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BMSC208 > Renal 8 > Flashcards

Renal 8 Flashcards

1
Q

Effects of Angiotensin 2

A

Increased Cardiac output
Increased Na+ Reabsorbtion
Thirst
Increased vasopressin secretion
Increased peripheral vasoconstriction
Stimulus: Low blood pressure

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2
Q

Thirst is controlled by

A

Hypothalamus

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3
Q

What are the sources of increasing thirst

A

Increased blood osmolarity
Decreased blood volume
Decreased blood pressure
Dry mouth

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4
Q

Behavioural mechnaisms for salt intake

A

increased aldosterone
increased angiotensin 2

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5
Q

Avoidance behaviours

A

Helps prevent dehydration

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6
Q

CV system responds

A

To blood volume and blood pressure

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7
Q

Renal responds to

A

Blood volume and blood osmolarity

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8
Q

increase osmolarity and increase blood volume

A

When eating salty popcorn. Ingesting more salt than water. Ingestion of hypertonic saline

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9
Q

How do kidneys resolve increase osmolarity and increased blood volume

A

By excreting hyperosmotic urine

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10
Q

Increased volume and no change in osmolarity

A

If salt and water are ingestes equally to isotonic solution

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11
Q

Increase volume and decreased osmolarity

A

Simply drinking pure water
Kidneys cannot excrete pure water

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12
Q

No volume increased osmolarity

A

Kidneys created concentrated urine
Thirst is triggered
Eating salt without drinking water, increases ECF osmolarity

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13
Q

No change in volume decreased osmolarity

A

if you are sweating. can lead to hypokalemia or hyponatremia

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14
Q

Decrease volume Increased osmolarity

A

Dehydration. due to excessive excersie or sweating or diarrhea
Can result in inadequate perfusion (decreased blood volume) and cell dysfunction
You want to increase water intake

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15
Q

Decrease volume no chnage osmolarity

A

Hemorrhage
Need blood transfusion

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16
Q

Decrease volume Decrease dehydration

A

May be due to incomplete dehydration

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17
Q

Dehydration is due to

A

Decreased blood pressure and increased osmolarity

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18
Q

Dehydration is restored by

A
  1. Conserving fluid to prevent additional loss
  2. Trigger cardiovascular reflexes to incrase blood pressure
  3. Stimulate thirst so normal fluid volume and osmolarity can be restored
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19
Q

ANP release in stimulated by

A

Increased blood volume

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20
Q

Renin - angiotensin is stimulated by

A

Decreased blood volume

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21
Q

Increase in osmolarity

A

Inhibits aldosterone release

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22
Q

What senses dehydration in CVVCC

A

Cartoid and aortic baroreceptors

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23
Q

how does CVCC respond to dehydration

A

Heart rate goes up as SA node controls shifts from parasympathetic to sympathetic.
2. Force of ventricular contraction increases from sympathetic stimulation
3. Sympathetic input to arterioles increases peripheral resistance (Vasoconstriction)
4. Sympathetic vasoconstriction of afferent arterioles in kidney decreses GFR, coserving fluid
5. Increased sympathetic activity at granular cells increases renin seretion

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24
Q

Direcr responses of Low blood pressure

A

Decreases blood pressure directly decreases GFR
Paracrine feedback at macula densa cells causees granular cells to release renin
Granular cells respond to decreased blood pressure by releasing renin
Decreased blood pressure, and increased osmolarity and increased ang 2 stimulate vasopressin and the thirst centers at hypothalamus
ANG 2 reinforces CV response

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25
Q

Results of blood pressure mechanisms

A
  1. Rapid attmept by the CVCC to maintain blood pressure
  2. Restoration of volume by water conservation and fluis intake
  3. Restoration of normal osmolarity by decreased na+ reabsorbtion and increased water reabsorbtion and intake
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26
Q

pH of solution

A

Is a measurement of H+ Concentration

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27
Q

pH of 7

A

Neutral

28
Q

A Change of 1 pH represents

A

10 fold change in H+ concentration

29
Q

Normal pH

A

in ECF is 7.38-7.42

30
Q

pH chnages can

A

Denature proteins

31
Q

low pH

A

Acidosis (CNS depression, cofusion and coma)

32
Q

High pH

A

Alkalosis (Hykerexcitability)
Sustained respiratory muscle contracttion

33
Q

Body is exposed

A

To more acid than base

34
Q

The largest source of acid is

A

Production of CO2 from aerobic metabolism

35
Q

pH homeostasis depends on 3 mechanisms

A
  1. Buffers (First line of defence)
  2. Vnetilation (handles 75% of disturnamces)
  3. Renal regulation of H+ and HCO3 (lowest)
36
Q

Intracellular buffers

A

Hemoglobin

37
Q

Major extracellular buffer

A

HCO3 itself

38
Q

Which of the following occurs during dehydration

A

Decreased aldosterone release
Increased vasopressin release
Increased ANG II released
Increased Sympathetic
Decreased ANC

39
Q

Buffer systems include

A

Proteins, phosphate ions and HCO3 -

40
Q

Intracellular buffer

A

Hemoglobin

41
Q

most important extracellular buffer system

A

Bicarbonate

42
Q

Increased CO2

A

Equilibrium shifts to right
It creates one hydrogen and one bicarbonate

43
Q

Increased hydrogen

A

Bicarbonate acts as a buffer creating carbonic acid. Function within a narrow range.

44
Q

Increased in CO2

A

Hypoventilation (Right Shift)

45
Q

Decrease CO2

A

Hyperventilation (Left shift)

46
Q

Rate of breathing increases when

A

Decreases plasma H+ and increased plasma CO2

47
Q

Kidneys respond to disturbances

A

Slowly
Directly
Indirectly

48
Q

how do you do it directly

A

By altering excretion or reabsorbtion of H+

49
Q

How do you do it indirectly

A

By changing the rate at which HCO3- buffer is reabsorbed or secreted

50
Q

Hydrogen is not

A

Filteres

51
Q

The proximal tubule

A

secretes H+ and reabsorbs HCO3-

52
Q

Glutamine

A

Metabolizes to ammonium and HCO3

53
Q

The distal nephron

A

Controls acid secretion and initial portion of the collecting duct

54
Q

Type A intercalated cells

A

During acidosis
There is excess hydrogen and co2
Goal is to secrete hydrogen
Also result in hyperkalemis

55
Q

Type B interclated cells

A

During Alkalosis
HCO3 and K+ is secreted
Hypokalemia

56
Q

Acidosis

A

More acidic

56
Q

Types of Acid/base disturbances

A

Respiratory
Metabolic

56
Q

Collecting duct

A

Plays a significant role in the fine regulation of acid base balance

56
Q

Alkalosis

A

More basic

57
Q

Respiratory acidosis

A

Increased CO2 and H+
Occurs in Alveloar hypoventilation results in CO2 retention and elevated plasma CO2

58
Q

What causes acidosis

A

Pulmonary fibrosis
Skeletal muscle disorders
Muscle dystrophy

59
Q

How is respiratory acidosis fixed

A

Must occur via Renal mechanisms

60
Q

Respiratory alkalosis

A

Decreased CO2 Decreased H+
Less commON
Result of hyperventilation

61
Q

Metabolic acidosis

A

Excessive acid intake
Excessive metabolic production of hydrogen
Can be due to ketoacidosis
Excessive Bicarbonate loss (Diarrhea)

62
Q

Metabolic Alkalosis

A

Excessive vomiting of acidic stomach contents or excessive ingestion of bicarbonate ccontaining antacids

BMSC208 (20 decks)

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