Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Renal > Water, Calcium, Phosphate Biochem > Flashcards

Water, Calcium, Phosphate Biochem Flashcards

1
Q

Exogenous sources of water

A 
Drinking water (1000-1500mL) 
Food 
 Metabolic water (400ml)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Functions of water

A

Reactant - hydrolytic rxns

Transportation of nutrients and waste hormones etc

Regulates body temp

Solvent

Digestion

Lubricant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Body water output

A

Kidney
Skin Evaporation
Exhalation from lungs
Feces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is an electrolytes

A

Substance that’s when is dissolved in solution dissociates into ions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Main electrolytes in intracellular compartment

A

Potassium
magnesium
phosphorus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Main electrolytes in extracellular compartment

A

Sodium
chlorite
bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Sodium concentration in extracellular fluid

A

140 mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Concentration of chloride in extracellular fluids

A

103 mEQ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Total amount of cations and anions

A

155 and 155

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Amount of potassium in intracellular fluid

A

150 mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Amount of phosphorus in intracellular

A

140 meq/l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Total onions and cations in intracellular Street

A

195 and 195

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Most abundant electrolytes in extracellular fluid

A

Sodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Essential electrolytes for not normal membrane accessibility for nerve impulse

A

Potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Electrolytes that regulates osmatic pressure and assist in regulation of acid-base balance

A

Chloride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Electrolytes that promotes nerve impulse and muscle contraction or relaxation

A

Calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Electrolytes that plays a role in carbohydrates and proteins metabolism storage and use of intracellular energy neural transmission

A

Magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is diffusion

A

Movement of particles down a concentration gradient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is osmosis

A

Movement of water across a membrane from less concentrated solution to a more concentrated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is osmolarity

A

Number of moles per liter of solution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is osmolality

A

Number of moles per kilogram of solvent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Plasma osmolality formula

A

2 x plasma Na

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Active transport

A

Movement is absolute across the membrane which requires transporters and energy expenditure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is filtration

