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41 Cards in this Set
- Front
- Back
what are the disorders of urine concentrating ability
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central diabetes insipidus
nephrogenic diabetes insipidus |
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what occurs in central diabetes insipidus
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lack of ADH therefore no placement of H2O channels and these people would excrete a lot of water in urine
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what is given to people with central diabetes insipidus
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desmopressin
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what occurs in nephrogenic diabetes insipidus
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ADH present in normal or higher amounts but the kidney is still unable to concentrate urine
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what are the causes of nephrogenic diabetes insipidus
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ADH receptor
medulary interstitium is not hyperosmotic (due to loop diuretics) |
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how do you treat nephrogenic diabetes insipidus
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don't give ADH cause that's not the issue must try underlying cause
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what is more sensitive for ADH baroreceptors or osmoreceptors
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osmoreceptors
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what happens to osmoreceptors if osmolarity is high
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they fire more causing ADH release
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what does ANTIDIURETIC HORMONE DO
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absorbs water back in
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what control ADH secretion
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osmoreceptors and baroreceptors
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what happens to ADH if BP is high
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high BP > low ADH > increased H2O secretion
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what happens to ADH if osmolarity is high
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low water > high osmolarity > increase ADH > less H2O secretion > MORE CONCENTRATED URINE
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other than osmoreceptors and baroreceptors what causes a release of ADH
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angiotensin 2
vomitting/nausea increase osmolarity decrease BP decrease Blood volume |
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what will inhibit ADH
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alcohol
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people with low ADH will have hypo or hypernatremia
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hypernatremia
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people will excess ADH will have hypo or hypernatremia
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hyponatremia
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someone w/ diabetes insipidus who is not compensating for a loss of water will have hypo or hypernatremia
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hypernatremia
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what are natriuretic hormones
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dopamine
ANP |
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what are the antinatriuretic hormones
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angiotensin 2
epinephrin/norepinephrine aldosterone |
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if there is excess Na what dominates natriuretic or antinatriuretic
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natruretic want to get rid of excess Na
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what is always secreted in the urine
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H+
K+ |
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people w/ any kind of kidney failure will have excess what
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potassium
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what does aldosterone do to Na and K
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acts on primary/peripheral cells at the Na/K ATP pump causing Na to be reabsorbed and K to be excreted
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what are the sources of H ion gain or loss
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activity of GI tract (diarrhea/vomitting)
de novo generation processing of ingested food |
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vomitting causes loss of what acid or base
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loss of acid therefore gain of base
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diarrhea causes what loss of acid or base
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loss of base (bicarbonate HCO3) gain of acid
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what are the systems that take care of acid generated
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lungs
kidney buffer system |
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what are the body fluid chemical buffers
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ammonia
phosphate protein (hemoglobin) bicarbonate |
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how fast does the buffer system react
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very fast and only temporary
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what buffers are in renal tubules
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phosphate and ammonia
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what is the bicarbonate system equation
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CO2 + H2O > carbonic anhydrase > H2CO3 > H+ + HCO3-
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what would cause respiratory acidosis
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emphycema/lung disease
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how can the kidney regulate teh blood pH
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b/c they regulate H+ and HCO3-
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what are the mechanism the kidney uses to regulate blood pH
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1st mechanism
-w/e HCO3- that gets filtered gets reabsorbed (for every 1 HCO3- that gets reabsorbed 1 H+ gets secreted) 2nd mechanism new carbonate is being formed |
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what are the steps that the kidney uses to make new bicarbonate
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CO2 from interstitium gets turned into a newly formed bicarbonate and goes back into the interstetium
the hydrogen goes into the filtrate and binds w/ phosphate and the product (NaH2PO4) is excreted |
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why does the H+ in the 2nd mechanim of the kidney not react w/ bicarbonate
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because all the bicarbonate has already been reabsorbed
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what are ways metabolic acidosis can occur
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diabetes millitus
OD o on acidic drugs (aspirin) diarrhea renal tubular acidocis carbonic anhydrase inhibitor |
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why does renal tubular acidocis cause metabolic acidocis
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because something is wrong w/ kidney and you are secreting less H+ therefore less HCO3- absorption
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why does carbonic anhydrase inhibitor cause metabolic acidocis
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inhibits carbonic anhydrase
therefore NO H+ IN FILTRATE, CO2 STAYS IN BODY AND HCO3- IS NOT ABSORBED URINE IS ALKALINE |
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what causes metabolic alkalosis
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vomitting
aldosterone mineral corticoids overuse of diuretics base intake (antacids) |
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how does overuse of diuretics cause metabolic alkalosis
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eliminate Na/H2O there fore ECF is low
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