Renal VI: Sodium and Water Handling Pathophysiology Flashcards
_____ diabetes insipidus: results from collecting duct not appropriately responding to ADH
Nephrogenic
_____ diabetes insipidus: results from deficiency of ADH and responds to administration of AVP
Central
Causes of decreased total body sodium hypernatremia (3)
Diuretics, severe burns, GI losses
Causes of edema (4)
CHF, nephrotic syndrome, cirrhosis, primary hormone excess
Causes of euvolemic hyponatremia (4)
Primary polydipsia, adrenal insufficiency, hypothyroidism, SIADH
Causes of hypernatremia (3)
Decreased, Normal, or Increased total body sodium categories
Causes of hypertonic hyponatremia (2)
Mannitol administration, hyperglycemia
Causes of hypervolemic hyponatremia (5)
CHF, hepatic cirrhosis, nephrotic syndrome, AKI, CKD
Causes of hypotonic hyponatremia (3)
Hypovolemic, euvolemic, or hypervolemic categories
Causes of hypovolemic hyponatremia (3)
GI losses, renal losses, diuretics
Causes of increased total body sodium hypernatremia (1)
Hypertonic fluid intake
Causes of isotonic hyponatremia (1)
Lab artifact
Causes of normal total body sodium hypernatremia (1)
Diabetes insipidus
High-pressure baroreceptors are located in the _______.
carotid body, aortic body
In glomerulotubular balance, the fractional excretion of sodium is ______ with an increase in GFR
constant
In hyperglycemia, an increase in serum glucose by 100 mg/dL results in a _____ in Na by ____
decrease; 1.6mEq/L
In hypernatremia, the urine sodium is _____ if the cause is renal in origin.
> 20mEq/L
In hypovolemic hyponatremia, the urine sodium is ____ if the cause is renal in origin.
> 20mEq/L
In tubuloglomerular feedback, increased delivery of sodium to the _______ results in vaso_____ of the afferent arteriole
macula densa; constriction
Intrarenal baroreceptors are located in the ______.
Juxtaglomerular Apparatus
Low-pressure baroreceptors are located in the _______.
atria, LV, and pulmonary vascular bed
Sosm =
2[Na] + BUN/2.8 + Glucose/18
What is the site and mechanism of action for acetazolamide?
Proximal Tubule; Inhibits Na/H exchanger
What is the site and mechanism of action for furosemide?
Loop of Henle; Inhibits Na/K/2Cl cotransporter
What is the site and mechanism of action for spironolactone?
Collecting duct; competitive inhibitor of aldosterone
What is the site and mechanism of action for thiazide diuretics?
Distal tubule; Inhibits Na/Cl cotransporter
What is the site and mechanism of action for triamterene or amiloride?
Collecting duct; inhibit sodium channels
When replacing fluids, the fluid infused should be _______.
Similar to the fluid lost
