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USMLE

Renal Physiology 2

QuestionAnswer
actions of angiotensin II? potent vasoconstriction release of aldosterone from adrenal cortex release of ADH from posterior pituitary stimulates hypothamus - increases thirst overall serves to increease intravascular volume and BP
what may be released from atria as a check on the RAA system, e.g. in CHF? ANP
what cells secrete renin? juxtaglomerular cells - in response to decreased renal BP, decreased Na+ delivery to distal tubule, and increased sympathetic tone
how can NSAIDs cause acute renal failure in high vasoconstrictive states? by inhibiting the renal production of prostaglandins, which keep the afferent arterioles vasodilated to maintain GFR
where does ADH bind? what is the result? binds to receptors on principal cells, causing an increase in the number of water channels/aquaporins and increased H2O reabsorption
what is ANF secreted in response to? what does it do? secreted in response to increased atrial pressure, causes increased GFR and increased Na+ excretion
what effect does aldosterone have? secreted in response to decreased blood volume (via AT II) and increased plasma K+ - causes increased Na+ reabsorption and increased K+ and H+ secretion
angiotensin II causes increased absorption of what? Na+ and HCO3-
primary disturbance in metabolic acidosis? decreased HCO3- (causes hyperventilation/ decreased PCO2)
primary disturbance in metablic alkalosis? increased HCO3- (causes hypoventilation/ increased PCO2)
primary disturbance in respiratory acidosis? increased PCO2 (causes increased renal HCO3- absorption)
primary disturbance in respiratory alkalosis? decreased PCO2 (causes decreased renal HCO3- absorption)
acidosis with PCO2 >40? respiratory acidosis
acidosis with PCO2 <40? metabolic acidosis with compensation
alkalosis with PCO2 <40? respiratory alkalosis
alkalosis with PCO2 >40? metabolic alkalosis with compensation
causes of respiratory acidosis? hypoventilation - airway obstruction, acute/chronic lung disease, opiods, narcotics, sedatives, weakening of respiratory muscles
causes of anion gap metabolic acidosis? MUD PILES Methanol Uremia Diabetic ketoacidosis Paraldehyde or Phenformin Iron tablets or INH Lactic acidosis Ethylene glycol Salicylates
causes of non-anion gap metabolic acidosis? diarrhea, glue sniffing, renal tubular acidosis, hyperchloremia
how do you calculate ion gap? Na+ - (Cl- + HCO3-)
causes of respiratory alkalosis? hyperventilation, aspirin ingestion (early)
causes of metabolic alkalosis? vomiting, diuretic use, antacid use, hyperaldosteronism
Winter's formula? PCO2 = 1.5(HCO3-) + 8 +/-2
type of metabolic disturbance commonly seen in cardiopulmonary arrest? mixed acidosis
Created by: Asclepius
 

 



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