Renal Part 2 Flashcards
Body fluid distribution
How much is water?
Of water, how much ICF, ECF
Of ECF, how much plasma, how much interstitial
How much is water? 60%
Of that 60% water, how much in ICF/ECF: 40/20
Of ECF, how much interstitial/plasma: 80/20
Defence of toxicity (mechanism to prevent our bodies from becoming toxic)
Which two factors contribute to this defence system?
Which two factors contribute to this?
thirst and vasopressin.
Vasopressin/ADH retains fluid
Osmolality: Na+ plus K+ / Total Body Water
Vasopressin: AKA ADH
Vasopressin actions — what do these do?
V2
V1A
V1B
V_2_: insert aquaporin 2 channels in the CD principle cells, antidiuretic effect
V1A: VAsoconstriction of blood vessels to increase BP
V1B: found in anterior pituitary and causes ACTH release, cortisol & aldosterone = retain water
Vasopressin clinical applications
Diabetes insipidus causes: 2
Symptoms
Describe SIADH: what’s causing it?
Diabetes insipidus causes:
1. Central = deficiency in ADH (hypothalamus tumour/trauma)
2. Nephrogenic = have ADH but kidneys don’t respond
Symptoms: Polydipsia & polyuria
SIADH:
— too much ADH release
— hyponatremia
— pituitary or lung tumour
Defence of volume
What does ANP do?
What does exogenous Ouabain do?
When blood sodium levels and pressure are increased, ANP is secreted from the heart. It binds to its receptor in the kidney and blood vessels, and promotes salt excretion, lowers blood volume and relaxes the vessel.
Naturetic = gets rid of Na+ and water will follow, thus decreasing volume
Exogenous ouabain inhibits the Na+/K+ pump and decreases Na+ excretion
[short answer] Renin-angiotensin system
Walk through the formation of Angiotensin II
Common side effect of ACE inhibitors? Why?
Common side effect of ACE inhibitors? cough
Why? ACE inactivates bradykinin. If you inhibit ACE, Bradykinin can bind to B2 receptors and cause a cough
ACE = angiotensin converting enzyme
Angiotensins: actions and receptors
Where are AT 1a and 1b cells?
Where are AT 1a and 1b cells?
1a are in the blood vessels and brain
1b are in the anterior pituitary and adrenal cortex
Angiotensin and SARS-CoV-2
Effects of aldosterone
Natriuretic hormones
ANP, BNP, CNP
Their goal is to get rid of sodium, so water follow, and volume is reduced
Review questions
ANP recap
Hormonal control of toxicity recap blood tonicity increases
When we have an increase in tonicity, we want to increase volume to dilute solutes
Hormonal control of volume recap blood volume decreases
Hormonal control of volume recap blood volume increases
Kidneys role in pH balance
Secretion of H+ and reabsorption of HCO3-
What does aldosterone do?
Fate of H+ in the urine
Contributors to H+ in the body
[short answer]
[short answer] Ammonia secretion
Steps in I cell for H+ secretion and HCO3- reabsorption as well as NH3 trapping in the urine [short answer]
