Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Physiology II > Renal Physiology: Acid Base Disorders > Flashcards

Renal Physiology: Acid Base Disorders Flashcards

1
Q

Normal anion gap is…

A

8-16

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

anion gap is calculated by…

A

Sodium - (Cl- + bicarb)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What causes of metabolic acidosis would maintain a normal anion gap?

A

simple bicarb loss due to diarrhea or RTAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What increases to meet the drop in bicarb in metabolic acidosis with a normal anion gap?

A

chloride increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When does the anion gap increase?

A

acidosis of fixed acid accumulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some examples of substances that would increase the anion gap, pushing downward the concentration of bicarb without allowing adjustment to chloride?

A

Lactic acid, oxalic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which RTA is this?

H+-ATPase activity reduced

generalized failure of alpha-intercalated cells

A

Type I, distal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which RTA is this?

Sodium-Hydrogen Antiporter activity reduced

A

Type II, proximal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which RTA is this?

reduced NH4+ formation

due to hyperkalemia secondary to aldosterone deficiency

glutamin enzymes inhibited

A

Type IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which RTA is this?

Metabolic acidosis

Hypokalemia

Normal anion gap

A

Type I, distal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The below mechanism represents which RTA?

Impaired H-ATPase

Decreased H+ secretion

Decreased bicarb recovery

Chronic metabolic acidosis

A

Type I, Distal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which RTA is this?

Caused by Toxins, genetics

Loss of bicarbonate recovery

Impaired H+ secretion

Less severe than type I

Normal anion gap

A

Type II, proximal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Type II RTA is caused by a defective _______ in what region of the nephron?

A

Sodium-Hydrogen Antiport

Proximal Convoluted Tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The below mechanism represents which RTA?

Decreased H+ secretion and bicarb recovery

Mild results in decreased plasma bicarb and mild acidemia
——
Severe results in urinary sodium loss, RAAS activation,

Increased potassium secretion and hypokalemia

A

type II, proximal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which RTA is this?

impaired bicarb generation

metabolic acidosis

hyperkalemia

inhibition of renal glutaminase

aldosterone deficiency

normal anion gap

A

Type IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is characteristic of type IV RTA?

A

hyperkalemia

Aldosterone deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

In type IV RTA, inhibition of renal glutaminase impairs formation of ____

A

NH4+

18
Q

Type IV RTA is correlated with Aldosterone deficiency. How does aldosterone deficiency lead to acidosis?

A

Decreased CD H+-ATPase activity leads to decreased H+ secretion

Decreased sodium reabsorption leads to decreased potassium secretion

Hyperkalemia inhibits glutaminase, leading to decreased NH4+ leading to acidosis

19
Q

The following would have what effect on anion gap?

lactic acidosis
ketoacidosis
renal failure
salicylate poisoning
ehtylene glycol poisoning
methanol poisoning
A

Increased anion gap

20
Q

renal failure can be secondary to accumulation of which acids?

A

phosphoric and sulphuric acids

21
Q

Patient presents with:

Otherwise healthy
severe HA
Muscle Weakness
HTN Urgency

this presentation is concerning for…

A

Conn syndrome

22
Q

A patient has the following labs concerning for:

Decreased potassium
Increased potassium excretion

Increased bicarb
increased pH
Increased PCO2

Increased serum aldosterone
decreased plasma renin

A

Conn Syndrome

23
Q

What should you expect to see on UA with Conn syndrome?

A

Elevated potassium

24
Q

What should you expect to see on blood work with Conn Syndrome?

A

Decreased potassium

Increased bicarb
increased pH
Increased PCO2

Increased serum aldosterone
decreased plasma renin

25
Q

What causes the HTN in Conn’s syndrome that differentiates it from pheo?

A

ECF expansion, not catecholamine production

26
Q

Hyperaldosteronism in Conn’s syndrome causes increased ____ retention, leading to ______ excretion

A

sodium retention, potassium excretion

27
Q

What is responsible for the increased plasma bicarb in conn’s syndrom?

A

aldo stimulating H+-ATPase leading to H+ secretion and bicarb reabsorption

28
Q

Conn syndrome causes what type of acid base disturbance?

A

partially compensated metabolic alkalosis

29
Q

A patient has the following labs concerning for…

Elevated potassium
Profoundly elevate glucose
Profoundly decreased bicarb
Decreased pH

Increased osmolality
decreased PCO2

Increased urine flow
glucose in urine
Ketones in urine

Increased Cosm
Increased anion gap

A

DKA

30
Q

What causes hypotension, tachy, sunken eyes and veins in DKA?

A

diuresis due to glucose in filtered load

31
Q

What causes the hyperkalemia in DKA?

A

low insulin promotes potassium efflux

Hyperosmolarity promotes efflux

32
Q

The volume depletion in DKa has what effect on hormones?

A

RAAS activation

Hyperosmotic blood leads to ADH

33
Q

Patient presents with:

Severe vomiting x 3 days
BP 100/60

Orthostatic BP
Decreased turgor
Dry membranes

This is concerning for…

A

Contraction alkalosis

34
Q

A patient with the following labs and hx of vomiting should be concerning for…

Decreased potassium
Decreased Chloride
Increased bicarb
Increased PCO2
Increased pH
A

Contraction alkalosis

35
Q

what acid/base disturbance is present with contraction alkalosis?

A

partially compensated metabolic alkalosis

36
Q

Prolonged vomiting causes loss of what three factors>

A

HCl

Fluid

Potassium

37
Q

What causes the maintained alkalosis with severe vomiting

A

volume contraction and hypokalemia

38
Q

Vomiting can cause a decreased volume and subsequent activation of RAAS.

This leads to what results with AT II and Aldosterone?

A

AT II stimulates bicarb reabsorption via Na-H antiport stimulation

Aldo stimulates H+-ATPase stimulation and potassium from principal cells

39
Q

What causes the hypokalemia in contraction alkalosis?

A

aldosterone stimulated, increases alkalosis and potassium secretion

40
Q

Is contraction alkalosis responsive to saline?

A

yes

Physiology II (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions