SG Water Handling

Question 1

Where does ADH act upon?

Answer 1

the collecting tubule

Question 2

What is the definition of orthostatic hypotension?

Answer 2

the BP drops by 10+ points from sitting to standing, and the HR increased by 10+ points from sitting to standing

Question 3

What will the total body water be in a hypertonic state?

Answer 3

it can go either direction

Question 4

What will the serum Na be in hypovolemia, hypervolemia, and euvolemia, respectively?

Answer 4

• VERY increased in hypo
• normal in hyper and eu

Question 5

Name the 3 subcategories in a hypotonic state.

Answer 5

1. hypovolemia
2. hypervolemia
3. euvolemia

Question 6

What is the definition of central DI?

Answer 6

no ADH is produced

Question 7

What is the equation to calculate serum osmolality?

Answer 7

Serum osmolality = (2xNa) + BUN/2.8 + glu/18

Question 8

What will the urine Na be in hypovolemia, hypervolemia, and euvolemia, respectively?

Answer 8

• decreased in hypo
• depends on the cause in hyper
• increased in eu

Question 9

For every increase of 100mEq of glucose, there will be an increase of _____ of ______ above normal.

Answer 9

1.6mEq of serum Na

Question 10

What is the normal urine osmolality value?

Answer 10

300-400

Question 11

When do you use the corrected Na formula?

Answer 11

if the serum glucose is abnormal

Question 12

What will the serum Na be in a hypertonic state?

Answer 12

increased

Question 13

For every increase of _____ of ______, there will be an increase of 1.6mEq of serum Na above normal.

Answer 13

100mEq of glucose

Question 14

What is the normal value for serum Na? If the corrected Na doesn’t equal this value, what does that tell you?

Answer 14

• 140
• something else has to be wrong other than the abnormal glucose

Question 15

What will the treatment be for a hypertonic state?

Answer 15

treat the underlying problem

Question 16

What syndrome can occur if hyponatremia is corrected too quickly in a chronic setting?

Answer 16

central pontine demyelination

Question 17

What is nephrogenic DI?

Answer 17

the kidney fails to respond to ADH

Question 18

Tell me about chlorpropamide.

Answer 18

• a sulfonurea that increases the action of insulin
• used to treat DMII
• not used anymore bc of side effects

Question 19

What happens when ADH is in excess?

Answer 19

water is retained in spite of the body not needing it and serum sodium decreases

Question 20

What will the total body water be in hypovolemia, hypervolemia, and euvolemia, respectively?

Answer 20

• decreased in hypo
• VERY VERY increased in hyper
• a little increased in eu

Question 21

Name the drug:

a phenothiazine serotonin antagonist used to treat schizo and psychosis not used anymore bc it causes heart arrhythmias

Answer 21

Thioridazine (Mellaril or Melleril)

Question 22

Tell me about Haloperidol (Haldol).

Answer 22

• a butyrophenone derivative that is an inverse agonist of dopamine
• used to treat schizo, psychosis, mania, chorea, Tourette etc
• Extrapyramidal side effects

Question 23

What is the tx for hypovolemia, hypervolemia, and euvolemia, respectively?

Answer 23

• isotonic saline in hypo
• diuretics in hyper
• restricted water intake and ADH blockers in eu

Question 24

Tell me about Thioridazine (Mellaril or Melleril).

Answer 24

• a phenothiazine serotonin antagonist
• used to treat schizo and psychosis
• not used anymore bc it causes heart arrhythmias

Question 25

What are some causes of hypertonic states?

Answer 25

excess osmolarity, usually from HYPERGLYCEMIA but also can be uremia or EtOH

Question 26

What happens to the urine when ADH is blocked?

Answer 26

low urine osmolarity (maximally diluted)

Question 27

Name the drug:

a butyrophenone derivative that is an inverse agonist of dopamine used to treat schizo, psychosis, mania, chorea, Tourette etc Extrapyramidal side effects

Answer 27

Haloperidol (Haldol)

Question 28

Name the drug.

a sulfonurea that increases the action of insulin used to treat DMII not used anymore bc of side effects

Answer 28

chlorpropamide

Question 29

A normally functioning kidney maximally filters ___L per day.

Answer 29

24

Question 30

In an isotonic state, what does a normal osmolarity tell you?

Answer 30

that a lab problem has occured

Question 31

What will the urine Na be in a hypertonic state?

Answer 31

increased