A

Transfer of water and salute through a membrane from a region of high pressure to a region of low pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Healthy body amount of water taken in and out every day
2100 milliliters
26
How is solutes homeostasis maintained
Ion transport water movements kidney function
27
Why are you a chemical mechanism that helps regulate water and electrolyte balance
``` The neural mechanism- thirst mechanism Antidiuretic hormone vasopressin raas aldosterone Atrial natriuretic peptide Kinins ```
28
How is thirst mechanism helpful in water electrolyte balance
Low plasma volume So high osmotic pressure because high solite concentration What are drawn from cells to plasma Cellular dehydration which activates thirst center located in hypothalamus Dryness of mouth and pharynx Feeling of thirst and then person drinks water
29
Where is the antidiuretic hormone produced
In the hypothalamus
30
Where is the antidiuretic hormone stored
In the pituitary gland
31
What is the mechanism of ADH
Hi osmolality in plasma ADH secretion promoted ADH act on Renal collecting tubule which promotes reabsorption of water by renal tubules Low urine output
32
When does RAAS works
When blood volume and blood pressure are low
33
Raas mechanism
Decrease blood pressure or blood volume kidney releases renin Renin activates Angiotensinogen produced by the liver to form angiotensin I Angiotensin I is converted to angiotensin II by angiotensinogen converting enzyme produced by the lung Angiotensin II leads to vasoconstriction which increases blood pressure and formation of aldosterone by adrenal cortex which increases water reabsorption
34
Aldosterone action
Increase rate of reabsorption of sodium and chloride Retains water increases potassium loss through urine
35
ANP action
Released when high blood pressure in atria suppresses renin level decreases release of aldosterone decreases ADH release stimulates excretion of sodium and water reduces vascular resistance by causing vasodilation
36
Kinins action
Cause inflammation affect blood pressure increases salt and water excretion
37
Organs involved in water and electrolytes Balance
``` Hypothalamus pituitary gland kidneys liver the lungs adrenal glands cardiac tissue ```
38
Water electrolytes conditions
Dehydration | overhydration
39
What is dehydration
Outputs of water exceeds the water intake which causes reduction of body water below normal level
40
Basic causes of dehydration
No ingestion of water | excessive loss of body fluids
41
Types of dehydration
Primary dehydration with pure water depletion Secondary dehydration with pure salt depletion Mixed dehydration with both water and electrolytes depletion
42
Causes of primary dehydration
Ill patients a week patient who can’t Ingests water mental patients who refuses to drink water, Coma person Person lost in desert or shipwrecked Hypothalamus defect renal tubular disorder diabetes insipidus
43
Main cause of pure water depletion
Lack of water intake
44
Clinical manifestation of pure dehydration
Dry tong pinched faces oligouria Low urine volume
45
Management of pure dehydration
Water to drink by mouth 5% glucose by IV Should never give isotonic saline
46
Most common type of dehydration
Mixed dehydration
47
Causes of mixed dehydration
Severe vomiting or diarrhea
48
Manifestation of mixed dehydration
Feeling of thirst low blood pressure increase blood urea urinary output low
49
Management of mixed dehydration
Mixture of saline and 5% glucose in 11 proportion
50
Secondary dehydration causes
``` Excessive sweating GIT loss of fluids during VOMITING and diarrhea continuous aspiration of G.I. fluids Addison’s disease vigorous use of diuretics ```
51
Manifestation of secondary dehydration
``` Absence of thirst apathetic listless hallucinations confusion anorexia nausea cramps in thigh abdominal and respiratory muscles Sunken eyes inelastic skin low blood pressure decreased GFR and excretion ```
52
Management of secondary dehydration
Administration of isotonic solution normal saline
53
General causes of overhydration
Excess water intake water retention Excessive administration of Parenteral fluids Hyper secretion of ADH administration of narcotics anesthesia which causes secretion of ADH excess aldosterone conn syndrome
54
Manifestation of overhydration
Headache nausea Incoordination of movements delirium
55
Withholding drinking fluids | administration of hypertonic saline IV
56
Edema definition
Excess fluid accumulates in interstitial compartment as response to inflammation, injury, pregnancy, medications
57
Causes of edema
High hydrostatic pressure Low plasma oncotic pressure Increased capillary membrane permeability
58
Reasons for high hydrostatic pressure in edema
Venous obstruction Lymphedema , Cardiac heart failure Renal failure
59
Low plasma oncotic pressure causes
Liver failure Malnutrition Burns
60
Increased capillary membrane permeability causes
Inflammation | Sepsis
61
Types of edema
Generalized edema Organ specific edema Cutaneous pitting edema Non pitting edema
62
Generelized edema defintion and causes
Fluid accumulation that affects entire body ``` CHF Cirrhosis Kidney disease Leg Veins damages Severe Protein deficiency ```
63
Pitting edema causes
Pregnancy Standing or sitting too long Side of effects of some drugs
64
Consequences of edema
``` Water and electrolytes imbalance Impaired blood flow Slow healing High risk of infections Pressures over bony prominences Impaired organ fucntiôn ```
65
Treatment of edema
Treat underlying conditions | Reduce salt amount
66
What is diabete insipidus
Endocrine disorder where theres ADH insuffiency affecting water and electrolyte imbalance
67
Manifestation of dibates insipidus
