Renal

Question 1

Diarrhea

Answer 1

Loss of HCO3-, nml anion gap, hyperchloremia

Question 2

PV Marker

Answer 2

Radioactive Albumin

Question 3

Isotonic IVF

Answer 3

5% Dextrose in H2O
0.9% NS
5% Dextrose in 0.225% NS
Ringers (LR)

Question 4

ANP

Answer 4

Vasodilation of afferent arteriole and vasoconstriction of efferent
Inhibits: Na+ R. @ medullary CD, renin/aldosterone/ADH secretion, and adenylate cyclase in target tissues

Question 5

Chronic Renal Failure

Answer 5

Inability to excrete H+, 👇🏽secretion of H+ as NH4, 👆🏽anion gap

Question 6

K+ Sparing Diuretic

Answer 6

Inhibit aldosterone, thus inhibiting K+ secretion

Question 7

Aldosterone

Answer 7

👆🏽Na+ and H2O R. by principal cell in LD/CD, 👆🏽K+ secretion, 👆🏽H+ secretion from alpha-interc cells in LD/CD via H+ATPase

Question 8

Thiazide

Answer 8

Inhibits reabsorption of Na+ by blocking Cl- in triple-cotransporter in ED
*subsequently increases K+ secretion

Question 9

Type 1 RTA

Answer 9

👇🏽excretion of H+ as titratable acid (alpha-intercalated cell), 👇🏽ability to adicify urine, nml anion gap

Question 10

TBW Marker

Answer 10

Antipyrine

Question 11

ADH aka Vasopressin

Answer 11

👆🏽H2O permeability (V2 receptors), 👆🏽vascular smooth m contraction (V1 receptors), 👆🏽triple co-transporter effectiveness, 👆🏽urea permeability

Question 12

Vomiting

Answer 12

*met alk

Loss of gastric H+ while HCO3- remains in blood, maintained by volume contraction, hyokalemia

Question 13

Hyperaldosteronism (Conn’s Syndrome)

Answer 13

*met alk

Increased H+ secretion by alpha intercalated cells, hypokalemia

Question 14

Alkalosis begets alkalosis

Answer 14

E.g. Vomiting/loop diuretics

👇🏽BV so 👆🏽RAAS which will 👆🏽H+ secretion, 👆🏽HCO3- reabsorption and 👆🏽K+ secretion causing hypokalemia

Question 15

Type 2 Renal Tubular Acidosis (RTA)

Answer 15

Failure to re absorb filtered HCO3-, nml. Anion gap, hyperchloremia

Question 16

Type 4 RTA

Answer 16

Hypoaldosteronism, 👇🏽secretion of NH4+, hyperkalemia inhibits HN3 synthesis, nml anion gap

Question 17

Angiotensin II

Answer 17

Stimulates thirst, 👆🏽NaCl and H2O R. in PCT, enhance Na+/H+ exchanger in PCT (will also 👆🏽HCO3- R.), vasoconstriction of efferent arteriole
*stimulates Aldosterone from adrenal

Question 18

Loop/Thiazides diuretics

Answer 18

*met alk

👆🏽HCO3- reabsorption due to 👆🏽angiotensin II and aldosterone

Question 19

Acetazolamide

Answer 19

Inhibits carbonic anhydride and acts as weak diuretic

Question 20

Base Excess (BE)

Answer 20

Base deficit < -2 mEq/L = met acidosis
BE from -2 to +2 mEq/L = respiratory acidosis/alkalosis
BE > +2 mEq/L = met alk
*(normal is 48mEq/L)

Question 21

ECW Marker

Answer 21

Inulin

Question 22

Metabolic Acidosis w/ 👆🏽Anion Gap

Answer 22

MUD PILES (methanol/formaldehyde, uremia, DKA, propylene glycol, iron/INH, lactic acidosis, ethylene glycol, salicylate poisoning)
*👆🏽H+

Question 23

Furosemide

Answer 23

Blocks Cl- portion of triple-cotransporter in ThAL

*👆🏽K+ secretion, 👆🏽excretion and inhibits R. of Mg2+,👇🏽Ca2+ R.

Question 24

Fluid concentration in ThAL without ADH present?

Answer 24

120mOsm/L

Question 25

Fluid concentration in ThAL in presence of ADH?

Answer 25

100mOsm/L

Question 26

How much Na+ is reabsorbed in PCT?

Answer 26

67%

Question 27

Anion gap equation

Answer 27

Gap = [Na+] - [HCO3-]

Question 28

How does ADH affect urea?

Answer 28

Causes reabsorption in CD and secreted in thin ascending limb of loop. Countercurrent multiplier to increase urine concentration

Question 29

SIADH

Answer 29

Hypoosmotic volume expansion