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23 Cards in this Set
- Front
- Back
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what can hyponatremia cause if onset is too rapid
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neurological problems
there is cell swelling bc water moves into cells |
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hyponatremia is not due to loss of
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na- instead it is due to excess h20 in relation to the sodium
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what type of hyponatremia is due to low adh
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1. resest osmostat
2.psychogenic polydipsia |
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what disease is related to true hyponatremia
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SIADH- dec effective circ volume
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high glucose can do what to na levels
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can cause pseudohyponatremia
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how do you calculate the plasma solute conc
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2( na) + glucose/18 +BUN/2.8
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what is the osmolar gap
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Difference between plasma osmolality estimated as above and true plasma osmolality measured with an osmometer. Normally < 10 mOsm/kg H2O
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what is true hyponatremia
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both na and osmolality are low
- should be dilute urine and ADH should be low |
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what is hypernatremia usually due to
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water loss and not na gain
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what are the most common causes of hypernatremia
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Extrarenal water loss (excessive sweating, diarrhea, vomiting): urine output should be low, circulating ADH should be high
Renal water loss: ADH mechanism for retaining water isn’t working: central or nephrogenic diabetes insipidus ( the nephrons arent responding to ADH) |
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central diabetes insipidus causes ADH to be
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low
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nephrogenic diabetes inspidius causes ADh to be
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high
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what are signs of hypovolemia
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orthostatic hypotension
orthostatic tachycardia loss of skin turgor dry mucous membranes |
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what causes and increase in creatinine
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a decrease in GFR
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what does the vicious cycle of chf involve
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cardiac injury,increase symp input, dec GFR, increase renin, increase AT II, inc prox tubule reabs of na
and also an increase in ANP which has the opp effect but not strong enough |
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where are most proteins reabsorbed and by what mechanism
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in the prox tubule by endocytosis
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normal protein excretion is
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50-150 mg/day
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what is the normal urinary protein composition
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40% albumin
10% IgG 5% immunoglobulin light chains 3% IgA remainder: mostly Tamm-Horsfall uromucoid (secreted by tubular epithelium) |
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what is the dipstick test
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Color reaction to protein
Far more sensitive to albumin than other proteins May not detect non-albumin protein in urine, e.g. immunoglobulin, myoglobin |
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what is the Sulfosalicylic acid test:
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etects all proteins
Add sulfosalicylic acid to urine: proteins precipitate, sample becomes turbid (cloudy). The more turbidity, the higher the protein concentration |
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what are physiological causes of proteinuria
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1.Orthostasis (especially in children)
2.Strenuous physical activity (e.g. running a marathon) |
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what are pathological causes of proteinuria
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Loss of charge barrier (e.g. minimal change nephropathy)
Loss of size barrier (e.g. inflammation in glomerular membrane: glomerulonephritis) Failure of proximal tubule to reabsorb filtered protein (e.g. tubulointerstitial disease affecting proximal tubule) Overload proteinuria: increased plasma concentrations of low-MW, filterable proteins |
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what kind of proteinuria can the dipstick test not be used for
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overload proteinuria
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