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41 Cards in this Set

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

URINE IS ALKALINE
what causes metabolic alkalosis
vomitting
aldosterone
mineral corticoids
overuse of diuretics
base intake (antacids)
how does overuse of diuretics cause metabolic alkalosis
eliminate Na/H2O there fore ECF is low