session 4 Flashcards

1
Q

response to raise in BP

A

-release in ANP to inhibit NaKATPase and ENaC

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2
Q

response to reduction in BP

A
  • prostoglandin release to remove systemic vasoconstriction

- RAAS activated

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3
Q

when does congestive cardiac failure occur

A

the heart muscle pump cannot cope with its qorkload

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4
Q

how does congestive cardiac failure cause oedema

A
  • heart cannot pump blood leading to kidney hypoperfusion, and so oedema
  • kidneys sense this as hypovolemia. retain NaCL and water to increase circulating volume, increasing oedema firther
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5
Q

management congestive heart failure

A

diuretics, ACE inhibitors, nitrates, vasodilators

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6
Q

causes hypervolaemia

A

kidney retention of Na+ and water, excessive sodium intake, cirrhosiis

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7
Q

what is hypertensive renal disease

A

when increase in BP is transferred to the kidney/glomerulus.
- arteriosclerosis of major renal arteries
- hyalinisation of small vesssels
leads to chronic renal damage and reduction in kidney size

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8
Q

where are osmoreceptors located

A

hypothalamus, OVLT

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9
Q

how do osmoreceptors work

A

fenestrated leaky epithelium exposed to systemic circulation, sense changes in plasma osmolarity. lead to changes in ADH and thirst

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10
Q

how is ADH formed

A

synthesised in supraoptic nucleus of hypothalamus as large precursos. transported to posterior pit where its syntehsis is completed

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11
Q

effects of ADH

A

V1 receptor- blood vessel vasoconstrition

V2 receptor- reduced water excretion. create more aquaporims.

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12
Q

diabetes insipidus

A

the inability to reabsorb water from nephron due to failure of secretion or action of ADH

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13
Q

symptoms diabetes insipidus

A

polyuria, polydypsia, low urine osmolality

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14
Q

2 types of DI

A

nephrogenic, central

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15
Q

causes central DI

A

damage to hypothalamus or pituitary causing impaired ADH secretion or synthesis. caused by brain injury or tumour.

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16
Q

how to treat central DI

A

administering ADH (desmopressin) or ADH injections/nasal spray

17
Q

what is nephrogenic DI

A

acquired insensitivity of kidney to ADH. water inadequately absorbed from collecting ducts so large quantity of urine produced.

18
Q

how to manage nephrogenic DI

A

low salt, low protein diet

19
Q

what is SIADH

A

syndrome of innapropriate ADH secretion. excessive reelease.

20
Q

symptoms SIADH

A
  • dilutional hyponatremia causing lowered plasma sodium and raised total body fluid
  • innapropriate urine osmolality
  • inappropriate Na+ secretion
21
Q

cause SIADH

A

stroke, malignancy, lung disease

22
Q

what is hypernatremia

A

plasma [Na] > 146mmol/L, increased solute:water ratio in body fluids and increased serum osmolality.

23
Q

causes hypernatremia

A

osmotic diuresis, fluid loss, DI, incorrect IV, primary aldosteronism

24
Q

what is hyponatremia

A

serum concentration of Na below 130/135mmol/L

25
Q

symptoms hyponatremia

A

agitation, nausea, focal neurology, coma

26
Q

causes hyponatremia

A

diuretics, water overload, increased ADH. D+V, burns

27
Q

normal serum osmolality

A

275-295mosm/kg

28
Q

what is hypovolemic hyponatremia

A

low volume, low sodium (not caused by increased fluid)

29
Q

causes of hypovolemic hyponatremia

A

Gi losses eg. vomiting, excessive sweating, cerebral sat wasting syndrome

30
Q

treatment hypovolemic hyponatremia

A

fluid restriction

31
Q

effect of aldosterone on bp, where produced and where act

A

increase BP, adrenal gland, DCT

32
Q

what class of hormone is aldosterone

A

steroid

33
Q

action of ADH

A

upregulation of aquaporin channels in CD

34
Q

which part of loop of henle is impremeable to water

A

thin and thick ascending limbs