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Flashcards in Sodium disorders Deck (65)
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1

Normal serum Na+?

135-145 Meq/L

2

Normal plasma/serum osmolality?

285-300 Meq/L

3

Eqn to estimate plama/serum osmolality?

Na x 2 + BUN/2.8 + Gluc/18

4

Main contributor to serum osmolality?

Na

5

Symptoms of hypo/hypernatremia are due to effects on which orhan?

Brain

6

Sodium abnormalities are usually caused by ____________ NOT ___________.

Water problems

NOT

Salt problems

7

Extracellular hyp-O-osmolality have what effent on neurons?

swelling

8

Sx if Na+

nausea

malaise

9

Sx if Na+ = 115-120:

headache

lethargy

10

Sx if Na+

obtundation

seizures

coma

11

More severe sx in fast or slow hyp-O-natremia?

Fast

brain has less time to adapt

12

Effect of hyp-ER-natremia on neurons?

cells shrink

13

Sx of hyp-ER-natremia?

lethargy

weakness

irritability

twitching

seizures

coma

death

14

Decreased brain volume due to hyp-ER-natremia can have what effect on vasculature?

rupture cerebral vessels

15

Clinically significant water shift occurs with 30-35 mosm/kg osmolar gradient between plasma and brain; what is the corresponding rise in serum Na+?

17 meq/L

16

Hormone responsible for maintenance of plasma osmolality:

ADH

(arginine vasopressin)

17

Where is ADH produced?

supraoptic and paraventricular nuclei of hypothalamus

18

Where is ADH stored and released?

secretory granules

posterior pituitary

19

Osmotic stumuli of ADH release:

INCREASED plasma osmolality

20

Non-osmotic stimuli of ADH release:

hypovolemia --> baroreceptors

pain

esophageal stimuli

medications

21

What receptor binds ADH to release aquaporin 2 to luminal membrane?

Where does this occur?

V2 (activates protein kinase)

collecting tubule

22

With high presence of ADH:

Urine osmolality = ?

Plasma osmolality = ?

urine- increased

serum- decreased

**water flows out of tubule back into blood

23

In low/absent ADH state:

Urine osmolality= ?

Blood osmolality= ?

urine- increased

blood- decreased

**water excreted in urine

24

Physiologic responses to HIGH plasma osmolality:

thirst

ADH release

water reabsorption

concentration of urine --> high urine osmolality

25

Physiologic response to LOW plasma osmolality:

No thirst

No ADH release

Loss of free water -- collecting tubules impermeable

Low urine osmolality -- dilute urine

26

Plasma osmolality maintained within __%.

1%

27

Indicator of the presence of ADH?

Urine osmolality

28

What generally tells you what the kidney THINKS about the body's volume status?

urine sodium

29

Range of urine osmolality in a normal kidney?

50-1400 mosm/L

30

Normal daily osmolar load from dietary protein/salt?

500-750 mosm

excreted in urine