonic hyponatremia Hypotonic hyponatremia Hypertonic hyponatremia

Question 27

Causes of isotonic hyponatremia?

Answer 27

Hyperproteinemia | Hyperlipidemia

Question 28

Causes of hypertonic hyponatremia?

Answer 28

Hyperglycemia | Contrast agents

Question 29

Hypotonic hyponatremia is further categorized into what 3 categories?

Answer 29

Hypovolemic hypotonic hyponatremia Euvolemic hypotonic hyponatremia Hypervolemic hypotonic hyponatremia

Question 30

Causes of hypervolemic hypotonic hyponatremia?

Answer 30

Edema CHF Advanced renal failure liver disease

Question 31

Causes of euvolemic hypotonic hyponatremia?

Answer 31

SAIDH | Postop hyponatremia

Question 32

Hypovolemic hypotonic hyponatremia can be caused by?

Answer 32

Dehydration, nausea, vomiting (U Na < 10) | Renal salt loss (U Na >20)

Question 33

What is the primary intracellular cation?

Answer 33

Potassium (K)

Question 34

Normal range for K?

Answer 34

3.5-5.5

Question 35

Potassium plays an important role in_____ function

Answer 35

Cardiac muscle

Question 36

Symptoms of hypokalemia?

Answer 36

Malaise, skeletal muscle weakness, arrythmias

Question 37

EKG findings in hypokalemia?

Answer 37

Flattened or inverted T waves

Question 38

Causes of hypokalemia?

Answer 38

``` Diuretic usage Burns Glucose administration Licorice ingestion Aldosterone excess (enhances K excretion) ```

Question 39

Causes of hyperkalemia?

Answer 39

Renal failure Acidosis ACEIs Hemolysis

Question 40

Symptoms of hyperkalemia?

Answer 40

Arrhythmias, cardiac arrest, numbness, tingling, weakness

Question 41

EKG findings in hyperkalemia?

Answer 41

Peaked T waves

Question 42

Most abundant extracellular ion?

Answer 42

Chloride

Question 43

Normal range of chloride?

Answer 43

96-106

Question 44

Conditions that would increase chloride levels?

Answer 44

Dehydration | Metabolic acidosis

Question 45

Conditions that would decrease chloride levels?

Answer 45

Overhydration SIADH Vomiting

Question 46

What is the primary buffer system of the body?

Answer 46

Carbonic acid/bicarbonate system

Question 47

Carbonic acid is regulated by?

Answer 47

The lungs

Question 48

Bicarbonate is regulated by?

Answer 48

The kidneys