Excretion of large amounts of severely dilute urine | Excessive thirst
68
Incidence of diabetes insipidis
3/100,000
69
Types of diabetes insipidus
Central DI Nephrogenic DI
70
Central DI
Vasopressin and ADH deficiency
71
Nephrogenic DI
Kidney or nephron dysfunction | They can be insensitive to ADH
72
Manifestation of DI
``` Polyuria Dilute urine Polydypsia Dehydration Electrolyte imbalance ```
73
Diagnosis of DI
Urine osmolarity Urine specific gravity Elevtrolyte concentration in serum and urine Fluid deprivation test
74
Treatment of DI
Desmopressin which is analog of vasopressin Given intranasal or orzl Only works for central DI
75
Addisons disease
Autoimmune and endocrine disorder with hypoadrenocorticism
76
Cause of addison disease
Defect or insuffiency of adrenal glands
77
Incidence of addisons disease
1/100,000
78
Biochemical alterations in addisons disease
Hypoglycemia Hyponatremia Hyperkalemia Hypercalcemia
79
Addisons disease manifestation
``` Low BP Syncope Confusion Psychosis Slurred speech Severe lethargy Convulsions ```
80
Diagnosis of addisons disease
Blood electrolytes of sodium and potassium Blood glucose Blood calcium Blood cortisol levels ACTH Stimulation test With Synthetic pituitary ACTH ( tetracosactide )
81
Addisons disease treatment
``` Iv of glucocorticoids Hydrocortisone tablets Prednisone tablets Iv saline solution with dextrose or glucose Fludrocortisone acetate oral ```
82
Cushings syndrome
Overactivity of adrenal glands causing excess aldosterone and cortisol
83
Incidence of cushing syndrome
1/100,000
84
Biochemical alterations in cushings syndrome
Hyperglycemia Hypernatremia Hypokalemia Hypocalcemia
85
Manifestation of cushing syndrome
``` High BP Weight gain Central obesity Buffalo hump Moon face Insomnia Excess sweating Depression Anxiety ```
86
Diagnosis of cushing syndrome
Blood electrolyte level of sodiul and potassium Blood glucose Blood calcium Blood cortisol
87
Manageemnt of cushing syndrome
Surgical removal if due to adrenal adenomas Ketoconazole Or metyrapone shich inhibits cortisol levels Mifepristone which is antagonist of glucocorticoid type II recept
88
How does stress play into water and electrolyte imbalance
Stress acts on hypothalamus which increase release of ACTH from anterior pituitary which leads to high cortisol and aldosterone and releass of ADH from posterior pituitary Both increase watee retention
89
Blood Diagnostic test ro check fluid and electrolytes imbalance
``` Serum electrolytes Serum creatinine (0.6-1.5 mg/ dl) Blood urea and BUN (8-20 mg/dl) Serum osmolality Serum albumin ( 3.5-5.5 g /dl) Serum hematocrit ( 40-54% for men and 38-47 for women ) ```
90
Urine investigations to do when checking for water elctrolytes imbalances
``` Urine pH Urine specific gravity Urine osmolality Urine creatinine clearance Urine sodium Urine potassium ```
91
Les la contrition of ionic form of calcium and Phosphates
1.3mM FOR BOTH
92
Functions of calcium
``` Cell signaling second messenger neurotransmitter hormone release exocytosis of proteins muscle contraction blood clotting bio mineralization ```
93
Serum presentation of ionic calcium
2.2-2.6 mM
94
Serum concentration of ionic phosphates
0.7 -1.4mM
95
Serum concentration of ionic magnesium
0.8 -1.2mM
96
Organs that play in important role in calcium metabolism
Skeleton G.I. tract kidney
97
What are the Calcitropic hormones
Parathyroid hormone calcitonin vitamin D (1, Dihydroxycholecalciférol) Parathyroid hormone related protein
98
Different form of circulating calcium in the body
``` Potein bound calcium ( inactive, not excreted) ionized calcium (free and active ) complexed calcium ( complexed with phosphate , bicarbonate, citrate ) ```
99
When do you have negative calcium balance
When the output is higher than the intake of calcium
100
What disease can be caused by negative calcium balance
Osteoporosis
101
What is positive calcium balance
When intake of calcium is higher than the output
102
When do you have a positive calcium balance
During growth
103
Is calcium essential or not essential
Essential so cannot synthesize it
104
What happens when the concentration of calcium is low
PTH stimulated which increases parathyroid hormone levels Parathyroid hormone acts on bone to release calcium which increases level of serum calcium level Parathyroid hormone acts on the kidney to release vitamin D which releases calcium and increases calcium level
105
Where is parathyroid hormone synthesized
In the four parathyroid glands
106
What is the action of calcium level on parathyroid hormone secretion
Parathyroid hormone increases when low calcium and decreases when high calcium
107
Action of parathyroid hormone on bones
Stimulates resorption and release of calcium in the ECF
108
Action of parathyroid hormones on kidney
Increase calcium reabsorption and phosphate excretion through GPCR in distal tubule Stimulate transcription of one alpha hydroxylase for vitamin D activation in kidney vitamin D then increases calcium and phosphate absorption
109
Composition of Bones
67% inorganic compounds hydroxyapatite, amorphous calcium phosphates 33% organic components called osteoid with - 28% type one Collagen - 5% of non-collagen structural proteins - growth factors - cytokines
110
Osteoblasts function
```  Bone formation synthesis of matrix proteins Type one collagen Osteocalcin mineralization activation of osteoclasts via RANKL production ```
111
Functions of osteoclasts
Bone resorption degradation of proteins by enzymes acidification RANK activated by RANKL and differentiation to osteoclasts
112
Bone remodeling process
Osteoclasts dissolve bone through large multi nucleated giant cells osteoblasts produce bone through parathyroid hormone vitamin D cytokines growth factors osteoblasts become encased and become osteocytes
