Metabolic mechanisms

Question 1

Explain counterproductive mechanism through RAAS in CCF/ nephrotic syndrome/ hepatic disease

Answer 1

Loss of protein/decreased pumping ability=> reduced oncotic pressure and loss of plasma volume (to intracellular fluid)=> intravascularly depleted but fluid overloaded; low plasma volume-> aldosterone secretion-> further water and salt retention

Question 2

Hormones involved in protein synthesis and breakdown

Answer 2

Protein synthesis: Testosterone, Growth hormone (especially pre-adulthood) and Insulin

Protein breakdown: Cortisol (promotes gluconeogenesis from breakdown of all other products), Tri-iodothyronine (T3)- stimulates protein anabolism but catabolic effects are more significant