1 - PUPD Flashcards
(103 cards)
1
Q
Normal drinking value
A
Less than 40 - 60 mL/kg/d
2
Q
What are contributors to body water hemostasis
A
Plasma osmolality, vascular volume, kidneys, pituitary gland
3
Q
Osmolality
A
Concentration osmotically active particles in solution , # particles in 1 kg solvent
4
Q
Osmolality is calculating what 2 factors
A
Size and number
5
Q
Osmolarity
A
particles per 1 L solvent
6
Q
If your body wants to lower osmolality will ADH increase or decrease
A
ADH will increase
7
Q
Increasing ADH causes what
A
Increase in thirst and increase in withholding water
8
Q
Where is the thirst center
A
Hypothalamus
9
Q
The hypothalamus has what 2 receptor
A
Osmoreceptors and baroreceptors
10
Q
Triggers for thirst
A
Hyper osmolality and decreased vascular volume
11
Q
ADH aka
A
Vasopressin
12
Q
ADH is produced
A
Hypothalamus
13
Q
ADH is storages
A
Posterior pituitary
14
Q
What does ADH effect
A
Reabsorbs water and concentrate urine
15
Q
Plasma osmolality primarily determined by
A
NA
16
Q
Where are the ADH receptor
A
Distal renal tubule
17
Q
Thirst center mediated primarily by
A
Hypothalamic osmoreceptor
18
Q
Decreased renal perfusion activates
A
RAAS
19
Q
Polydipsia
A
Greater than 100 mL/kg/d
20
Q
Polyuria
A
Greater than 50 mL/kg/d
21
Q
With PUPD will you have an increase or decrease in volume
A
Increase
22
Q
Common pretenders of PUPD
A
Pollakiuria, incontience, behavioral
23
Q
What USG be with PUPD
A
Persistently less than fully concentrated
24
Q
What does USG measure
A
Urine osmolality
25
Plasma osmolality in dogs and cats
290 - 310 moms
26
Hyposthenuria
1.00 - 1.007
27
What is the osmolality of hyposthenuria
Urine is less than plasma
28
Isothenuria
1.008 - 1.012
29
Minimally concentrated
Dogs - 1.013 - 1.030 Cats - 1.013 - 1.040
30
What is the osmolality of minimally concentrated
Urine is greater than plasma
31
Wet cat food will cause minimally concentrated or concentrated?
Minimally concentrated
32
What do you need to make concentrated urine
Functioning nephrons, hypertonic medullary gradient, ADH, and responsiveness to ADH
33
What percent of functioning nephrons needs to be parent to concentrate
1/3 present
34
Hypertonic medically gradient depend on what two components
Na and urea
35
80 - 90% of fluid filtered at the glomerulus is reabsorbed in teh
Proximal tubule
36
Hyposthenuric urine at
Distal nephrons
37
What is the most common cause of PUPD
Primary polyuria
38
What can cause primary polyuria
Osmotic diuresis, decreased ADH production, decreased ADH receptor function, medically washout
39
Causes of osmotic diuresis
Presence of poorly reabsorbed solutes and excessive salt intake
40
What are examples of portal reabsorbed solutes
Mannitol, urea, glucose
41
ADH production and receptor function is decreased signals for
Diabetes insipidus
42
If there is a decrease in ADH production what is the primary DI coming from
Central
43
With what type of diabetes insipidus is there NO ADH produced
Central
44
Obligate water drinker is ign of
Primary nephrogenic DI
45
What is the mot common cause of DI in dogs/cat
Acquired nephrogenic DI
46
What can interfere with the ADH receptor
Cortisol, endotoxin, electrolytes - CA
47
DDAVP
Vasopressin used for treatment of CDI
48
RAAS
Regulates blood pressure and volume
49
CDI
Lack of ADH production from the pituitary
50
nephrogenic diabetes insipidus
Lack of ADH receptors in the kidney or decreased response of the ADH receptors
51
Insensible loss
Water loss primarily due to evaporative respiratory loss
52
Vasopressin acts on receptors in the
Distal tubule - aquaporins
53
Thirst center can be stimulated by
Increases in Extracellular osmolality or decreases in the intravascular volume
54
Do cat on canned diet drink more or less
Less
55
