Lecture Notes

Question 1

Total osmolality will change but tonicity will not with large changes in

Answer 1

BUN

Question 2

What is the normal range of serum osmolality?

Answer 2

285-295 mOsm/kg

Question 3

The ONLY place filtration occurs

Answer 3

Glomerulus

Question 4

The minimum GFR we like to see is

Answer 4

60

Question 5

In a healthy adult, steady state creatinine should be less than

Answer 5

1.5 mg/dL

Question 6

What is the relationship between GFR and creatinine levels?

Answer 6

They are inversely related (i.e. as GFR goes up, creatinine goes down)

Question 7

What is impeded if GFR is either too low or too high?

Answer 7

Reabsorption

Question 8

The distal nephron can communicate with the glomerulus via the

Answer 8

Macula densa

Question 9

An increase in NaCl tells the macula densa what?

Answer 9

That GFR is too high

Question 10

Works in cohort with SNS to maintain BP

Answer 10

RAAS

Question 11

What does AN-II do?

Answer 11

1. ) Good vasoconstrictor (especially of efferent arteriole)
2. ) Promotes aldosterone secretion
3. ) Inhibits Renin
4. ) promotes Na+ and H2O reabsorption

Question 12

Upregulated by low BP or high Na+

Answer 12

AVP

Question 13

What does AVP do?

Answer 13

1. ) Promotes H2O reabsorption

2. ) Potent vasoconstrictor

Question 14

What does Aldosterone do?

Answer 14

1. ) Very active in Na+ reabsorption

2. ) Excess will cause K+ excretion

Question 15

Extrarenal event caused by reduced renal perfusion

Answer 15

Azotemia

Question 16

Moves K+ into forming urine to help drive NKCC

Answer 16

ROMK-2

Question 17

What does furosemide do?

Answer 17

Blocks NKCC and promotes K+ and Ca2+ wasting

Question 18

Which hormone is the major hormone responsible for Na+ reabsorption?

-also important for acid-base status

Answer 18

Aldosterone

Question 19

When we see “presser” response, we are talking about

Answer 19

AVP

Question 20

Stimulates a change in gene transcription which causes an increase in the secretion of K+ by aldosterone

Answer 20

Hyperkalemia

Question 21

Mineralocorticoid hypertension is caused by

Answer 21

Hyperaldosteronism

Question 22

What are the possible effects of hyperaldosteronism?

Answer 22

Possible hypokalemia and metabolic alkalosis

Question 23

What are the possible symptoms of hypoaldosteronism?

Answer 23

Hyponatremia, Hyperkalemia, Metabolic acidosis, and increased HR

Question 24

If blood and urine Na+ are not following the same trend we should suspect

Answer 24

AVP problem

Question 25

Urine osmolality is 1. ) Maximally dilute at values below 2. ) Maximally concentrated at values above

Answer 25

1. ) 100 | 2. ) 600

Question 26

Acute alcohol consumption suppresses

Answer 26

AVP

Question 27

Can cause AVP secretion

Answer 27

Nausea

Question 28

ANP is secreted in response to

Answer 28

Increased BP and RAP

Question 29

ANP inhibits

Answer 29

Renin secretion

Question 30

Characterized as an AVP insensitivity or loss of AVP

Answer 30

Diabetes Insipidus (DI)

Question 31

What are the effects of DI?

Answer 31

Mass diuresis - dilute urine - constant thirst

Question 32

A mismatch between blood osmolality and water retention can signify

Answer 32

DI

Question 33

What are the symptoms of SIADH?

Answer 33

Hyponatremia, increased SG of urine, potential hypertension

Question 34

In SIADH, patients body's are holding too much

Answer 34

Water

Question 35

A patient presents with hypernatriemia, but is NOT antidiuresing. This suggests?

Answer 35

DI

Question 36

A patient presents with hyponatremia, but is NOT diuresing. This suggests

Answer 36

SIADH

Question 37

How can we characterize a type 2 RTA?

Answer 37

General proximal tubule defec leading to a normal AG metabolic acidosis

Question 38

Glucose in urine, PO4 wasting, and vitamin D deficiency are all symptoms of a

Answer 38

Type 2 RTA

Question 39

A UAG that is greater than 0 suggests

Answer 39

Type 1 RTA

Question 40

A patient with a kalemic and acid base disorder likely has a disorder with

Answer 40

Aldosterone

Question 41

Sulfonylureas set up gradients that favor

Answer 41

Insulin secretion

Question 42

Are patients with type 1 DM typically overweight or thin?

Answer 42

Thin

Question 43

Defects with insulin can cause problems with

Answer 43

Callular K+ uptake, FFA uptake, and peripheral glucose uptake

Question 44

DKA is very common with

Answer 44

Type 1 DM

Question 45

An autoimmune disease characterized by a destruction of B cells

Answer 45

Type 1 DM

Question 46

ST elevations and depressions suggest a problem with

Answer 46

K+

Question 47

QT elongations or shortening suggests a problem with

Answer 47

Ca2+

Question 48

Calcitriol has a negative feedback effect on

Answer 48

PTH secretion

Question 49

The point of regulation for calcitriol formation

Answer 49

1a-hydroxylase (CYP27B1)

Question 50

Under normal conditions, which effects will win, PTH or Calcitriol?

Answer 50

PTH

Question 51

In a very sick kidney, Ca2+ reabsorption will not occur and we will not be able to make calcitriol. This leads to

Answer 51

Secondary hyperparathyroidism -eventually leads to osteoporosis

Question 52

Long QT syndrome is caused by

Answer 52

Hypocalcemia