Xx - Renal Physiology Viii

Front 1

LACK of Aldosterone has what effects on the Kidney?

LACK of Aldosterone causes similar Excretion effects as what drug?

Back 1

1.) Decreased Na+ Reabsorption
2.) Decreased H+ Secretion
3.) Decreased K+ Secretion

Similar Excretion effects as:
K+ Sparing Diuretics (SAT)

Front 2

HYPOALDOSTERONISM

Resulting effects of:
- Decreased Na+ Reabsorption
- Decreased H+ Secretion
- Decreased K+ Secretion

Back 2

- ECF Volume Contraction
- Hyponatremia

- Metabolic Acidosis

- Hyperkalemia

Front 3

HYPOALDOSTERONISM

- ECF Volume Contraction decreases Pa, thus what Pressure Condition occurs?

- Decreased Pa also elicits what Sx
(via what mechanism?)

Back 3

- Orthostatic HYPOTension

- Increased Pulse Rate
(via Baroreceptors triggering Sympathetics)

Front 4

HYPOALDOSTERONISM

- ECF Volume Contraction also stimulates the release of?

- From?

- Thus what [electrolyte] effected?

- What about the serum Osm?

Back 4

- ADH

- Posterior Pituitary

- HYPONatremia
(b/c ADH increase H2O resorption)

- Decreased Osm
(b/c ADH increases H2O resorption)

Front 5

HYPERPIGMENTATION

- caused by what insufficiency condition?

- lack of what hormone results?

- thus what is the effect? why?

Back 5

- Adrenal insufficiency

- Cortisol insufficiency
(normally cortisol inhibits ACTH)

- ACTH increases
(ACTH has pigmenting effects similar to melanocyte-stimulating hormone)

Front 6

HYPOALDOSTERONISM

- causes what major electrolyte changes?

Back 6

- Hyperkalemia

- Hyponatremia

Front 7

HYPOALDOSTERONISM

- causes what pressure condition?
(why?)

- causes what effect on pulse rate?
(why?)

Back 7

- Orthostatic Hypotension
(due to decreased Na+ reabsorption causing ECF Contraction)

- Increased Pulse
(decreased Pa will cause Baroreceptors to trigger Sympathetics on SA node)

Front 8

Cortisol normally inhibits what?

Back 8

ACTH

Front 9

ACTH has pigmenting effects similar to?

Back 9

Melanocyte-Stimulating Hormone (MSH)

Front 10

VOMITING

- causes what acid/base disorder?

- due to what?

- resulting compensation?

Back 10

- Metabolic Alkalosis

- Loss of gastric H+
(leaving more Bicarb behind in blood)

- Hypoventilation

Front 11

VOMITING

- along with H+, what other electrolyte is lost?

- what is the resulting effect for Concentration & Volume

Back 11

Cl-

1.) Hypochloremia
2.) ECF Volume Contraction

Front 12

VOMITING

- ECF Contraction is associated with what Kidney blood flow effect?

- Kidney compensates by releasing what?

Back 12

Decreased Renal Perfusion Pressure

Renin secretion is increased
(RAAS activation system)

Front 13

VOMITING

- ECF Contraction activates what system?

- how does this worsen the alkalosis?
(list 3 ways)

Back 13

- Angiotensin II increases bicarb resorption

- Aldosterone increases K+ secretion, so Hypokalemia
(increasing acid excretion as NH4+)

- Aldosterone increases H+ secretion, so worsening alkalosis

Front 14

VOMITING

- Causes the increase in what 2 important hormones that contribute to its metabolic alkalosis?

- what initiates the release of these hormones?

Back 14

- Angiotensin II

- Aldosterone

- ECF Contraction decreases Renal Perfusion pressure, releasing Renin
(thus activating RAAS)

Front 15

VOMITING

- Treatment?
(explain why for each)

Back 15

1.) NaCl infusion
(to correct ECF contraction)

2.) K+
(to replace K+ lost in urine)

Front 16

DIARRHEA

- causes the loss of?

- what replaces the loss?

- thus what is the Specific Acid/Base Disorder?

- Compensation?

Back 16

- Loss of GI Bicarb

- Replaced by increasing [Cl-]

- Metabolic Acidosis with Normal AG

- Hyperventilation

Front 17

DIARRHEA

- ECF Volume effect?

- Causing what response?

- thus causing what changes to pulse rate?

- also causing what changes to vasculature?
(what is the resulting Sx?)

