Physiology Renal Exam 4 (IP2): Control of Na+ and H2O Excretion II Lecture

Diabetes Mellitus is excessive (water/glucose) excretion

glucose

diabetes insipidus is excessive (water/glucose) excretion

water

Diabetes (mellitus/insipidus) is excess glucose excretion

mellitus

Diabetes (mellitus/insipidus) is excess water excretion

insipidus

what are the two types of diabetes mellitus

type 1, type 2

type 1 diabetes mellitus is (lack of/resistance to) insulin

lack of

type 2 diabetes mellitus is (lack of/resistance to) insulin

resistance to

what are the two types of diabetes insipidus

central, nephrogenic

central diabetes insipidus is (lack of/resistance to) vasopressin/ADH

lack of

nephrogenic diabetes insipidus is (lack of/resistance to) vasopressin/ADH

resistance to

if ADH/vasopressin are present in the kidneys, but the kidneys aren't responding this is diabetes (mellitus/insipidus) (type 1/central/type 2/nephrogenic)

insipidus, nephrogenic

if ADH/vasopressin are not present in the kidneys at all this is diabetes (mellitus/insipidus) (type 1/central/type 2/nephrogenic)

insipidus, central

what hormone is responsible for regulating blood volume and plasma osmolarity

anti diuretic hormone

what two things does anti diuretic hormone regulate?

Hint:

- Blood __________

- Plasma ___________

- volume

- osmolarity

ADH is synthesized in the ____________ and then secreted from the ______________ into the blood

hypothalamus, posterior pituitary

ADH is synthesized in the (posterior pituitary/hypothalamus) and then secreted from the (posterior pituitary/hypothalamus) into the blood

hypothalamus, posterior pituitary

the primary renal function of ADH is to (increase/decrease) water reabsorption in (what part of the nephron)?

increase, late distal and collecting tubules/duct

ADH will bind to receptors on the epithelial cells of the late distal and collecting tubules and duct to (increase/decrease) aquaporin expression on the (basolateral/apical) membrane

increase, apical

aquaporins are expressed on the (basolateral/apical) membrane of the late distal/collecting tubules

apical

ADH secretion is regulated by what three things

hint: two of them are receptors and one is another hormone

baroreceptors, osmoreceptors, angiotensin II

baroreceptors sense changes in blood (osmolarity/pressure)

pressure

osmoreceptors sense changes in blood (osmolarity/pressure)

osmolarity

what two neuron groups in the hypothalamus are responsible for making ADH?

supraoptic, paraventricular

(paraventricular/supraoptic) neurons produce more ADH

supraoptic

Paraventricular and supraoptic neurons receive input from what two receptors in order to released ADH?

osmoreceptors, baroreceptors

when blood volume increases this is sensed by (osmoreceptors/baroreceptors) and ADH secretion is (increased/decreased)

baroreceptors, decreased

when blood volume decreases this is sensed by (osmoreceptors/baroreceptors) and ADH secretion is (increased/decreased)

baroreceptors, increased

when blood pressure drops, baroreceptor firing is (increased/decreased) and ADH secretion is (increased/decreased)

decreased, increased

when blood pressure increased, baroreceptor firing is (increased/decreased) and ADH secretion is (increased/decreased)

increased, decreased

when plasma osmolarity decreases this is sensed by (osmoreceptors/baroreceptors) and ADH secretion is (increased/decreased)

osmoreceptors, decreased

when plasma osmolarity increases this is sensed by (osmoreceptors/baroreceptors) and ADH secretion is (increased/decreased)

osmoreceptors, increased

when plasma osmolarity is increased, osmoreceptor firing is (increased/decreased) and ADH secretion is (increased/decreased)

increased, increased

when plasma osmolarity is decreased, osmoreceptor firing is (increased/decreased) and ADH secretion is (increased/decreased)

decreased, decreased

when plasma osmolarity is hyperosmotic, water is (entering/normal/leaving) the cell and the interstitial fluid has (low/equal/high) sodium levels

leaving, high

when plasma osmolarity is isosmotic, water is (entering/normal/leaving) in the cell and the interstitial fluid has (low/equal/high) sodium levels

normal, equal

when plasma osmolarity is hyposmotic, water is (entering/normal/leaving) the cell and the interstitial fluid has (low/equal/high) sodium levels

entering, low

in response to increases in plasma osmolarity, ADH secretion (increases/decreases)

increases

in response to decreases in plasma osmolarity, ADH secretion (increases/decreases)

decreases

in response to increases in blood pressure, ADH secretion (increases/decreases)

decreases

in response to decreases in blood pressure, ADH secretion (increases/decreases)

increases

with an increase in water ingestion:

