MariaDelMar Shared "Renal System" - 65 Picmonics

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Renal System

Blood Acid-Base Control
Characteristics
In a State of Acidemia
Medullary Chemoreceptors Control Ventilation Rate
Expulsion of CO2 through Lungs Increases pH
Bicarbonate Reabsorption from the Kidney Increases pH
Kidney Excretion of H+ Increases pH
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High Blood Pressure Response
Characteristics
Atria Release Atrial Natriuretic Peptide
Vasodilation
Antagonizes Aldosterone
Na+ and Water Excreted
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Low Blood Pressure Response
Characteristics
Posterior Pituitary Releases Vasopressin
Vasoconstriction
Adrenal Cortex Releases Aldosterone
Increased Na+ and H2O Reabsorption
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Winter's Formula
Evaluates Respiratory Compensation
Used in Metabolic Acidosis
Equation
(HCO3 x 1.5 ) + 8 plus-minus 2 = PCO2
Steps
Bicarbonate (HCO3) x 1.5
+ 8
± 2
= Expected Value for PCO2
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Renal Corpuscle
Characteristics
Arterioles
Glomerulus
Capillaries
Fenestrations
Plasma Solutes and Other Small Molecules Become Ultrafiltrate
Bowman's Capsule Encapsulates Glomerulus
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Proximal Tubule
Characteristics
Na+ Reabsorbed Via Active Transport
Water Follows Na+
Most Of Glucose Reabsorbed
Most Of Amino Acids Reabsorbed
Bicarbonate Exchanged For H+
Drugs and Toxins Excreted
Filtrate Osmolarity Same As Plasma
Leads To Loop Of Henle
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Loop of Henle
Characteristics
Descending Limb
Water Follows Na+
Medullary Hypertonicity
Increased Water Reabsorption
Vasa Recta
Na+ Reabsorbed Via Active Transport
Ascending Limb
Reabsorbs Na+, K+, Cl-
Decreased Concentration of Filtrate
Impermeable to Water
Distal Tubule
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Distal Tubule
Characteristics
Hormonally Regulated
Aldosterone Causes Na+ Reabsorption
Na+ Reabsorbed Via Active Transport
Water follows Na+
Parathyroid Hormone Causes Ca2+ Reabsorption
Leads to Collecting Duct
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Collecting Duct
Characteristics
Na+ Reabsorption via Passive Transport
Vasopressin Causes Water reabsorption
Concentrates Filtrate
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Acetazolamide
Indications
Glaucoma
Altitude Sickness
Pseudotumor Cerebri
CHF
Metabolic Alkalosis
Mechanism of Action
Carbonic Anhydrase Inhibitor
Sodium Bicarbonate (NaHCO3) Diuresis
Side Effects
Metabolic Acidosis
Paresthesias
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Mannitol (Osmitrol)
Indications
Increased Intracranial Pressure (ICP)
Glaucoma
Drug Overdose
Mechanism of Action
Osmotic diuretic
Increased Urine Flow
Side Effects
Dehydration
Contraindications
Anuria
CHF
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Loop Diuretics
Mechanism of Action
Thick Ascending Limb of Loop of Henle
Inhibits Na+-K+-2Cl- Symporter
Sulfa Drug
Drug Names
Furosemide
Lasix
Side Effects
Gout
Ototoxicity
Hypocalcemia
Hypokalemia
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Ethacrynic Acid
Mechanism of Action
Non-sulfa Drug
Phenoxyacetic Acid Derivative
Loop Diuretic
Inhibits Na+-K+-2Cl- Cotransporter
Thick Ascending Loop of Henle
Clinical Use
Diuresis
Side Effects
Hypokalemia
Ototoxicity
Gout
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Thiazide Diuretics
Early Distal Tubule
Inhibits NaCl Reabsorption
Sulfa Drug
Hyperglycemia
Hyperlipidemia
Hypercalcemia
Hyperuricemia
Hyponatremia
Hypokalemic Metabolic Alkalosis
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Hydrochlorothiazide HCTZ
Mechanism of Action
Inhibits Reabsorption NaCl and H2O
Indications
Edema
Mild to Moderate Hypertension
Side Effects
Hypokalemia
Hyponatremia
Dehydration
Hyperglycemia
Gout
Contraindications
Sulfa Allergy
Pregnancy and Breastfeeding
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1 min
K+ Sparing Diuretics
Indications
CHF and Hypertension
Hypokalemia
Hyperaldosteronism
Mechanism of Action
Collecting Tubule
Spironolactone
Competitive Aldosterone Receptor Antagonist
Amiloride and Triamterene
Block Na+ Channels
Side Effects
Hyperkalemia
Gynecomastia
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Spironolactone (Aldactone)
Mechanisms
Inhibition of Aldosterone
Potassium Retention
Indications
Hypertension
Edema
Heart Failure
Side Effects
Hyperkalemia
Endocrine Effects
Consideration
Avoid Potassium Supplements
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ACE Inhibitors
-Pril Suffix
Indications
Hypertension
CHF
Diabetic Nephropathy
Mechanism of Action
Inhibits ACE
Decreases GFR
Inhibits Constriction of Efferent Arteriole
Side Effect
Increased Bradykinin
Cough
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ACE Inhibitor Toxicity
CAPTOPRIL Mnemonic
Cough
Angioedema
Potassium Changes (Hyperkalemia)
Taste Change
Hypotension
Pregnancy Changes
Rash
Increased Renin
Lower Angiotensin II
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2 mins
Angiotensin Receptor Blockers (ARBs)
-sartan suffix
Indications
Hypertension
CHF
Diabetic Nephropathy
Mechanism of Action
Angiotensin II Receptor Blockers
Side Effect
Hyperkalemia
Contraindication
Pregnancy
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1 min

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