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CPR 3 Renal Exam > Wolff k+/na+ crossword > Flashcards

Wolff k+/na+ crossword Flashcards

1
Q

means plasma K+ conc is <3.5(ish), hyperpolarizes most cell membranes; can be caused by K+ losing diuretics

A

hypokalemia

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2
Q

a large volume of this in plasma can cause pseudohyponatremia

A

lipid

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3
Q

refers to the fact that RBF and GFR are maintained approximately constant at MAP of ~100 mmHg +/- 40 mmHg because of myogenic mechanism and tubuloglomerular feedback

A

autoregulation

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4
Q

type of metabolic alkalosis seen with thiazinde and loop diuretics secondary to K+ loss

A

hypochloremic

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5
Q

hypovolemic form of this is a sign of neglect in nursing homes

A

hypernatremia

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6
Q

channel responsible for Ca2+ reabsorption in DCT, major site of regulation with calcitriol increasing its synthesis and PTH helping to regulate its conductance

A

TRPV5

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7
Q

generic term for the portion of the nephron that increases potassium reabsorption when plasma levels are low

A

Distal

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8
Q

0.45% NaCl solution is an example of this type of solution that causes cells to swell, can be administered to treat hypernatremia

A

hypotonic

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9
Q

it means plasma Na+ concentration is <135 mEq/L; seen in 15-20% of hospitalized patients, it is the most common electrolyte abnormality seen in clinical practice

A

hyponatremia

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10
Q

hormone principally responsible for cellular uptake of K+, can cause hypokalemia with normal acid-base balance

A

insulin

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11
Q

hyperkalemic/most common form of renal tubular acidosis, caused by lack of aldosterone or failure to respond to it

A

Type 4

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12
Q

caused by lack of ADH secretion or a failure of the kidneys to respond to it; leads to euvolemic hypernatremia

A

Diabetes Insipidus

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13
Q

refers to factors such as Ang II, ANP and SNS activity that modify the intrinsic renal relationship between arterial pressure and sodium excretion

A

extrinsic

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14
Q

class of drugs that interferes with renin secretion and the ability of diuretics to cause a diuresis

A

NSAIDs

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15
Q

adverse effect associated with administration of tolvaptan for >30 days

A

hepatotoxicity

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16
Q

ionized form of this divalent cation is a crucial cofactor in many biological processes, plasma levels are maintained in normal range by regulation of reabsorption through TRPM6 channels in DCT in a still poorly understood manner; both loop and thiazide diuretics cause it to be lost in urine, especially thiazide

A

magnesium

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17
Q

identified the forces that determine the net magnitude and direction of fluid movement across capillary barriers

A

starling

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18
Q

type of acids that have less of an effect on plasma K+ than, for example, hydrochloric or sulfuric acid

A

organic

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19
Q

when this (abbr.) is less than about 30 ml/min, thiazides no longer work but loop diuretics still do work when treating hypertension; can be a cause of hyperkalemia when

A

GFR

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20
Q

V2 agonist used to treat central diabetes insipidus

A

DDAVP

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21
Q

Receptors that sense body sodium content via measurement of effective blood volume

A

stretch

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22
Q

whether excreting a maximally dilute or maximally concentrated urine, the elimination of this is approximately unchanged

A

solute

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23
Q

irrespective of whether hyponatremia or hypernatremia, if this word applies the rate of correction must be slow

A

chronic

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24
Q

cause of euvolemic hyponatremia

A

SIADH

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25
Q

this of body is monitored by special sensors in the brain, cannot be eye-balled but instead approximated clinically by summing things that are measured (or measured directly via colligative properties of vapor point elevation or freezing point depression)

A

osmolality

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26
Q

administered to raise the threshold potential when people present with hyperkalemia

A

calcium

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27
Q

its blockade of carbonic anhydrase causes a sodium bicarb diuresis with hyperchloremic acidosis; principal uses include urinary alkalinization to hasten elimination of weak acid toxins (aspirin), treatment of metabolic alkalosis, acute mountain sickness, and glaucoma

A

acetazolamide

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28
Q

whether extracellular or intracellular, means that too much sodium is in this compartment (water followed); extracellular location is a common indication for a loop diuretic

