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Step 2 Critical Care Course > The Renal System > Flashcards

The Renal System Flashcards

1
Q

What is the functions of the kidneys?

A
  • Fluid balance
  • Electrolyte balance
  • Acid base balance
  • Excretion of waste products
  • Regulation of blood pressure
  • Maintenance of calcium
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2
Q

What is the nephron often referred to as?

A

The functional unit of the kidneys.

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3
Q

What happens in the nephron?

A

Blood is filtered and urine is formed.
There are 3 processes involved:
- Filtration (occurs in the bowman’s capsule)
- Selective reabsorption (PCT)
- Secretion (secreted into tubules by peritubular capillaries)

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4
Q

What are the 4 hormones impacting blood pressure?

A
  • Renin angiotensin
  • Aldosterone
  • Antidiuretic Hormone (ADH)
  • Atrial Natriuretic Peptide (ANP)
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5
Q

What is Aldosterone?

A

Aldosterone is a hormone that increases the reabsorption of sodium and water, and the excretion of potassium.

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6
Q

Where is Aldosterone secreted?

A

The adrenal cortex (outside of the adrenal gland, on top of the kidneys).

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7
Q

How does Aldosterone increase blood pressure?

A

It increases the reabsorption from the tubules and back into the blood therefore, increasing blood pressure.

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8
Q

What is Atrial Natriuretic Peptide (ANP)?

A

ANP is a hormone secreted by the atria of the heart in response to stretching of the atrial wall when blood volume is increased (recognised by baroreceptors).

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9
Q

What does ANP decrease?

A

ANP decreases the reabsorption of sodium and water out of the proximal convoluted tubules and collecting ducts to promote excretion.

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10
Q

What does Atrial Natriuretic Peptide ultimately do?

A

It increasers urinary volume and decreases blood volume. Which ultimately reduces blood pressure.

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11
Q

What is Atrial Natriuretic Peptides “job”?

A

To reduce blood pressure.

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12
Q

What is Antidiuretic Hormone (ADH)?

A

ADH is a hormone which is secreted by the posterior pituitary.

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13
Q

What are the main roles of the Antidiuretic Hormone (ADH)?

A
  • To increase blood pressure by reabsorbing water from the nephron back into blood rather than in urine.
  • Contributes to negative feedback to maintain blood pressure.
  • It increases water reabsorption.
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14
Q

What is diabetes insipidus?

A

Diabetes insipidus is a rare condition where there is a hypo-secretion of ADH.

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15
Q

What occurs in diabetes insipidus?

A
  • Water reabsorption is impaired leading to excessive polyurisis. (Often more than 10 litres a day).
  • Life threatening dehydration occurs.
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16
Q

Is diabetes insipidus a primary or secondary cause?

A

Secondary cause of the hypothalamus.

17
Q

What does RAAS stand for?

A

Renin Angiotensin Aldosterone Systen (RAAS).

18
Q

What is Aldosterone’s effect on blood pressure?

A

Increases blood pressure.

19
Q

What is Atrial Natriuretic Peptide (ANP) effect on blood pressure?

A

Decreases blood pressure.

20
Q

What is Antidiuretic Hormone (ADH) effect on blood pressure?

A

Increases blood pressure.

21
Q

What is Renin Angiotensin effect on blood pressure?

A

Increases blood pressure.

22
Q

What is Aldosterone’s role?

A
  • Increases the reabsorption of sodium and water.
  • Excretion of potassium.
23
Q

What is Atrial Natriuretic Peptide (ANP) role?

A
  • Decreases the reabsorption of sodium and water from PCT and collecting ducts.
  • Increases water absorption.
24
Q

What is Antidiuretic Hormone (ADH) role?

A
  • Increases the permeability of DCT and collecting ducts.
  • Increases water absorption.
25
Q

What is Renin Angiotensin Role?

A
  • Long term blood pressure control.
  • Process of RAAS kicks in.
26
Q

Explain the process of RAAS?

A
  • When there is a drop in blood pressure Renin is released into the blood.
  • Renin converts plasma protein Angiotensinogen into Angiotensinogen 1. This happens in the liver.
  • Angiotensinogen 1 is converted into Angiotensinogen 2 by the Angiotensin Converting Enzyme (ACE). This is produced in the lungs and in the kidneys.
  • Angiotensin 2 is a hormone, which stimulates vasoconstriction of systemic arterioles.
  • Angiotensin 2 stimulates the adrenal cortex to secrete aldosterone.
  • This promotes the reabsorption of sodium in PCT; it acts on the nervous system to:
  • Increase thirst via the hypothalamus.
  • Release ADH in posterior pituitary (water retention).
  • Reduces baroreflex sensitivity so it cannot counteract the RAAS effect.
  • All of this helps to increase blood pressure.
27
Q

What are the 5 different types of Renal Replacement Therapy?

A
  • Continuous Renal Replacement Therapy (CRRT).
  • Continuous Veno-venous Haemofiltration (CVVH).
  • Continuous Veno-venous Haemodialysis (CVVHD).
  • Continuous Veno-venous HaemoDiaFiltration (CVVHDF).
  • Slow continuous Ultrafiltration.

Step 2 Critical Care Course (7 decks)

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