Term
| 900 mOsm/L, you have to get out at least 600 mOsm |
|
Definition
| what is the average solute excretion rate? |
|
|
Term
| 900 mOsm/day / 50 mOsm/kg = 18 L/day |
|
Definition
| if you are excreting solutes at the average solute excretion rate of 900 mOsm/L and you can only concentrate your urine to 50 mOsm/L, how much urine do you have to excrete to get rid of all the solutes you need to? |
|
|
Term
hot weather: decrease water out by 100 mL
heavy excercise: increase water lost by 300 mL |
|
Definition
| what happens to water loss in the lungs during hot weather? during heavy excercise compared to normal loss? |
|
|
Term
hot weather: 1300 more mL's lost
heavy excercise: lose 4900 more mLs H2O |
|
Definition
| what happens to water loss in the sweat during hot weather? during heavy excercise compared to normal loss? |
|
|
Term
| No, even in heavy exercise or hot weather, the skin and feces water loss remains at 350 mL and 200 mL respectively |
|
Definition
| does the amount of water loss change in the feces or from the skin depending on environmental conditions changing? |
|
|
Term
hot weather: retain 300 mL's (normally lose 1500, in hot weather lost 1200)
heavy excercise: retain 1000 more mLs H2O |
|
Definition
| how does water loss in the urine change in hot weather? heavy exercise? |
|
|
Term
1) ECFV: increases
2) Plasma Osm: decreases
3) urine flow rate: increases
4) sodium lost in the urine: decreases |
|
Definition
what does drinking a hypotonic solution do to the following:
1) ECFV
2) Plasma Osm
3) urine flow rate
4) sodium lost in the urine |
|
|
Term
1) ECFV: increases
2) Plasma Osm: increases
3) urine flow rate: increases a lot
4) sodium lost in the urine: increases |
|
Definition
what does drinking a hypertonic solution do to the following:
1) ECFV
2) Plasma Osm
3) urine flow rate
4) sodium lost in the urine |
|
|
Term
1) ECFV: increases
2) Plasma Osm: stays the same
3) urine flow rate: increases
4) sodium lost in the urine: increases |
|
Definition
what does drinking a isotonic solution do to the following:
1) ECFV
2) Plasma Osm
3) urine flow rate
4) sodium lost in the urine |
|
|
Term
1) ECFV: decreases
2) Plasma Osm: increases
3) urine flow rate: decreases
4) sodium lost in the urine: decreases |
|
Definition
what does dying of thirst do to the following:
1) ECFV
2) Plasma Osm
3) urine flow rate
4) sodium lost in the urine |
|
|
Term
| P Na (plasma sodium concentration) |
|
Definition
|
|
Term
|
Definition
| if plasma sodium concentration = 142 mEq/ml, what is the plasma osmolarity? |
|
|
Term
| increased extracellular osmolarity (NaCl) stimulates ADH release which increases H2O reabsorption and stimulates thirst(H2O intake) |
|
Definition
| what is the thirst mechanism? |
|
|
Term
| ADH - Thirst Osmoreceptor system |
|
Definition
| what is the name of the thirst system? |
|
|
Term
| magnocellular neurons of the hypothalmus make it, then it is released from the posterior pituitary |
|
Definition
| what neurons synthesize ADH? |
|
|
Term
1) water deficit which causes
2) increased Extracellular osmolarity
3) osmoreceptors detect that and cause ADH secretion
4) which increases plasma ADH
5) which increase H2O permeability in the DCT & collecting ducts
6) water is reabsorbed
7) and less water is excreted |
|
Definition
| describe the osmoreceptor-ADH feedback mechanism flow chart |
|
|
Term
1) increased osmolarity!!
