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Renal 2 > Sodium and Water Homeostasis > Flashcards

Sodium and Water Homeostasis Flashcards

1
Q

WHat happens to the ECF volume with increased Na intake?

A

Increases (changes) quickly and levels off

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2
Q

Where is the majority of Na Reabsorbed?

A

Proximl Concoluded tubule

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3
Q

WHat are the determinants of Reabsorption of Na?

A 
Na-H+ exchange
Na-Glucose Cotransport
AT II
Norepinephrine
Peritubular Capillary hemodynamics
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4
Q

What determines reabsorption through the Loop of henle and distal tubule?

A

Flow-dependent

Flow- dependent

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5
Q

What happens to GFR and Renal Plasma Flow during low effective arterial volume?

A 
Slight Decrease in GFR.
Large decrease in RPF 
leads to INCREASED FILTRATION FRACTION
Inc oncotic P
Inc reabsorption
Dec Backleak
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6
Q

What are the clinical signs of Volume expansion

A 
Edema
Pulmonary Crackles
Ascites
JVD
Hepatojugular reflux 
Hypertension
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7
Q

What are the treatments of Volume expansion?

A 
Tx underlying disorder
Reduce Na intake
Diuretic Therapy
-Carbonic Anhydrase Inhibitors
-loop diuretic therapy
-Thiazide Diuretic Therapy
-ALdosterone antagonist thx
-K sparing diuretics
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8
Q

What are the applications for Carbonic anhydrase inhibitors?

A

Mets acidosis

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9
Q

What are the applications for Loop Diuretics?

A

Acts on Loop of Henle

  • electrolyte disorders
  • ototoxicity
  • hypersensitivity rxn
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10
Q

What are the applications for Thiazide Diuretics?

A

Electrolyte disorders-HypoK, Hypo Na
Gout
Metabolic Disorders-lipid Dis

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11
Q

What are the applications for ALdosterone antagonist therapy?

A

Acts on Aldo sensitive principle cells in cortical coll tubule HyperKalemia
Gynecomastia, amenorrhea

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12
Q

What are the applications for K sparing Diuretics?

A

Acts on Aldo sensitive principle cells in cortical coll tubule
Hyper K
Weak naturetic effect

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13
Q

What are the clinical symptoms of Volume depletion?

A 
Orthostatic Hypotention 
Dec Pulse Vol
Dec venous pressure
Loss of axillary sweating 
Dec Skin turgor
Dry mucous membranes
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14
Q

What is the major determinant of water excretion?

A

ADH

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15
Q

What are the treatments of Chronic Hyponatremia?

A

Fluid Restriction
Inhibition of ADH action
Increased Solute intake

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16
Q

What are the causes of Hyponatremia?

A

Salt wasting nephropathy

Cerebral salt wasting (rare)

17
Q

How can SIADH be diagnosed?

A

Water deprivation test

18
Q

What is the Tx of Nephrogenic DI?

A 
Correct Ca and K
Remove offending drug
Low Na diet
Thiazide Diuretic
Amiloride (lithium induced DI)
19
Q

What is the Equation for Free water Deficit?

A

.6x [Total body water] x (SNa-140)/140

Renal 2 (13 decks)

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