Renal phys Flashcards
RPF, GFR, FF (GFR/RPF) in afferent arteriole constriction
RPF: down
GFR: up
FF: constant
RPF, GFR, FF (GFR/RPF) in efferent arteriole constriction
RPF: down
GFR: up
FF: up
RPF, GFR, FF (GFR/RPF) in increased plasma protein concentration
RPF: constant
GFR: down
FF: down
RPF, GFR, FF (GFR/RPF) in decreased plasma protein concentration
RPF: constant
GFR: up
FF: up
RPF, GFR, FF (GFR/RPF) in constriction of ureter
RPF: constant
GFR: down
FF: down
What shifts K+ out of cell causing hyperkalemia?
Digitalis HyperOsmolarity Insulin deficiency Lysis of cells Acidosis β-adrenergic antagonist
Patient with hyperkalemia? DO Insulin LAβ
work.
What shifts K+ into cells causing hypokalemia?
Hypo-osmolarity
Insulin (increase Na+/K+ ATPase)
Alkalosis
β-adrenergic agonist (increase Na+/K+ ATPase)
INsulin shifts K+ INto cells
What will S/Sx a low serum concentration of Na+? high serum concentration?
Low:Nausea and malaise, stupor, coma
High: Irritability, stupor, coma
What will S/Sx a low serum concentration of K+? high serum concentration?
Low: U waves on ECG, flattened T waves, arrhythmias, muscle weakness
High: Wide QRS and peaked T waves on ECG, arrhythmias, muscle weakness
What will S/Sx a low serum concentration of Ca+? high serum concentration?
Low: Tetany, seizures, QT prolongation
High: Stones (renal), bones (pain), groans (abdominal pain), psychiatric overtones (anxiety, altered mental status), but not necessarily calciuria
What will S/Sx a low serum concentration of Mg+? high serum concentration?
Low: Tetany, torsades de pointes
High: decreased DTRs, lethargy, bradycardia, hypotension, cardiac arrest, hypocalcemia
What will S/Sx a low serum concentration of PO4-? high serum concentration?
Low: Bone loss, osteomalacia
High: Renal stones, metastatic calcifications, hypocalcemia
Give the pH, PCO2, HCO3 & compensatory response for metabolic acidosis
pH: down
PCO2: down
HCO: down (most imp)
Compensatory: immediate hyperventilate
Give the pH, PCO2, HCO3 & compensatory response for metabolic alkalosis
pH: up
PCO2: up
HCO: up (most imp)
Compensatory: immediate hypoventilate
Give the pH, PCO2, HCO3 & compensatory response for respiratory acidosis
pH: down
PCO2: up (most imp)
HCO: up
Compensatory: delayed increased renal HCO3 reabsorb
Give the pH, PCO2, HCO3 & compensatory response for respiratory alkalosis
pH: up
PCO2: down (most imp)
HCO: low
Compensatory: decreased renal HCO3 reabsorb
Differentiate acidosis/alkalosis by checking arterial pH & if compensation has occurred
pH < 7.4 => PCO2 > 40mmHg => respiratory acidosis
pH < 7.4 => PCO2 < 40mmHg => metabolic acidosis w/ hypervent
pH >7.4 => PCO2 > 40mmHg => metabolic alkalosis w/ hypovent
pH > 7.4 => PCO < 40mmHg => respiratory alkalosis
What are causes of respiratory acidosis?
hypoventiliation due to => airway obstruction acute lung dz chronic lung dz opioids, sedatives weakening of respiratory muscles
What are causes of respiratory alkalosis?
hyperventilation due to => hysteria hypoxemia (high altitude) Salicylates (early) Tumor Pulmonary embolism
What are causes of metabolic alkalosis w/ compensation of hypoventilation?
Loop diuretics
Vomiting
Antacid use
Hyperaldosteronism
How do you calculate anion gap? what is normal range?
anion gap = Na+ - (Cl- + HCO3-) => 8-12 mEq/L
What are causes of metabolic acidosis w/ increased anion gap?
MUDPILES: Methanol (formic acid) Uremia DKA Propylene glycol Iron tablets or INH Lactic acidosis Ethylene glycol (oxalic acid) Salicylates (late)
What are causes of normal anion gap metabolic acidosis?
HARD-ASS: Hyperalimentation Addison dz Renal tubular acidosis Diarrhea Acetazolamide Spironolactone Saline infusion
