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Endo > Hormones regulating body fluids and electryolytes > Flashcards

Hormones regulating body fluids and electryolytes Flashcards

Wk 11

1
Q

What are the hormones that regulate body fluid and electrolytes?

A

Vasopressin (ADH)

Aldosterone

Angiotensin II

Atrial Natriuretic Peptide

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2
Q

Where is ADH synthesised?

A

cell bodies of supraoptic and paraventricular nucleus

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3
Q

What is the major factor that controls AVP release?

A

plasma osmolality

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4
Q

Describe the physiology effects of ADH on Target organ.

A

Reabsorbing water from renal tubules

Induces production and insertion of Aquaporin 2 into the luminal membrane

Enhances permeability of cell to water

Increases water reabsorption = increased osmolality

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5
Q

outline the cellular mechanism of action for vasopression.

A

Binds to V2 receptor in distal convoluted tubules and medullary collecting ducts –> activate AC –> increases cAMP formation and Aquaporin 2 phosphorylation –> insertion into luminal membrane

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6
Q

What can Vasopressin do at high concentrations in relation to receptors?

A

ADH constricts arterioles using V1A receptor

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7
Q

How does decreased plasma volume result in increased total water?

A

Decreased plasma volume = decreased BP = increased ADH = increased reabsorption = increased total water

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8
Q

How does decreased fluid osmolality result in decreased total body water body

A

Decreased fluid osmolality = decreased ADH secretion = decreased water reabsorption= decreased total body water

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9
Q

What occurs to ADH in when there is water ingestion?

A

suppression of osmoreceptor firing = shuts of ADH release

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10
Q

What is the cause of Diabetes insipidus?

A

Vasopressin deficiency or when kidneys fail to respond to vasopressin

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11
Q

What are the four types of diabetes insidious and there association with ADH

A

Decreased ADH release: Hypothalamic diabetes insipidus (HDI)

  • Decreased renal responsiveness to ADH: Nephrogenic diabetes insipidus (NDI)
  • Gestational DI
  • Inappropriate, excessive water drinking: Dipsogenic diabetes insipidus (DDI)
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12
Q

What test is used to differentiate cranial DI and Nephrogenic DI? What does it show?

A

Water deprivation test= Synthetic AVP Analougue DDAVP Desmopressin test

Differentiates Cranial Di and Nephrogenic DI

Desmopressin = more renal effect than vasoconstrictor effect

If urine becomes concentrated = Cranial DI

Urines fails to become concentrated = nephrogenic DI

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13
Q

What is Syndrome of inappropriate ADH, what is it caused by and what are some symptoms?

A

Too much ADH with inappropriate water retention and decreased sodium

cause
brain injury
tumor production of ADH

presentations
low osmolality
concentrated urine

Inability to produce dilute urine –>water
retention –> increased ECF volume –>
hyponatremia (dilutional hyponatremia)

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14
Q

What is the mechanism of Action for Aldosterone.

A

Acts on cytosolic receptors to alter cell membrane Na transporters and Na/K pump = increased Na+ channels in luminal membrane

increased urinary excretion

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15
Q

What is the site of action for Aldosterone?

A

Distal convoluted tubule and collecting duct

Principal cells

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16
Q

what are the circulatory effects of Aldosterone?

A

Increased Blood volume and pressure

17
Q

What are the overall effects of Aldosterone on plasma Na?

A

Increases expression of Na Channels and expression of proteins involved in Na transporter synthesis

Increases Ca reabsorption

18
Q

What are the three disorders that result from hyper-secretion of the three corticosteroids? What are the corticosteroids that cause each of them?

A

Cushing Syndrome - glucocorticoid

Conn’s Syndrome- Excess mineralocorticoids (primary and secondary)

Adrenogenitial syndrome - excess Adrenal sex steroids- congenital Adrenal Hyperplasia

19
Q

What is the cause of primary Conn’s syndrome?

A

result of adrenal hyperplasia and aldosterone producting adenomas

20
Q

What is the cause of secondary Conn’s syndrome?

A

high plasma renin –> stimulation of angiotensin II and aldosterone.

21
Q

What is the effect of Conn’s Syndrome on Na?

A

hypersectertion = excessive NA+ reabsoprtion = water retention = expansion of ECF volume, Arterial hypertensin

22
Q

What is the cause and effect of Hypoaldosteronism?

A

Cause
Reduced renin
Congenital defect (deficiency of enzyme for renin synthesis)
Excision of aldosterone secterting hormone

Effects
Hypotension
Hyperkalaemia
Metabolic acidosis

23
Q

What are the major effcts of renin?

A

increased formation of angiotensin II

Increased aldosterone secretion –> increases sodium reabsorption in kidney + blood pressure

24
Q

What is the stimuli for the renin-Angiotensin system?

A

renal ischemia, decreased blood volume and pressure and sympathetic nerve stimulation.

25
Q

In the renin-Angiotensin- aldosterone system:

What decreases secretion of Renin?

A

Increase Na+ and Cl- reabsorption in kidney

Angiotensin II

Vasopressin

Increased blood volume

26
Q

What are some actions of Angiotensin?

A

BP: Arteriolar constriction –> hypertension

Aldosterone: increases it

Catecholamines: increases NE release from sympathetic nerve endings.

Kidney: renal tubules –> increase NA reabsorption

Hormones: increases ADH, ACTH and Aldosterone.

27
Q

What is the overall impact of Angiotensin on Na?

A

increases Na reabsoprtion in renal tubules

increased action of Aldosterone–> increased expression of Na channels

28
Q

What are the two receptors of Angiotensin?

A

AT1 and AT2

29
Q

When stimulated, what does AT2 do?

A

vasodilation and inhibition of vascular smooth muscle growth

30
Q

What is the site of release for Atrial Natriuretic peptide?

A

Cardiac muscle cells in atria

31
Q

What stimulates the release of ANP?

A

increased serum sodium
increased ECF volume

32
Q

what are the effects of ANP on body fluid volume and BP?

A

Increases loss of Sodium
decreased body water and ECF volume

increases capillary permeability - decreased blood pressure

33
Q

What are the actions of ANP on Na?

A

Increases loss of body Na

Increases Na+ excretion of Na in kidneys (inhibits Na reabsorption)

34
Q

Describe the effect of K+ intake?

A

Increased K intake –> Increased plasma concentration –> increased aldosterone secretion and plasma concentration –> increased K+ secretion from principal cells of collecting ducts –> increased K+ secretion

35
Q

Hormonal regulation of K+

A

Insulin –> stimulates K cellular uptake

Epinephrine –> DECREASES

Aldosterone –> increases K secretion.

Cortisol – increases secretion

36
Q

How does K increase K secretion?

A

Increases intracellular K+ via stimulating Na+K+ATPase.

Endo (14 decks)

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