Hormonal control, Fluid and electrolyte balance, Kidney disease

Question 1

What is the primary route for excreting ions and water?

Answer 1

The kidney

Question 2

WHat other routes does the body use to excrete water and ions?

Answer 2

Feces
Sweat
Lungs (via CO2 and bicarbonate)

Question 3

Which systems respond rapidly to fluid/electrolyte imbalance?

Answer 3

Respiratory and cardiovascular systems (uncer neural control)

Question 4

Which organ responds slowls to fluid imbalance and is under hormonal control?

Answer 4

The kidneys

Question 5

What are the suorces of water intake?

Answer 5

Ingestion
Metabolism
IV injection

Question 6

What are the methods of water loss?

Answer 6

Urine
Feces
Insensible loss (skin/lungs)
Pathological causes (vomiting, diarrhea, sweating)

Question 7

What does vasopressin do?

Answer 7

Increase water reabsorption in the nephron’s collecting duct

Question 8

What stimulates vasopressin release?

Answer 8

Increased blood osmolarity and low blood volume

Question 9

What is the mechanism of vasopressin action?

Answer 9

Stimulates aquaporin insertion into apical membrane

Question 10

What is the half-life of vasopressin?

Answer 10

About 20 minutes

Question 11

What inhibts vasopressin release?

Answer 11

Alcohol

Question 12

How does vasopressin secretion vary with time?

Answer 12

Circadian pattern - less urine at night

Question 13

What happens when NaCl levels rise?

Answer 13

Osmolarity increases –> vasopressin released –> water retained –> thirst stimulated

Question 14

What does aldosterone do?

Answer 14

Increases Na+ reabsorption and K+ secretion in the distal nephron

Question 15

What stimulates aldosterone release?

Answer 15

Low blood pressure

Question 16

What triggers renin secretion?

Answer 16

Decrease in blood pressure

Question 17

What is the of RAAS activation?

Answer 17

Renin –> angiotensinogen –> ANG I –> (via ACE) –> ANG II

Question 18

What are the effects of ANG II?

Answer 18

Vasopressin release
Increased thirst
Vasoconstriction
Stimulation of CVCC
Na+ reabsorption in the proximal tubule

Question 19

What is natriuresis?

Answer 19

Urinary sodium loss

Question 20

What produces artial natriuretic peptide (ANP)?

Answer 20

Artial myocardial cells

Question 21

What produces brain natiuretic peptide (BNP) ?

Answer 21

Ventricular myocardial cells and some brain neurons

Question 22

What are the effects of ANP/BNP?

Answer 22

Increase GFR
Reduce Na+ reabsorption
Supress RAAS
Reduce blood volume

Question 23

What is normal plasma pH?

Answer 23

7.38 - 7.42

Question 24

What happens if pH deviates too much?

Answer 24

Protien denaturation and metbaolic dysfunction

Question 25

What are the body's buffer systems?

Answer 25

Protiens Pohsohate ions Bicarbonate (HCO3)

Question 26

How aare most acid-base imbalances corrected?

Answer 26

Ventilation (75%)

Question 27

How do kidneys help with pH balance?

Answer 27

Use ammonia and phosphate buffers to ecrete H+

Question 28

What does high specific gravity indicate?

Answer 28

Dehydration or diabetes

Question 29

What can cause acidic or alkaline urine pH?

Answer 29

Diet Disease Kidney stone type

Question 30

What does urine glucose suggest?

Answer 30

Diabetes mellitus

Question 31

What does high bilirubin in urine indicate?

Answer 31

Liver disease or failure

Question 32

What does ketones in urine suggest?

Answer 32

Diabetes or low-carb diet

Question 33

What do plasma proteins in urine indicate?

Answer 33

Kidney damage

Question 34

What do nitrites/nitrates suggest?

Answer 34

UTI

Question 35

What does blood in urine suggest?

Answer 35

Infection or kidney damage

Question 36

What do white blood cells in urine suggest?

Answer 36

UTI

Question 37

What cause diabetes insipidus?

Answer 37

Poor secretion (cranial DI) Response (nephrogenic DI) to vasopressin

Question 38

What is the result of DI?

Answer 38

Polyuria (5-10L/day) Dilute urine Intense thirst

Question 39

Who is at risk for diabetic nephropathy?

Answer 39

30-40% of type 1 diabetics 10-20% of type 2 diabetics

Question 40

What are key features of diabetic nephropathy?

Answer 40

Early increase in GFR, followed by proteniria and decrease in GFR due to mesangial cell growth

Question 41

Why are women more prone to UTI's?

Answer 41

Shorter urethre Clsoer to anus

Question 42

What serious kidney infection can UTI's lead to?

Answer 42

Pyelonephritis

Question 43

What is glmoerulonephritis?

Answer 43

Inflammation of glomeruli

Question 44

What leaks into urine with glomerular damage?

Answer 44

Blood proteins (albumin) and cells

Question 45

Difference between primary and secondary glomerulonephritis?

Answer 45

Primary: Direct kidney disease Secondary: Due to another condition (e.g., lupus)

Question 46

What causes kidney stone pain?

Answer 46

Stones blocking the ureter

Question 47

What are stones made of?

Answer 47

Crystals of inorganic ions (e.g., calcium)

Question 48

What risk factor increases kidney stone information?

Answer 48

Hypercalciuria and high vitamin D intake

Question 49

What causes polycystuc kidney disease?

Answer 49

Autosomal dominant mutation (chromosome 16)

Question 50

What are symptoms of PKD?

Answer 50

Hypertension Proteinuria Haematuria

Question 51

What is the treatment for PKD?

Answer 51

Dialysis or transplant

Question 52

What happens in chronic renal failure?

Answer 52

Progressive nephron destruction --> decrease in GFR, oliguria/anuria

Question 53

What causes chronic renal failure?

Answer 53

Hypertension Diabetes Aging Altherosclerosis

Question 54

WHat hormone is affected in chronic kideny disease?

Answer 54

Erythropoietin (anemia)

Question 55

What are signs of end-stage renal failure?

Answer 55

Uraemia, acidosis, hyperkalaemmia --> confusion, coma, death

Question 56

What are the treatments for end stage renal failure?

Answer 56

Hempdoalysis or kidney transplant

Question 57

What are the two main types of dialysis?

Answer 57

Hemodialysis Peritoneal dialysis

Question 58

What is RRT?

Answer 58

Renal Replacement Therapy - dialysis or transplant