Renal Labs Part 2 (Exam 4) Flashcards

1
Q

What is the primary circulating cation? (extracellular cation)

A

Na

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2
Q

What is the normal range for sodium?

A

136-145 mEq/L

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3
Q

How does sodium indicate free body water?

A

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

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4
Q

What ion is a major contributor to plasma osmolality?

A

Na

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5
Q

What is a normal serum osmolality?

A

280-295mOsm/kg H2O

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6
Q

What hormone regulates body water and osmolality?

A

Antidiuretic hormone

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7
Q

What stimulates ADH?

A

Increased osmolality
Hypovolemia
Thirst

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8
Q

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

A

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

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9
Q

Name a few conditions that would cause increased serum osmolality.

A
Hypernatremia
Hyperglycemia
Ketosis
Dehydration
Diabetes insipidus
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10
Q

Name 2 conditions that would cause decreased serum osmolality.

A

Overhydration

SIADH

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11
Q

Common cause of SIADH?

A

Iatrogenic causes

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12
Q

Diabetes insipidus is caused by?

A

Inadequate amount of ADH present

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13
Q

Symptoms of diabetes insipidus

A

Increased thirst, polyuria, dilute urine

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14
Q

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

A

Urine osmolality

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15
Q

Name 2 conditions that would increase urine osmolality?

A

SIADH

CHF

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16
Q

Name 2 causes of decreased urine osmolality?

A

Diabetes insipidus

Excess fluid intake

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17
Q

What is more worrisome, hyponatremia or hypernatremia?

A

Hyponatremia

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18
Q

Serum sodium below ____ is hyponatremia?

A

136

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19
Q

What are the two types of hyponatremia?

A

Sodium depletion

Dilutional

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20
Q

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

A

120

21
Q

Symptoms of hyponatremia?

A

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

22
Q

Serum sodium above ____ is hypernatremia.

A

145

23
Q

Causes of hypernatremia?

A

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

24
Q

Treatment for hypernatremia?

A

Rehydration

25
Q

What test distinguishes between renal and nonrenal causes of hyponatremia?

A

Urine sodium

26
Q

What are the three categories of hyponatremia?

A

Isotonic hypovolemia
Hypotonic hyponatremia
Hypertonic hyponatremia

27
Q

Causes of isotonic hyponatremia?

A

Hyperproteinemia

Hyperlipidemia

28
Q

Causes of hypertonic hyponatremia?

A

Hyperglycemia

Contrast agents

29
Q

Hypotonic hyponatremia is further categorized into what 3 categories?

A

Hypovolemic hypotonic hyponatremia
Euvolemic hypotonic hyponatremia
Hypervolemic hypotonic hyponatremia

30
Q

Causes of hypervolemic hypotonic hypernatremia?

A

Edema
CHF
Advanced renal failure
liver disease

31
Q

Causes of euvolemic hypotonic hyponatremia?

A

SAIDH

Postop hyponatremia

32
Q

Hypovolemic hypotonic hyponatremia can be caused by?

A

Dehydration, nausea, vomiting (U Na < 10)

Renal salt loss (U Na >20)

33
Q

What is the primary intracellular cation?

A

Potassium (K)

34
Q

Normal range for K?

A

3.5-5.5

35
Q

Potassium plays and important role is _____ function

A

Cardiac muscle

36
Q

Symptoms of kypokalemia?

A

Malaise, skeletal muscle weakness, arrythmias

37
Q

EKG findings in hypokalemia?

A

Flattened or inverted T waves

38
Q

Causes of hypokalemia?

A
Diuretic usage
Burns
Glucose administration
Licorice ingestion
Aldosterone excess (enhances K excretion)
39
Q

Causes of kyperkalemia?

A

Renal failure
Acidosis
ACEIs
Hemolysis

40
Q

Symptoms of hyperkalemia?

A

Arrhythmias, cardiac arrest, numbness, tingling, weakness

41
Q

EKG findings in hyperkalemia?

A

Peaked T waves

42
Q

Most abundant extracellular ion?

A

Chloride

43
Q

Normal range of chloride?

A

96-106

44
Q

Conditions that would increase chloride levels?

A

Dehydration

Metabolic acidosis

45
Q

Conditions that would decrease chloride levels?

A

Overhydration
SIADH
Vomiting

46
Q

What is the primary buffer system of the body?

A

Carbonic acid/bicarbonate system

47
Q

Carbonic acid is regulated by?

A

The lungs

48
Q

Bicarbonate is regulated by?

A

The kidneys