- blood volume (increases/decreases)

- baroreceptor firing (increases/decreases)

- ADH secretion (increases/decreases)

- plasma osmolarity (increases/decreases)

- osmoreceptor firing (increases/decreases)

- Water reabsorption (increases/decreases)

- there is (low/high) volume of urine

- urine is (dilute/concentrated)

- increases

- increases

- decreases

- decreases

- decreases

- decreases

- high

- dilute

with dehydration:

- blood volume (increases/decreases)

- baroreceptor firing (increases/decreases)

- ADH secretion (increases/decreases)

- plasma osmolarity (increases/decreases)

- osmoreceptor firing (increases/decreases)

- Water reabsorption (increases/decreases)

- there is (low/high) volume of urine

- urine is (dilute/concentrated)

- decreases

- decreases

- increases

- increases

- increases

- increases

- low

- concentrated

during a hemorrhage, the large decrease in blood volume will stimulate the release of what hormone to help regulate

ADH

in the case of hemorrhage, in addition to a decrease in baroreceptor firing stimulating the release of ADH, what else will?

high levels of plasma angiotensin II

diuresis is an (increased/decreased) rate of urine production

increased

an increased rate of urine production is known as what

diuresis

T/F: diuresis can be due to a decrease in water intake

false, increase

T/F: diuresis can be clinically induced

true

with diuretics

what are the two kinds of diuresis?

water, osmotic

water diuresis is (low/high) urine volume and (hyposmotic/isosmotic/hyperosmotic) urine

high, hyposmotic

osmotic diuresis is (low/high) urine volume and (hyposmotic/isosmotic/hyperosmotic) urine

high, isosmotic

with water diuresis, increased water intake (increases/decreases) blood volume and (increases/decreases) osmolarity which (increases/decreases) ADH release

increases, decreases, decreases

with water diuresis, lower ADH levels results in (less/more) water reabsorption in the distal/collecting tubule and duct which means the urine is (concentrated/dilute), (hyposmotic/isosmotic/hyperosmotic), and (lower/higher) in volume

less, dilute, hyposmotic, higher

diabetes (mellitus/insipidus) is caused by a failure of the ADH-induced water reabsorption mechanism - water diuresis

insipidus

what two drug examples were given in lecture that can induce water diuresis?

glucocorticoids, amphotericin

glucocorticoids (stimulate/inhibit) the release of ADH

inhibit

a reduced secretion of ADH from the brain is known (nephrogenic/central) diabetes insipidus

central

if ADH is still secreted into the circulation but is no longer effective in the kidneys then this is known as (nephrogenic/central) diabetes insipidus

nephrogenic

T/F: both nephrogenic and central diabetes insipidus can be due to genetic mutations, tumors, trauma, or drugs

true

osmotic diuresis produces a large volume of (dilute/isosmotic/concentrated) urine

isomostic

osmotic diuresis is due to a causative substance increasing the osmolarity of the filtrate in what part of the nephron?

proximal tubule

osmotic diuresis is due to effects in the proximal tubule where the causative substance increases the osmolarity of the filtrate which in turn (increases/decreases) the osmotic gradient across the tubular epithelium which (increases/decreases) water reabsorption in the proximal tubule

decreases, decreases

polyuria in diabetes mellitus is due to the (low/high) glucose levels in the tubule which (decreases/increases) the osmolarity of the filtrate

high, increases

what kind of drugs are used in the clinic to increase urine output as a means to remove fluid from the body

diuretics

diuretic drugs are used in clinics to (decrease/increase) urine output as a means to (remove/retain) fluid within the body

increase, remove

what drug was mentioned in lecture that is an osmotic diuretic occasionally given in small animals to reduce fluid in glaucoma, head injury, and ascites

mannitol

water diuretics (stimulate/inhibit) sodium reabsorption and therefore water

inhibit

amiloride is an example of a (NKCC/NCC/ENaC) inhibitor

ENaC

furosemide is an example of a (NKCC/NCC/ENaC) inhibitor

NKCC

hydroxychlorothiazide is an example of a (NKCC/NCC/ENaC) inhibitor

NCC

spironolactone is an (angiotensin/aldosterone/anti diuretic hormone) antagonist

aldosterone

(NKCC/NCC/ENaC) inhibitors are potassium sparing

ENaC

- these channels only let sodium through, others are co-transporters

(NKCC/NCC/ENaC) are found in the late distal collecting tubule/duct

ENaC

(NKCC/NCC/ENaC) are found in the distal tubule

NCC

(NKCC/NCC/ENaC) are found in the loop of henle

NKCC