Back 17

- ECF Volume Contraction

- Barareceptor reflex
(which triggers sympathetics @ SA)

- Increases Pulse Rate

- Cutaneous Vasoconstriction
(Pale skin)

Front 18

DIARRHEA

- ECF volume contraction activates what system?

- MOA?

- thus causes what electrolyte change?

- why?

Back 18

- RAAS

- ECF Contraction causes decreased Renal Perfusion Pressure, so Renin is secreted

- Hypokalemia

- Aldosterone increases K+ secretion
(thus hypokalemia)

Front 19

DIARRHEA

- Treatment?

Back 19

Replace ALL Fluids & Electrolytes

(lost in diarrhea & urine)
(including Na+, Bicarb, & K+)

Front 20

DIARRHEA

- what electrolyte changes are seen with the acid/base disorder

Back 20

(Metabolic Acidosis with normal AG)

- HyperChloremic

- HypoKalemic

Front 21

RENAL HORMONES

- PTH stimulated by?

Back 21

- Decreased plasma [Ca2+]

Front 22

RENAL HORMONES

- PTH receptors where on nephron?

Back 22

- Basolateral membrane of DT

Front 23

RENAL HORMONES

- PTH MOA?

Back 23

- Activates Adenylate Cyclase

(secondary messenger is cAMP)

Front 24

RENAL HORMONES

- PTH causes increased urinary excretion of?

Back 24

- Phosphates

- cAMP

Front 25

RENAL HORMONES

- PTH effects on reabsorption @ PT?

- PTH effects on reabsorption @ DT?

Back 25

- Decreases Phosphate reabsorption

- Increases Calcium reabsorption

Front 26

RENAL HORMONES

- PTH also activates what @ the PT?

Back 26

- Alpha-Hydroxylase

Front 27

RENAL HORMONES

- ADH is stimulated by?

Back 27

- Increased Plasma Osm

- Decreased Blood Volume

Front 28

RENAL HORMONES

- ADH receptors where?

Back 28

V1 receptors
- @ blood vessels

V2 receptors
- @ Basolateral membrane
- Late DT & CD

Front 29

RENAL HORMONES

- ADH MOA?

Back 29

V1 receptors
- Ca2+/IP3

V2 receptors
- Adenylate Cyclase, so cAMP

Front 30

RENAL HORMONES

- ADH effects on kidneys

- location?

Back 30

Increases H2O Permeability

Principle Cells of Late DT & CD

Front 31

RENAL HORMONES

- Aldosterone is stimulated by?

Back 31

- Increased plasma [K+]

- Decreased blood volume
(via RAAS)

Front 32

RENAL HORMONES

- Aldosterone effects on kidney
(include location)

Back 32

- Increase Na+ reabsorption
(@ Principle Cells of DT)

- Increased H+ secretion
(@ Alpha-Intercalated cells of DT)

- Increases K+ secretion
(@ Principle cells of DT)

Front 33

RENAL HORMONES

- ANP is stimulated by?

Back 33

Increased Atrial Pressure

Front 34

RENAL HORMONES

- ANP MOA

Back 34

Activates Guanylate Cyclase

(so cGMP is secondary messenger)

Front 35

RENAL HORMONES

- ANP effects on Kidney?

Back 35

- Increases GFR

- Decreases Na+ Reabsorption

Front 36

RENAL HORMONES

- Angiotensin II is stimulated by?

Back 36

- Decreased Blood Volume
(via renin)

Front 37

RENAL HORMONES

- Angiotensin II MOA

Back 37

- stimulates Na+/H+ Exchanger

(@ Early PT)

Front 38

RENAL HORMONES

- Angiotensin II effects on kidney?

Back 38

- Increases Bicarb reabsorption

(@ Early PT)

Front 39

RENAL HORMONES

- Decreased Blood Volume stimulates what renal hormones?

Back 39

- Angiotensin II (via renin)
- Aldosterone (via RAAS)

- ADH

Front 40

RENAL HORMONES

- all renal hormones act Fast, except the Slow _____?

- why is this slow?

Back 40

Aldosterone

Requires New Protein Synthesis

Front 41

RENAL HORMONES

Stimulated by Increased Concentration of:

- Ca2+
- Osmolarity
- K+

Back 41

- PTH

- ADH

- Aldosterone

Front 42

RENAL HORMONES

- Na+ reabsorption increases with what renal hormones?

- Na+ reabsorption decreases with what renal hormones?

Back 42

- Angiotensin II (@ PT)
- Aldosterone (@ DT Principle cells)

- ANP