Chapter 19- EXAM 3

Question 1

how does the renal body fluid system work

Answer 1

Using blood volume to control Blood Pressure

Question 2

what helps control the long term pressure control

Answer 2

renal body fluid system

–as extracellular fluid volume increases arterial pressure increases.

Question 3

what does an increase in arterial pressure cause the kidneys to lose

Answer 3

kidneys to lose Na and water which returns extracellular fluid volume to normal

– look at slide 2 flow chart

Question 4

what is pressure diuresis

Answer 4

The effect of pressure to increase water excretion

Question 5

what is pressure natriuresis

Answer 5

The effect of pressure to increase Na excretion

– Look at slide 4

Question 6

what are major determinants of long-term arterial pressure control

Answer 6

Renal Fucntion

Salt and water intake

** It is impossible to change the long-term mean arterial pressure level to a new value without changing Renal Function Curve and/or Salt & Water intake

Question 7

where is the equilibrium point

Answer 7

where intake and output curves intersect

– look at the slide 5

Question 8

what kind of gain does the renal body fluid feed back system has an ?

Answer 8

infinite gain

Question 9

do changes in the TPR affect long term atrial pressure levels

Answer 9

no

Question 10

what curve must be altered to have to have long term changes in arterial pressure

Answer 10

one must alter the renal fx curve to have long term changes

Question 11

what is another things that would change leads to arterial pressure

Answer 11

changing renal vascular resistance will lead to long term changes in arterial pressure

–Look at slide 6

Question 12

what happens when Na intake is increased

Answer 12

Na stimulates drinking, increased Na concentration stimulates thirst and ADH secretion

Question 13

what do changes in Na intake lead to

Answer 13

leads to changes in extracellular fluid volume (ECFV)

Question 14

ECFV is determined by

Answer 14

the balance of Na intake and output

–Look at slide 7

Question 15

what are the 2 sequential stages of Volume-loading hypertension

Answer 15

1 first

• — increased Q form increased fluid volume
• —- produces the HTN

2 second
—– HTN continues with high blood pressure and high total peripheral resistance but Q returns to near normal

Question 16

when does increased TPR occur

Answer 16

after hypertension has developed so it is secondary to the hypertension rather than being the cause

Question 17

what is the final stage of Volume-loading hypertension

Answer 17

1. Hypertension
2. Marked increase in total peripheral resistance
3. Almost complete return of the extracellular fluid volume, blood volume, and cardiac output back to normal

Question 18

look at this slide

Answer 18

9

Question 19

where is renin synthexsized and is stored in

Answer 19

Renin is synthesized and stored in modified smooth muscle cells in afferent arterioles of the kidney

Question 20

why is renin released

Answer 20

Renin is released in response to a fall in pressure

Question 21

what does renin acts on

Answer 21

Renin acts on a substance called angiotensinogen to form a peptide called angiotensin I.

Question 22

what is AI converted into

Answer 22

AI is converted to AII by a converting enzyme located in the endothelial cells in the pulmonary circulation

Question 23

Look at slides

Answer 23

10, 11, 12, 13, 14

Question 24

what are some action of the renin angiotensin system

Answer 24

• vasoconstriction
• na retention by direct and indirect acts on the kidney
• shifts in renal function curve to the right

Question 25

what is the Na retention by direct acts

Answer 25

Direct actions on the tubular cells to increase tubular reabsorption of sodium and water

Question 26

what is Na retention by indirect acts

Answer 26

Indirect by stimulating release of Aldosterone by adrenal glands

Question 27

what is renin angiotenssin system important in maintaining

Answer 27

maintaining a normal Art Pressure during changes in Na intake

Question 28

what happens to reniin level as Na intake is increased

Answer 28

it will fall to near 0

Question 29

what happens to reniin level as Na intake is decreased

Answer 29

levels increased significantly

Question 30

what does the renin angiotenssin system cause the renal fx curve to look like

Answer 30

RAS causes the Na loading renal function curve to be steep

Question 31

who gets primary hypertension

Answer 31

90% of hypertensive patients - - mild form of hypertension, slow progression - - cause is unknown but most likely related to weight gain - - 2/3 of essential hypertensives are overweight

Question 32

what are some other types of hypertension caused by volume loading and vasoconstriction

Answer 32

* Renal Artery Stenosis * Chronic renal disease * Primary hyperaldosteronism * Sleep Apnea * Pheochromocytoma * Preeclampsia * Aortic Coarctation

Question 33

what does renal artery disease cause | renal artery stenosis

Answer 33

renal artery disease can cause of narrowing of the vessel lumen (stenosis).

Question 34

what does the reduced lumen diameter in the renal artery do | (renal artery stenosis)

Answer 34

increases reduces the pressure at the afferent arteriole in the kidney.

Question 35

what does Reduced renal perfusion stimulate renin release by the kidney do (renal artery stenosis)

Answer 35

This increases circulating angiotensin II(ANGII) and aldosterone.

Question 36

what do angiotensin II(ANGII) and aldosterone do in the blood (renal artery stenosis)

Answer 36

These hormones increase blood volume by enhancing renal reabsorption of sodium and water. Increased ANGII also causes systemic vasoconstriction.

Question 37

what is the net effect of these renal mechanisms | renal artery stenosis

Answer 37

The net effect of these renal mechanisms is an increase in systemic vascular resistance and an increase in cardiac output (transient)

Question 38

what can cause damage nephrons in the kidney | chronic renal disease

Answer 38

a number of pathologic processes (e.g., diabetic nephropathy, glomerulonephritis) can damage nephrons in the kidney.

Question 39

what happens when there is damage to the nephrons of the kidneys (chronic renal disease)

Answer 39

When this occurs, the kidney cannot excrete normal amounts of sodium which leads to sodium and water retention, increased blood volume, Renal disease may also result in increased release of renin leading to a renin-dependent form of hypertension.

Question 40

what can the elevation in arterial pressure secondary to renal disease can be viewed as what (chronic renal disease)

Answer 40

The elevation in arterial pressure secondary to renal disease can be viewed as an attempt by the kidney to increase renal perfusion and restore glomerular filtration.

Question 41

what can catecholamine secreting tumors cause | Pheochromocytoma

Answer 41

Catecholamine secreting tumors in the adrenal medulla can lead to very high levels of circulating epinephrine and norepinephrine. 

Question 42

LOOK/ Read slide

Answer 42

19- as there is a lot of stuff about (Pheochromocytoma)