A

edema

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29
Q

interval widened by hyperkalemia

A

QRS

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30
Q

occurs when K+ (and Cl-) are lost in urine due to, for example, diuretics; cells donate K+ while taking up H+ (and leaving behind HCO3-) in an effort to maintain hypokalemic plasma K+ levels closer to normal

A

metabolic alkalosis

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31
Q

nephron cells that can change their phenotype and are normally associated with the maintenance of acid-base balance; they are also a target of thiazide diuretics

A

intercalated

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32
Q

slowing the progression of this is a reason for continued administration of expensive tolvaptan

A

APKD

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33
Q

becomes prominent in severe hypokalemia

A

no U wave

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34
Q

volume expanded by infusion of 0.9% NaCl solution

A

extracellular

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35
Q

administering a 5% solution of this is ultimately equivalent to infusing approximately that volume of distilled water

A

dextrose

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36
Q

potential adverse effect of spironolactone use by females

A

hirsutism

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37
Q

syndrome that is a cause of type 2 RTA due to impaired ability to reabsorb filtered bicarb in the proximal tubule

A

fanconi

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38
Q

cells in the collecting duct that are the primary target of K+ sparing diuretics

A

principal

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39
Q

caused by cell lysis in a collected blood sample

A

pseudohyperkalemia

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40
Q

characteristic of urine excreted with maximally effective doses of furosemide, irrespective of plasma ADH levels

A

isotonic

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41
Q

substance that promotes free water clearance

A

aquaretic

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42
Q

potassium excretion is increased when this is increased in the distal nephron

A

tubular fluid flow rate

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43
Q

positive inotrope used in heart failure whose toxicity is increased by loop diuretic-induced K+ loss

A

digoxin

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44
Q

real European form of this contains sweet glycyrrhizic acid which dose-dependently potentiates aldosterone effects and increases systolic blood pressure

A

licorice

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45
Q

consequence of treating hyponatremia too rapidly

A

osmotic demyelination

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46
Q

substance that promotes excretion of urine, potential cause of hypovolemic hyponatremia

A

diuretic

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47
Q

a potassium salt formed with this bicarb precursor can be administered to a person with hypokalemia and acidosis

A

acetate

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48
Q

common cause of hypervolemic hyponatremia

A

heart failure

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49
Q

loop diuretic that can be used by patients with sulfa allergy

A

ethacrynic acid

50
Q

contraindication for loop diuretics and not a good time to start thiazide diuretics

A

pregnancy

51
Q

glomerulotubular ______ refers to forces acting across proximal tubular epithelium that result in proportional rather than absolute amounts of ~isotonic fluid reabsorption from the proximal tubule

A

balance

52
Q

can cause hyperkalemia

A

tissue necrosis

53
Q

recent episodes of this can give rise to hyponatremia, hypovolemia, and metabolic alkalosis with renal retention of K+ and Na+ (eg <20 and 30 mEq/L respectively)

A

vomiting

54
Q

part of the coma cocktail, it is also often administered along with other agents to patients presenting with hyperkalemia

A

glucose

55
Q

means plasma level is <1.7 mg/dL, often coexists with hypokalemia and hypocalcemia; contributes to clinical signs such as muscle weakness, tremors, tetany, seizures, paresthesias, vertical and horizontal nystagmus, torsades de pointes

A

hypomagnesemia

56
Q

not a good time to take a loop or thiazide diuretic given their typical duration of action

A

bedtime

57
Q

administration of this to treat bipolar disorder is the most common cause of nephrogenic diabetes insipidus, treated with amiloride

A

lithium

58
Q

channel responsible for Mg2+ distal convoluted tubule, can compensate somewhat when Mg2+ reabsorption is blocked in TAL by loop diuretics but downregulates in presence of thiazides leading to more profound Mg2+ loss in urine

A

TRPM6

59
Q

occurs in liver disease due to impaired synthesis of plasma proteins and increased portal venous pressure, reason to administer loop diuretics

A

ascites

60
Q

broad characterization of diuretics that includes thiazides, loop diuretics, carbonic anhydrase inhibitors, and osmotic diuretics

A

K+ losing

61
Q

common term for diuretic class with “high ceiling” effects exerted in the TAL

A

Loop

62
Q

consuming this decreases ADH secretion

A

alcohol

63
Q

3% NaCl is an example of this type of sodium that causes cells to shrink, can be used to treat acute severe hyponatremia

A

hypertonic

64
Q

refers to type of diabetes insipidus when kidney fails to respond to ADH

A

nephrogenic

65
Q

potential adverse effect of spironolactone use by males

A

gynecomastia

66
Q

prototype for the non-peptide V2 receptor antagonists that can be used judiciously to treat euvolemic and hypervolemic hyponatremia if unresponsive to other measures; causes water excretion without solute excretion

A

conivaptan

67
Q

blocks EnaC channels in the principal cells of the connecting tubule and collecting duct, similar to amiloride

A

triamterene

68
Q

hormone released by posterior pituitary whose receptor-mediated water-retaining effects are blocked by the vaptans

A

ADH

69
Q

well known toxicity of loop diuretics

A

ototoxicity

70
Q

receptors in collecting duct that mediate the response to ADH (aka arginine vasopressin) leading to insertion of aquaporin 2 water channels in the luminal membrane for water reabsorption

A

V2

71
Q

among the neuromuscular manifestations of hypokalemia

A

constipation

72
Q

organ that doesn’t have space for its cells to swell due to hyponatremia, lack of space leads to symptoms of encephalopathy and possible uncal herniation +/- death

A

brain

73
Q

disease that causes hyperkalemia despite adequate GFR

A

addison

74
Q

suggestive clues include hypervolemic hypernatremia, hypokalemia with metabolic alkalosis, significant urinary Cl- loss despite low plasma levels and hypertension

A

hyperaldosteronis

75
Q

ion that exchanges with cellular K+ during acid-base maintenance and/or compensation; reason acidosis can cause hyperkalemia

A

hydrogen

76
Q

along with massive, this adjective characterizes the fluid removal response to loop diuretics

A

rapid

77
Q

classical aldosterone antagonist; its effects in the principal cells of the collecting duct cause it to act as a K+ sparing diuretic

A

spironolactone

78
Q

suggested by acidemia in a patient with a normal anion gap and serum creatinine level, and without diarrhea

A

RTA

79
Q

increased by a step change in daily sodium intake

A

body weight

80
Q

class of diuretics with medium Na+ losing ability due to effects that include blockade of a transporter in distal convoluted tubules; treatment for nephrogenic diabetes insipidus

A

thiazide

81
Q

characterizes the on and off-rate for drugs such as spironolactone that decrease protein expression with disappearance of existing proteins each having their own half-life (hours or days) to see side effects

A

slow

82
Q

causes include anything that interferes with normal renin secretion or angiotensin II generation or the actions of angiotensin II or aldosterone

A

hyperkalemia

83
Q

caused by loop and thiazide diuretics, increases the risk of gout

A

hyperuricemia

84
Q

cause of hyperosmolar hyponatremia

A

hyperglucemia

85
Q

prototypical loop diuretic

A

furosemide

86
Q

common name for transporter in TAL that, in combination with water impermeability and direction of flow outside of TAL, gives rise to dilute tubular fluid and a hypertonic renal medullary interstitium; target of loop diuretics

A

NaK2Cl

87
Q

typical route for KCl administration (40-100 mEq in divided doses) to a person with hypokalemia

A

oral

88
Q

hormone whose levels decrease in response to a dietary sodium load to help facilitate its renal elminition

A

aldosterone

89
Q

surprising consequences of hyperkalemia, occurs because hyperkalemia increases K+ conductance in SA nodal tissue enough to cause membrane hyperpolarization; other regions of heart do become hyperexcitable so arrhythmias likely

A

bradycardia

90
Q

predictable consequence of severe hypokalemia, diabetes insipidus and vaptan administration

A

polyuria

91
Q

major pathway for Mg2+ reabsorption in TAL, Ca2+ is also reabsorbed here in addition to its major reabsorption via this pathway in proximal tubules