2) decreased blood volume
3) decreased blood pressure
4) other: fear, angiotensin 2, nausea, nicotine, morphine |
|
Definition
| what are the stimuli for ADH secretion? |
|
|
Term
| small changes(increase) in osmolarity or big change(decrease) in blood volume |
|
Definition
| ___ changes in osmolarity cause ADH release, whereas ____ changes in blood volume cause ADH release |
|
|
Term
| they shrink due to increased osmolarity |
|
Definition
| what happens to the osmoreceptor cells to cause ADH release? |
|
|
Term
| ADH decreases water excretion, and decreases urine volume, however it does not affect solute excretion, so the urine is more concentrated |
|
Definition
| what does ADH do to water excreted? solutes excreted? |
|
|
Term
| causes them to swell and decrease ADH, so there is a lot of dilute urine released |
|
Definition
| what does excess water do to the osmoreceptor cells? |
|
|
Term
1) decreased osmolarity
2) increased blood volume
3) increased BP
4) other: alcohol, clonidine, haloperidol |
|
Definition
| what 4 things DECREASE ADH secretion? |
|
|
Term
| eat salty food to counteract inhibition of ethanol and being up your osmolarity |
|
Definition
| what do you do to counteract the effects of alcohol blocking your ADH secretion (making you pee a lot?) |
|
|
Term
1) high osmolarity (shrink the osmoreceptors)
2) decreased blood volume
3) decreased BP
4) angiotensin 2 (aldosterone and salt reabsorption)
5) low h2O -> decreased salivary gland excretion so dry mouth (and gastric distention = variable effect) |
|
Definition
| what 5 things stimulate thirst? |
|
|
Term
| small changes in GFR can cause BIG changes in renal excretion (which is why the body tries to maintain the GFR) |
|
Definition
| how does GFR affect renal excretion? |
|
|
Term
| GFR or tubular resorption |
|
Definition
| ALL feedback mechanisms that control renal excretion of Na & H2O alter either ___ or ___ |
|
|
Term
| causes increased sodium excretion |
|
Definition
| what does a increased BP do in pressure natiuresis? |
|
|
Term
|
Definition
| what does a increased BP do in pressure diuresis? |
|
|
Term
| increase in blood pressure |
|
Definition
| what happens in chronic HTN when the kidneys fail to successfully excrete salt and water at normal pressures? |
|
|
Term
| natriuretics and diuretics to decrease blood volume and BP by decreasing salt and water retention |
|
Definition
| what is a common treatment of HTN, what does it do? |
|
|
Term
1) high ADH
2) high osmolarity of renal interstitium |
|
Definition
| what are the basic requirements for secretion of concentrated urine? |
|
|
Term
| initially the blood volume increases, but after a few days (8ish) the body adjusts and lowers the blood volume by excreting more sodium |
|
Definition
| if you increase your sodium intake what happens to blood volume initially? after about 8 days? |
|
|
Term
| it will lower the concentration slightly, but it doesn't play a huge, role in regulating it (unlike ADH) |
|
Definition
| if aldosterone/AngII is blocked, what effect will it have on plasma sodium concentration as more sodium is taken in? |
|
|
Term
|
Definition
| what concentration of sodium in the ECF activates the thirst mechanism? |
|
|
Term
| right next to each other on the 3rd ventricle |
|
Definition
| where in the brain are the thirst and ADH centers? |
|
|
Term
| both are elicited (increased) |
|
Definition
| if there is a decrease in extracelluar sodium and decreased blood volume, what happens to thirst and salt appetite? |
|
|
Term
| it sky rockets because ADH is a major regulator of plasma sodium concentration |
|
Definition
| what happens to plasma concentration of sodium when ADH is blocked and sodium intake increases? |
|
|
Term
| there is increased blood volume, causing you to have low ADH and excrete water |
|
Definition
| baroreceptors and volume receptors firing tonically inhibit SON (supraoptic nucleus) and PVN(paraventricular nucleus) when ?? |
|
|
Term
| elevate plasma osmolarity, causes you to then retain and drink water |
|
Definition
| what stimulates the osmoreceptors to increase ADH in the plasma? |