113
In the renal system 80% of the absorption of calcium occurs at
Proximal tubal and is PTH independence
114
Calcitonin action
Inhibits osteoclast Mediated bone resorption which decreases serum calcium promotes renal excretion of calcium
115
Which hormone is a potential treatment for hypercalcemia
Calcitonin
116
Where is vitamin D dependent calcium absorption more important Duodenum? Jejunum?ileum?
Dudodenum | Best in acidic conditions
117
What disease is caused when vitamin D deficient
Rickets
118
What can cause rickets
Inadequate intake of vitamin D | absence of sunlight
119
Most prominent clinical effects of vitamin D deficiency
Osteomalacia
120
What causes vitamin D resistant rickets
Deficiency of renal one alpha hydroxylase
121
Function of parathyroid hormone related protein
Physiological role in lactation Hormone for mobilization or transfer of calcium to the milk important in fetal development important in development of hypercalcemia of malignancy
122
Causes of hypocalcemia
Hypoparathyroid level due to postoperative conditions could beat idiopathic or postradiation Non-parathyroid cause due to vitamin D deficiency ,malabsorption ,liver disease ,kidney disease ,vitamin D resistance PTH resistance due to pseudo hypoparathyroidism
123
Symptoms and signs of pseudo hypoparathyroidism
``` Hypocalcemia hyperphosphatemia short stature round face short thick neck obesity Enamel hypoplasia shortening of the metacarpals Autosomal dominant resistance to parathyroid hormone ```
124
Cause of pseudo hyperparathyroidism
50% efficiency of GPC are in all cells and not due to parathyroid glands not working
125
Treatment of pseudohypo parathyroidism
Vitamin D and calcium
126
Signs and symptoms of hypercalcemia
Neurologic (lethargy drowsiness depression confusion which can lead to coma or death ) neuromuscular (muscle weakness, hypotonia, decreased reflexes ) cardiac arrhythmias bones (ache, pain, fracture)
127
CommonCauses of hypercalcemia
Malignant disease like lung cancers hyperparathyroidism vitamin D toxicity
128
Uncommon causes of hypercalcemia
Renal failure sarcoidosis multiple myeLoma
129
triad of complaints in hyperparathyroidism
Bone Stones Abdominal groans
130
Biochemistry of hyperparathyroidism
Hypercalcuria Hypophosphatemia Hyperphosphaturia
131
What is primary hyperparathyroidsm
Calcium excretion higher than calcium intake Bone replaced with connective tissue Lesiosn on forehead and maxilla
132
When is treating hypercalcemia of malignancy useful
When hypercalcemia not life threatening | Treatment can improve way of life
133
Treatment of hypercalcemia of malignancy
Biphosphonates to inhibit osteoclastic activity | NaCl iv whhen more than 3.00mM ca2+
134
What is osteoporosis
Reduction in bone mineral density and matrix compared to age and sex norms
135
Most common metabolic disease of bone
Osteoporosis
136
Risk factors to osteoporosis
``` Gender => male more than females Race => blacks more the whites Genetics (estrogen receptor, type I collagen gene, vitamin D receptor gene ) Gonadal steroids deficiency Less Growth hormone No Calcium intake in case of deficit Lack of Exercise ```
137
Age of peak bone mass
30
138
Treatment to decrease in bone mass, osteoporosis
Exercise , activity Calcium intake (1000-1500mg/day) Estrogen treatment => inhibit osteoclastic activity Bisphophonates => inhibits osteoclasts Calcitonin Vitamin D Parathyroid hormone => expensive and need constant injections
139
Normal serum phosphorus level
2.5-4.5mg/100ml
140
When calcium high , phosphate is …
Low
141
Hypophosphetemia
Less than 2.5 mEq/L
142
Causes of hypophosphetemia
Overzealous intake of simple carbohydrates Severe protein calorie malnutrition Anorexia, alcoholism
143
Hypophosphatemia clinical manisfestations
``` Muscle weakness Seizures Coma Irritability Fatigue Confusion Numbness ```
144
Management of hypophosphatemia
``` Prevention IV phosphorus when severe Prevention of infection Monitor phosphorus level Increase oral intake of phosphorus rich food ```
145
Food rich in phosphorus
``` Milk Milk products Whole grains Organ meats Nuts Fish ```
146
Hyperphosphatemia
More than 4>5mEq/L
147
Causes of hyperphosphatemia
Renal failure Chemotherapy Hypoparathyroidism High phosphate intake
148
Clinical manifestations of hyperphosphatemia
Tetany Mucle weakness Looks like hypocalcemia
149
Intervention for hyperphosphatemia
Treat underlying conditions | Avoid food rich in phosphorus
150
Normal magnesium serum level
1.5 - 2.4 mEq/L
151
Hypomagnenesemia
Less than 1.5 mEq/L
152
Causes of hypomagnesemia
``` Chronic alcoholism Diarrhea Disruption of small bowel function TPN DKA ```
153
Clinical manifestations of hypomegnesemia
``` Neuromuscular irritability Tousseau sign Positive chvostek EKG chnges , long QRS , depressed ST segment , cardiac dysrrhyrtmias Hypocalcemia , hypokalemia ``` ``` Starved Seizures Tetany Anorexia Rapid heart rate Vomiting Emotional lability Deep tendon reflex ```
154
General interventions for hypomagnesemia
``` IV magnesium Calcium gluconate if hypocalcemia Monitor dysphagia Soft foods Vital signs monitoring ```
155
Food high in magnesium
``` Green vegetables Nuts Legumes Seafood Chocolate ```
156
Hypermagnesemia
More than 2.4mEq/L
157
Causes of hypermagnesemia
Renal failure Untreated DKA Excessive use of antacids and laxatives
158
Clinical manifestations of hypermagnesemia
``` Flushed face Skin warmth Mild hypotension Heart block Cardiac arrest Muscle weakness Paralysis ECG changes - bradycardia, hypotension Nausea vomiting Lethargy ```
159
Intervention for hypermagnesemia
Monitor magnesium levels , RR, cardiac rythm Increase fluids IV calcium in emergencies

Renal (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions