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Endocrinology > Exam 3: Salt/water Balance > Flashcards

Exam 3: Salt/water Balance Flashcards

(93 cards)

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1
Q

Osmolarity of ECF is monitored/adjusted by

A

Regulating water excretion in kidney in response to ADH

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2
Q

Major electrolyte in ECF

A

Na+

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3
Q

Renal mechanisms of Na+ balance

A

RAAS

Atrial natriuretic peptide

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4
Q

ADH contributes ___ to volume regulation

A

Directly

**Trumps osmolarity

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5
Q

Virtually all Na+ reabsorption in kidney is due to

A

Passive Na+ reabsorption following gradient

Active Na+ removal due to ATPase

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6
Q

Na+ coupled transport also reabsorbs

A

Glucose
AA
Phosphate
HCO3

(Water follows)

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7
Q

H2O is impermeable across

A

Ascending loop of Henle

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8
Q

Hormones that regulate NaCl/H2O

A

Antidiuretic hormone
RAAS
ANP

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9
Q

ADH AKA

A

Vasopressin

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10
Q

ADH signals kidney to

A

Conserve H2O

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11
Q

ADH is released when

A

Plasma osmolarity inc

Plasma volume dec 10-15%

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12
Q

Osmole receptors are very sensitive and ___% inc can stim ADH release

A

1-2%

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13
Q

Blood volume changes are sensed by _____ receptors

A

High and low pressure receptors

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14
Q

Response to ___ volume is an emergency response

A

Dec

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15
Q

ADH is a powerful vaso____ which targets

A

Constrictor; arteriolar smooth muscle (V1 receptor)

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16
Q

ADH via V2 receptor causes

A

Insertion of aquaporins

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17
Q

Aquaporins are H2O channels that

A

Make collecting duct permeable to H2O

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18
Q

Osmole receptors are found in

A

Circumventricular organs

  • organum vasculosum
  • subfonical organ
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19
Q

Axons from circumventricular organs project to ADH producing cells in

A

Hypothalamic supraoptin and paraventricular nuclei

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20
Q

Most potent osmolyte

A

NaCl

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21
Q

Dehydration and ADH

A

Inc osmolarity and dec volume stimulate ADH

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22
Q

Dec osmolarity and small dec in volume

A

Osmolarity kept constant

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23
Q

Dec osmolarity and LARGE dec in volume

A

Osmolarity sacrificed to maintain integrity of ciruclation

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24
Q

Diabetes insipidis

A

Large amounts of dilute urine

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25
Central diabetes insipidis
Dec ADH production | Low circulating ADH
26
Nephrogenic diabetes insipidis
Dec response of kidney to ADH | Circulating ADH levels high
27
Syndrome of inappropriate ADH
Inc ADH secretion even if plasma osmolarity low
28
Syndrome of inappropriate ADH death occurs when
Profound dilution of plasma electrolytes
29
ADH cell bodies found in
Supraoptic nuclei
30
Oxytocin cell bodies found in
Paraventricular nuclei
31
ADH and oxytocin are secreted from nerve terminals in
Posterior pituitary
32
Supraoptic nuclei can make both
Oxytocin and ADH
33
ADH acts on principal cells in last ___ to inc H2O reabsorption, thus ___ body fluid osmolarity
DCT; dec (back to normal)
34
V2 receptor for ADH elicits response via
cAMP
35
CAMP causes insertion of aquaporin 2 which ____ the urine
Concentrates
36
V1 receptor is coupled to
Phospholipase C
37
Net result of ADH w/ V1 receptor
Contraction of vascular SM Constrict arterioles Inc TPR
38
Thiazide diuretics are used to treat
Nephrogenic diabetes insipidus
39
Thiazide diuretics ___ Na+ reabsorption in distal tubule
Inhibit
40
Thiazide diuretics ___ GFR
Dec Less H2O filtered—less excreted
41
Thiazide diuretics can cause a secondary ____ due to inc Na+ excretion
ECF volume contraction
42
Renin is a hormone synthesized/secreted by
Juxtaglomerular cells in renal arterioles
43
Renin stimulated by
SNS activation | Dec tension/pressure in glomerulus
44
Dec pressure in glomerulus can ___ rate of NaCl delivery to macula densa
Dec
45
Renin catalyzes formation of ____ from ___
Angiotensin I; angiotensinogen
46
Angiotensin I is the ____ form
Inactive
47
Angiotensin I is converted to angiotensin II by ___ in the ____
ACE; liver
48
Angiotensin II is also produced locally in
BV Adipose Brain
49
Angiotensin II may act locally as a paracrine to
Stim prostaglandins Act as local growth factor
50
Angiotensin II is the primary signal for the release of
Aldosterone
51
Angiotensin II also causes vasoconstriction in the kidney which
Dec renal blood flow and glomerular filtration
52
Constriction of the EA by angiotensin II ___ colloid pressure in peritubular caps which ____ reabsorption
Inc; inc
53
Angiotensin effect on cardiac contractility
Inc
54
Angiotensin inc blood flow to ___ and dec blood flow to ___
Inc: heart, brain, skeletal muscle Dec: skin, viscera
55
One of the most potent pressor substance known
Angiotensin II
56
Angiotensin II in CNS stimulates _______ and secretion of ___
Stims thirst and appetite for Na+ Stims secretion of ADH
57
Angiotensin II in hypothalamic cells project to
Supraoptic and paraventricular N Vasomotor centers
58
Angiotensin II stim in paraventricular nuclei
Release ADH
59
Major regulator of RAAS
Negative feedback
60
Blood volume ___ as a result of sodium retention
Inc
61
ANP promotes excretion of
Sodium in urine
62
ANP synthesized and secreted from
Atrial myocytes
63
Two other forms of ANP
BNP (brain) | CNP (CNS)
64
ANP/BNP binds to which receptor
Natriuretic peptide receptor-A (NPR-A)
65
CNP binds to which receptor
NPR-B
66
All three hormones (ANP/BNP/CNP) bind to which receptor
NPR-C
67
NPR-C may function as
Clearance receptor — removes ANP/BNP/CNP from blood
68
ANP and BNP both stim formation of
Cyclic GMP
69
Cyclic GMP modifies cellular functions via 3 mechanisms
1. Phosphorylation of proteins 2. Cyclic nucleotide phodphodiesterases 3. Ion channel regulation
70
ANP acts on these organs ___ to lower _______
CN system Kidneys Adrenal glands CNS Lower blood volume and pressure
71
ANP on CV system
Vasodilation of vascular SM
72
ANP in the kidney inc Na+ and H2O excretion by inc ____ and dec Na+ and H2O reabsorption
Glomerular filtration
73
ANP causes ___ renin secretion
Dec
74
ANP effects on hypothalamus
Dec ADH secretion dec vasomotor activity Inhibits thirst Dec Na+ appetite
75
ANP in pituitary gland inhibits release of
ACTH (causes dec adrenal support)
76
ANP on adrenal gland
Dec aldosterone secretion
77
ANP effect on SNS
Dec NE/epi release
78
Hemorrhage effect on osmolarity
No change
79
Immediate response to hemorrhage
Vasoconstriction mediated by SNS
80
Slower response to hemorrhage
RAAS
81
Hemorrhage stims ___ and inhibits ___
ADH; ANP
82
Dehydration
H2O loss > solute loss
83
Dehydration effect on osmolarity
Inc in ECF/ICF osmolarity
84
Primary way to correct dehydration
ADH — promotes H2O reabsorption w/out reabsorbing solute
85
Dehydration ___ ANP
Inhibits
86
Salt loading promotes ____ of Na+ in urine
Excretion
87
Salt depletion minimizes _____ of Na+ in urine
Excretion
88
Salt loading causes ___ ANP and ADH
Inc
89
Salt loading causes ____ in plasma osmolarity
Slight inc
90
Salt depletion causes ___ in ANP and ADH
Dec
91
Salt depletion ___ plasma osmolarity
Slight dec
92
High salt intake suppresses ____ and slight increase in osmolarity stims ___
RAAS; ADH
93
Low salt intake stims release of ____ and slight decrease in osmolarity inhibits ____
RAAS; ADH

Endocrinology (11 decks)

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