Renal System and Diuretics

Question 0

CHF, renal failure and cirrhosis make patients more susceptible to what?

Answer 0

Fluid overload

Question 1

What is the normal fractional excretion of Na? (FENa)

Answer 1

FENa < 1%

Question 2

T or F. Na is mostly reabsorbed isotonically.

Answer 2

True. Water follows the Na

Question 3

T or F. Diuretics do not work on patients with renal failure because the diuretic is unable to get into the renal tubule, which is the site of action.

Answer 3

True

Question 4

T or F. K is the main electrolyte in your vasculature.

Answer 4

False. Na is the main electrolyte in your vasculature. Na=140, K=4

Question 5

Which two diuretics work in the proximal convoluted tubule and the proximal straight tubule?

Answer 5

Mannitol and Acetazolamide

Question 6

Which 3 diuretics work in the thick ascending limb of the loop of Henle?

Answer 6

Bumetanide, Ethacrynic Acid, Furosemide

Question 7

What 2 diuretics work in the distal convoluted tubule?

Answer 7

Thiazide, Metolazone

Question 8

What 3 diuretics work in the collecting ducts?

Answer 8

Amiloride, Spironolactone, Triamterene

Question 9

Where does Acetazolamide (Diamox) work and what is the mechanism of action?

Answer 9

It works in the proximal convoluted tubule and is a Carbonic Anhydrase inhibitor. It reverses the Na/H pump. Na reabsorption is inhibited, and water follows Na.

Question 10

Which diuretic is described by the following:

Carbonic Anhydrase inhibition
Alkaline urine + hyperchloremic metabolic acidosis
Cross sensitivity with sulfa

Answer 10

Acetazolamide

Question 11

Which diuretic is characterized by the following:

freely filtered and poorly absorbed
increases renal tubular osmolarity
limits passive water reabsorption that follows active Na reabsorption

Answer 11

Mannitol

Question 12

Which diuretic is characterized by the following:

draws water from cells into plasma -> increased RBF
can lead to fluid overload/pulm edema, hypoNa->hyperNa

Answer 12

Mannitol

Question 13

Which diuretic is characterized by the following:

can be used to decrease formation of CSF and aqueous humor

Answer 13

Acetazolamide

Question 14

Which diuretic is characterized by the following:

prevents salt reabsorption in the thick ascending limb of the Loop of Henle
binds to Cl site
possibility of oto-toxicity

Answer 14

Loop Diuretics:

Furosemide (lasix), Bumetanide (Bumex), Torsemide(demadex)

Question 15

Which diuretic is characterized by the following:

relieve congestion, pulmonary edema, swelling and peripheral edema

Answer 15

Loop Diuretics:

Furosemide (lasix), Bumetanide (Bumex), Torsemide(demadex)

Question 16

Which diuretic is characterized by the following:

First line treatment for acute CHF

Answer 16

loop diuretics

Question 17

Which diuretic is characterized by the following:

Side effects = hypoNa, hypoK, hypovolemia

Answer 17

loop diuretics

Question 18

Which diuretic is characterized by the following:

Diuretics that work here are responsible for 25% of Na reabsorption

Answer 18

loop diuretics

Question 19

Which diuretic is characterized by the following:

Block NaCl reabsorption
Large Na gradient in the distal tubules -> K excretion

Answer 19

Thiazides (HCTZ)

Question 20

Which diuretic is characterized by the following:

Treatment for HTN, volume overload, and pregnancy associated edema - initial effect is due to decreased extracellular volume but sustained effect is due to peripheral vasodilation

Answer 20

HCTZ

Question 21

Which diuretic is characterized by the following:

Side Effects: hypoNa, hypoK, orthostatic HTN

Hypokalemic hypochloremic metabolic alkalosis

Answer 21

HCTZ

Question 22

Amiloride and Triamterene are what type of diuretics?

Answer 22

K sparing

Question 23

What is the mechanism of action of Amiloride and where is its site of action?

Answer 23

Distal collecting ducts - K sparing. Block epithelial Na channels to prevent reabsorption of NA. Inhibit K secretion into renal tubules

Question 24

Which diuretic is characterized by the following:

Often used in combination with loop/thiazide diuretics

Answer 24

K sparing diuretics - Amiloride and triamterene

Question 25

Which diuretic is characterized by the following:

Block epithelial Na Channels to prevent Na reabsorption
Inhibit K secretion into renal distal tubules
Side effects: hypoNa, HyperK

Answer 25

K sparing (Amiloride and Triamterene)

Question 26

Which diuretic is characterized by the following:

Inhibits reabsorption of Na, causes K retention
Effective treatment in volume overload w/ heart failure, cirrhosis
Commonly combined w/ other antihypertensive agents
Side Effects: hypoNa, HyperK, gynecomastia

Answer 26

Spironolactone