Primary polydipsia is often a
Behavioral problem
56
When Na is selectively reabsorbed this makes the urine
Hyposthenuric
57
What are some disease that cause PU through osmotic diuresis mechanism
DM, primary renal glucose Rita, Fanconi’s Syndrome, CKD, post obstructive diuresis
58
Can patient with CDI concentrate urine if given exogenous ADH
Yes because the receptors are functional
59
Idk what medullary washout is
60
If you need more water is your osmoality high or low
High
61
What triggers thirst
Hyperosmoolality and decreased vascular volume
62
What are the effects of ADH
Reabsorb water and concentrate urine
63
Plasma osmoality is primarily determined by
Sodium
64
Where are the ADH receptors located
Distal renal tubule
65
The thirst center is mediated by
Hypothalamic omoreceptors
66
Polydipsia value
More than 100 mL/kg.d
67
Polyuria values
More than 50 mL/kg/d
68
What are common pretenders of PUPD
Pollakiuria, Incontience or behavioral
69
What USG should you consider pUPD
Persistent less than fully concentrated
70
What is USG measuring
Urine osmoality
71
Isosthenuric values
1.008 - 1.012
72
How can you concentrate urine
Functioning nephrons, hypertonic medullary gradient, ADH, response to ADH
73
What two are important in hypertonic medullary gradient
Na and urea
74
H20 is mostly permeable where
Descending tubule
75
Na is mostly permeable where
Ascending tubule
76
Urea recycling is maintained through
Selective reabsorption and recycling
77
80 - 90% of fluid filtered at the glomerulus is reabsorbed in the
Proximal tubule
78
Selective reabsorption of sodium happens where
Thick ascending loop
79
After selective reabsorption sodium what happens to the urine
Hyposthenuric urine
80
Where is hyposthenuric urine found
At distal nephrons
81
Most common caues of primary polyuria
Osmotic dieresis, decreased ADH production, decreased receptor function, medullary washout
82
What are some causes of osmotic dieresis
Excessive salt intake, DM , mannitol, lepto, jerky treats, Franconia, renal glucosuria
83
If there is osmotic dieresis, where is the problem most likely
Proximal tubule - because it absorbs all the glucose usually
84
What are causes of primary polyuria
Osmotic dieresis, reduced/ absent ADH production and receptor, and medullary washout
85
If you have decreased ADH or decreased ADH receptor function, what is the problem
Diabetes Insipidus
86
Decreased ADH production is indicative of
Central DI
87
Decreased ADH receptor is indicative of
Nephrogenic DI
88
What are primary nephrongenic DI examples
No ADH receptors in the kidney, obligate water drinker
89
What interferes with ADH receptors
Cortisol, endotoxin, calcium
90
What can impair medically gradient
Increase flow urine or blood, decrease urea, decrease Na
91
What can cause increase flow of urine or blood
Solute washout, impaired reabsorption Na or urea
92
What can cause decrease in Urea
Liver insufficiency, low protein diet
93
What can cause decrease in Na
Hypoadrenocorticism, loop diuretics, electrolytes los
94
Low serum sodium can be indicative of
Primary polydipsia
95
If you have PUPD in dog what are the main suspicions
Cushing, DM, CKD
96
What is the main suspicion of PUPD in cats
DM, CKD, hyperthyroidism
97
Can you consider PUPD with concentrated urine
No
98
If you have dilute urine what is considered
DI and primary polydipsia
99
If you have isosthenuria what is considered
CKD, secondary NDI, and partial CDI
100
What test should you do when ther is normal to increased NA
Desmopressin trial
101
If they can concentrated ADH given what do they have
CDI
102
If they cannot concentrate when given ADH what do they have
Primary NDI
103
What are the steps of the desmopressin trial
Measure water intake 2 -3 day, do USG, drops 5 -7 days, blah blah