A

paracellular

92
Q

abuse of this can cause extra-renal K+ losses leading to hypokalemia that can occur +/- concurrent metabolic acidosis

A

laxative

93
Q

you will learn about the gliflozin class of drugs that lowers circulating glucose levels in diabetes by blocking its reabsorption in the proximal tubule… this causes polyuria as does diabetes itself because glucose excreted in the urine functions as this type of diuretic

A

osmotic

94
Q

failure of this to treat hyponatremia in symptomatic hospitalized patients is an indication for vaptans

A

fluid restriction

95
Q

refers to the channels directly blocked by amiloride and triamterene in collecting duct cells

A

EnaC

96
Q

osmotic pressure is the driving force for water movement across this

A

cellular membrane

97
Q

problematic with diuretics presumably in part because of the urgent need to urinate

A

non-adherence

98
Q

likelihood of formation from calcium in the urinary pelvis is increased by loop diuretics and decreased by thiazide diuretics due to their differing effects on its reabsorption

A

stones

99
Q

this clearance is zero when urine is isotonic, positive when urine is dilute, and negative when urine is hypertonic; negative means the water in which urinary solute was diluted has been returned to the body to dilute to lower plasma osmolality

A

free water

100
Q

example of an osmotic diuretic administered in gram quantities o help eliminate excess intracellular volume (causing elevated intracranial pressure) now often supplanted by hypertonic saline

A

mannitol

101
Q

a diuretic that blocks epithelial sodium channels in the principal cells of the collecting ducts, effects are rapid when compared to spironolactone

A

amiloride

102
Q

loss of this in excess of water is why loop and thiazide diuretics can cause hyponatremia

A

sodium

103
Q

membrane potential that is determined by extracellular K+ levels

A

resting

104
Q

routine dietary intake of this cation would increase its plasma levels to the toxic range if not for a means for rapid redistribution into cells

A

potassium

105
Q

can be hidden source of excessive K+ intake

A

antibiotics

106
Q

nephron location where osmotic diuretics and carbonic anhydrase inhibitors exert their effects; increasing or decreasing the fraction of the filtered load reabsorbed here is a primary determinant of sodium excretion

A

proximal tubule

107
Q

cotransporter in the DCT that acts to further dilute the tubular fluid; target of thiazide diuretics

A

Na-Cl

108
Q

ability impaired in the kidney by loop diuretics, Bartter syndrome and hypokalemia (here presumably due to need for K+ by Na+-K+-2Cl- cotransporter) resulting in polyuria and nocturia

A

concentrating

109
Q

with worsening hyperkalemia, may have muscle twitching/weakness and numbness/prickling sensation give way to this type of paralysis

A

flaccid

110
Q

selective non-peptide V2 receptor antagonist that can be cautiously administered orally to patients with persistent hyponatremia despite use of initial therapies

A

tolvaptan

111
Q

RTA with hypokalemia due to, for example, autoimmunity leading to fibrosis with impaired function in the cortical collecting duct

A

Type 1

112
Q

aldosterone antagonist with greater selectivity than spironolactone, also much more expensive

A

eplerenone

113
Q

invasive means for treating life-threatening hyperkalemia

A

dialysis

114
Q

this of sodium increases as blood pressure increases

A

urinary output

115
Q

thirst, tenting of skin, sunken eyes and oliguria are among the signs of this, ultimately a more powerful stimulus of ADH release than increases in plasma osmolality

A

hypovolemia

116
Q

hypo- or hyper- means there is too little or too much sodium in the body

A

volemia

117
Q

chicory, dandelion leaves, fennel, goldenseal, etc are diuretics of this type of alternative medicine with generally uncharacterized mechanisms of action and uncertain efficacy

A

herbal

118
Q

hypo- and hyper- mean that there is too much or too little water diluting the body’s sodium content

A

natremia

119
Q

class of diuretics acting in the collecting duct to block Na+/K+ exchange, useful to counterbalance an adverse effect of loop and thiazide diuretics

A

K+ sparing

120
Q

healthy way to transiently raise extracellular K+ levels

A

exercise

121
Q

tablets that are treatment for hypovolemic hyponatremia

A

salt tablets

CPR 3 Renal Exam (14 decks)

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