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Renal System, A/B

Clinical Medicine

If intake is 3g last 2-3 days, what will output be next 2-3 days 3g intake must equal output in water and electrolytes
What is TBW, ICF, ECF 60%, I: 66% E: 33% (8% IVF or plasma and 25% in ISF)
What % is the blood of TBW 12%
What is free water comes as no expense to energy
Fxs of the kidneys filtration, secretion, reabsorbtion, endocrine, metabolic
What are the metabolic fxns of the kidneys activation of Vit D3, gluconeogenesis, metabolisms of insulin and steroids
What is crucial to remember as kidney fxn fails about kidney metabolism for diabetics as renal fxn ↓ insulin ↑so ↓ need for insulin replacement
If a pt is on the same insulin dose, but their kidney fxn fails, why can they get hypoglycemic ↓ insulin metabolism (stays in the body)
What secretes renin, fxn? juxtaglomerular apparatus, powerful regulator of BP
What secretes erythropoietin, fxn interstitial cells, RBC production
What happens with a clamp on the renal artery ↑ BP d/t ↑ renin
Fxns of prostaglandins on the kidneys vasodilation effect on the renal vasculature
What happens if we give NSAIDS in periods of vasoconstriction kidney failure (prostaglandin inhibitors on the kidney)
What happens to blood w/ kidney failure ↓ d/t ↓ EPO
What is nephrotic syndrome d/t kidney damage, it leaks large amounts of protein from blood to urine, often see ↑ cholesterol, TGs, swelling (edema)
What is nephrictic syndrome d/t kidney damage RBCs leak into urine: hematuria
Are proteins and protein bound compounds normally filtered? no.
What normally passes through bowman’s capsule water and small molecular wt. ions/molecules
What proteins are most commonly found with the nephrotic syndrome albumin
Where does most of the secretion occur proximal tubule (active transport) goes from plasma to tubular lumen
What blocks penicillin secretion probenecid
What plays a high role in elimination of drugs p-glycoprotein in proximal tubule
What blocks p-glycoprotein verapamil and cyclosporine
How can we tx aspirin overdose (in part) ↑ urine pH, minimizes reabsorption which ↑ elimination
Where does most of the reabsorption occur DT and CDs
What is a sign of acute renal failure ↑ creatining
What classifies subacute renal failure weeks to months
Levels of CrCl for renal failure, irreversible? R: <30, sometimes irreversible: <20
How do we measure CrCl 24 hr urine collection
Formulas to estimate CrCl Crochroft-Gaul, MDRD Cystatin-C CKD-EPI
What is Iodothalmate non-radioactive marker given 1st thing in the morning, measure blood and urine in afternoon, CrCl measurement
5 ways to measure/estimate CrCl CrCl 24 hr measure, Formulas, Iodothalmate, Inulin, Neutrophil gelatinase associated lipocalin
What is creatining based on muscle mass
Nl creatning levels .5-1.2 BUT depends on GFR, need to use Cockgroft-golt equation
Why doesn’t our creatning ↑ with age if our renal fxn ↓ muscle mass usually decreases
Nl pH and PCO2 7.40-7.44, 40-44mmHg
Rule #1 for A/B determine pH Alkalosis vs. acidosis (>7.44, <7.40)
What two A/B d/o can’t you have at the same time can’t have a respiratory acidosis and alkalosis at the same time
PCO2 is substantially (+/-2) less than 40mmHg respiratory alkalemia
If bicarb is greater than 25mEq/L metabolic alkalemia
How can we compensate for a metabolic alkalemia hypoventilate (stop breathing)
If PCO2 is >44mmHg respiratory academia
If bicarb is less than 25 mEq/ L metabolic academia
Look up some compensation stuff
What is the anion gap Na+-(bicarb+cl)
If an anion gap is >10mEq what does this mean possible metabolic acidosis, for sure if >20mEq
What is nl range of anion gap 7-20, <7 concerned about excess protein? But relate it to hx (given saline? Will ↓ gap)
What A/B do/o can’t happen together Respiratory acidosis and alkalosis
Created by: becker15
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