|
|
Term
|
Definition
| in severe dehydration, what can ADH do to EC sodium? |
|
|
Term
| increases, this is what happens when you drink beer because it inhibits ADH |
|
Definition
| as you have less Plasma ADH, collecting duct reabsorbtion declines and urinary flow ______ |
|
|
Term
|
Definition
| if you take in 3 beers/hour (1 L), what does your urinary flow become to maintain water balance? |
|
|
Term
1) ECF volume increases
2) MABP increases
3) these inhibit ADH
4) POsm increases (due to ethanol)
5) ethanol inhibits ADH secretion |
|
Definition
| how does beer drinking make your urinary flow increase? |
|
|
Term
|
Definition
| what disease is caused by a decrease in ADH production? |
|
|
Term
| inability of the posterior petuitary to secrete ADH (head injuries) |
|
Definition
| what causes CENTRAL diabetes indipidus? |
|
|
Term
| PU & PD, large volume of dilute urine |
|
Definition
| what are the clinical signs of diabetes insipidus |
|
|
Term
1) inability of the renal tubules to respond to ADH
2) impariment of the counter-current mechanism |
|
Definition
| what causes nephrogenic diabetes insipidus |
|
|
Term
| special atrial cells when the atria are distended |
|
Definition
| when/where is ANP secreted? |
|
|
Term
| causes increased GFR to increase sodium and H2O excretion |
|
Definition
|
|
Term
| inappropriate ADH syndrome |
|
Definition
what disorder is characterized by excess ADH leading to
1) excess water reabsorption and
2) decreased plasma osmolarity
3) hyponatremia |
|
|
Term
| inappropriate ADH syndrome |
|
Definition
what disorder is characterized by excess ADH leading to
1) excess water reabsorption and
2) decreased plasma osmolarity
3) hyponatremia |
|
|
Term
| central diabetes insipidus |
|
Definition
what disorder is characterized by insufficient ADH leading to
1) increased plasma osmolarity
2) hypernatremia
3) excess thirst |
|
|
Term
1) ADH deficiency (central diabetes insipidus)
2) failure to respond to ADH (nephrogenic diabetes insipidus)
-defect in ADH action
-impaired loop NaCl reabsorption
- drug induced renal damage(lithium, analgesics)
- malnutrition (decreased urea concentration)
- kidney disease: pyelonephritis, hydronephrosis, chronic renal falure
- |
|
Definition
| what things cause problems concentrating the urine? |
|
|
Term
| hypothalamic or Cenral DI |
|
Definition
| name the diabetes type: defect in ADH sythesis or released (depresses PADH) |
|
|
Term
|
Definition
name the diabetes type:
defect in ADH action, failure to maintain hyperosmotic medullary gradient |
|
|
Term
|
Definition
name the diabetes type:
compulsive water drinking |
|
|
Term
| Diabetes mellitus (H2O out with the glucose) |
|
Definition
name the diabetes type:
elevated blood glucose leads to osmotic diuresis |
|
|
Term
central: hypernatremia, with LOW plasma ADH
neprhogenic: hypernatremia with elevated plasma ADH |
|
Definition
| what happens when you restrict fluid to a central DI patient? with a nephrogenic DI patient? |
|
|
Term
|
Definition
| which patient will respond to ADH administration with reduced urine output and urine osmolarity? central DI or nephrogenic DI |
|
|
Term
|
Definition
| what is the treatment of central DI? |
|
|
Term
1)1st correct the underlying renal disorder if possible
2) low sodium diet
3) diuretic to enhance Na+ excretion |
|
Definition
| what is the treatment of nephrogenic DI? |
|
|
Term
| fluid restriction normalizes the situation |
|
Definition
| what will fix a patiendt with polydipsic DI with polyuria and hyponatremia? |
|
|
Term
total GFR: decreases
GFR/nephron: increases
urine flow rate: stays the same
volume excreted: increases (more dilute urine) |
|
Definition
| if you lose 75% of your nephrons, what happens to total GFR? GFR/nephron? urine flow rate? urine volume excreted? |
|
|
Term
| 20 million or 1 in 9 US adults |
|
Definition
| how many americans have chronic kidney disease? |
|
|
Term
|
Definition
| what can help prevent the progression of kidney disease to kidney failure? |
|
|
Term
|
Definition
| what is the best estimate of kidney function? |
|
|
