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12 Cards in this Set
- Front
- Back
change na conc reflect disturbed ___ homeostasis
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H2O
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In PT, Ang II and NE tweek ? on apical and ? on basolateral to promote na reabs
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Na/H on apical (lumenal side)
Na/K ATPase basolateral side |
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In Cortical C.D. ____ inc. Na reabs
ENaC on ? side and Na/K ATPase on ? side |
Aldosterone
work ENaC apical and Na/K ATPase on basolateral |
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What else ADH do besides inc. aquaporin ch. in CD
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1. inc Na reabs in th. asc. limb and CCD
2. Inc. urea transport in IMCD (TO HELP MAINTAIN CONC. Gradient in INNER MEDULLA w/o conc. ADH wouldn't be effective! |
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dec. osmolality, dec. vol.(hypotens) and inc. Ang all cause INC. in ?
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ADH aka vasopressin and Thirst
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Pl Na<136, INC. h2O, inc. na, dec. plasma osm, Una<20mm/L, Uosm: high to isoosmotic
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Hypervol. Hyponatremia
d/t EDEMA ish (3rd spacin: CHF, cirrhosis w/ ascites, adv. renal fail, nephrotic syndrome) hyponat want to stop ADH BUT loss blood vol. therefore high ADH. urine conc. varies d/t dec art. blood vol (want inc. ADH) but hyponatremia (want dec. ADH) |
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Inc. cap hydraulic P, dec. cap oncotic P, dec. cap permeability, lymph obstruction all-->
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Edema, inc. interstitial Oncotic P inc.
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True vol depletion, dec h2o, DEC. Na, dec. plasma osmol, Uosm low to high
extrarenal if? renal if? |
Hypovol hyponat
extrarenal=Una<20mm/L renal=Una>20mm/L extrarenal=GI loss, xs sweat, burns, 3rdspacin renal= diuretics, mineralocorticoid def., ketonuria, bicarbonuria, salt-wastin neuropathy |
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INC INC Una >40mm/L dec. plasma osmolality, Uosm high
what if Uosm low? |
Normovolemic hyponatremia: Uosm high= SIADH or ish that mimics (hypothyroidism, adrenal glucocorticoid defic)
Uosm low= toast tea, beer potomania, primary polydipsia |
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inc H2o INC. Na, Inc Plosm
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hypervol hypernatremia
ex=hypertonic salin xs, NaHCO3 sol'n |
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Diabetes insipidus causes __volemic ___natremia
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normovolemic hypernatremia, too lil adh! Febrile pt.'s, net H2O loss w/ no change body Na therefore
Inc Plosm, dec. Uosm |
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Uosm High, DEC. H2o dec. Na INC. Plsosm!
can be extrarenal or renal |
hypovolemic hypernatremia
Renal causes- Thiazide, osmotic diuretic(urea,glucose, mannitol, glycol) Extrarenal= GI loss(diarrhea,vomit), xs sweat, burns |