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What hormone is missing in Diabetes Insipidus?
ADH (Posterior Pituitary)
2 types:
Central (neurologic): caused by the destruction of the post. pituitary gland
Nephrogenic: ADH is present, but the kidnes don't respond to it.
Acquired: caused by CRD, sickle cell, hypokalemia, hypercalcemia
What is another name for primary Aldosteronism?
Conn's Syndrome
Minerlacorticoid excess
-it is a hyperplasia or carcinoma of the adrenal gland (unilaterl); has nothing to do witht he reninangio system
What are the S&S of Diabetes Insipidus?
What gland and hormone are involved?
polyuria, polydipsia, in absence of hyperglycemia
Post. pituitary-- produces ADH
DI is not enough ADH (central)or body doesn't respond to ADH (nephrogenic or acquired)
List the possible causes of a mineralcorticoid deficiency
  • Atrophy or destruction of the adrenal glands
  • Unilateral adrenalectomy
  • DM
  • Heparin therapy
What is Cushing's Syndrome?
glucocorticoid escessCaused by excess ACTH secretion by pituitary tumor
**most common form of glucocorticoid excess
What is the most common form of glucocorticoid excess?
Cushing's syndrome
What is the preop treatement for pheochromocytoma?
Phenoxybenzamine:  Ensure Alpha adrenergic blockade is started; this prevents catechoamine vasoconstrictiona nd allows for volume resucitation preop
Beta Blockade: can be started once the alpha blockade is established
What anesthetic drugs should be avoided in Pheochromocytoma?
Ketamine, Pancuronium, Halothane
what are the S&S of Pheochromocytoma?
HTN, wtih a triad of diaphoreses, tachycardia, and HA
**it is a catecholaimne secreting tumor (most often found in the adrenal medulla)
What is another name for Primary Hypothyroidism?
Hashimoto's: destructionof the thyroid
What is anohter name for Hyperthyroidism?
Grave's Disease
What are the signs and symptoms of Hypoparathyroidism?
All related to Hypocalcemia:
Chvostck'ssign (face twitching
Trosseau's sign (foot twitching)
Parasthesia (tingiling around lips/mouth)
muscle cramps
First degree AV blcock (widened QT interval)
List 3 characteristics of the endocrine system
  • Ductless
  • secretes hormones (interstial and then into blood)
  • no anatmical connections among the endocrine organs
List the three chemical structures of hormones
  • protiens (peptides): synthesized on endoplasmic reticulum of endocrine cells then transferred to Golgi apparatus for packaging into secretory vesicles
  • Steroids: corticsol., aldosterone
  • Amino acid derivatives (amines): synthesized from the amino aicd tyrosine.
Give some examples of amino acid hormones
catecholamines, thyroid hormones
What type of hormones are water soluble, meaning they can dissolve in the plasma and travel to target organ via interstitial spaces?
What does autocrine mean?
a hormone that produces effect on the same cell that released it
What hromones are bound to plasma proteins?
stroids and thyroid hormones
List the 4 ways that hormones are cleared from body:
  • Metabolic destruction by tissues
  • Bidning with tissues
  • Ecretion into bile by the liver
  • Excretion intot urine by the kidneys
  • **Hormones that are boundto protiens clear at a musch slower rate
Secreted by
Type of Hormone
  • beta cells of the pancreas (50 units/day)
  • Polypeptide (51 a.a.)
  • uptake,storage, anduse of glucose by the liver
Secreted by
Type of hormone
  • Alpha cells of Pancreas
  • Polypeptide (29 a.a)
  • Opposes insulin (increase BS concentrations)
Sectreted by
Type of Hormone
  • Delta cells of pancreas
  • Polypeptide (14 a.a)
  • Increase length of time food is in GI tract to prevent rapid exhaustion of food nutrients
Secreted by
Type of hormone
  • Anterior Pituitary
  • Peptide
  • Stimulates adrenal cortex to produce steroid hormons (cortisol or aldosterone)
What is the functional unit of the kidney?
The nephron
what are the 3 major endocrine functions of the kidneys?
  • Erythropoieten: stimulates RBC production
  • Renin-angiotensins system: BP regualtion
  • Vitamin DConverts Vit D to its physiologically active form (D3): when there is a Vt. D deficiency, pt becomes hypocalcemic b/c calcium absorption requires Vit D
  • Regulation of arterial BP
HOw does the kidney regulate extracellular osmolality?
Kidneys regulate sodium concnecntration: this is how they regulate osmolality b/c sodium salts represent 90% of total osmolality
What is extracelular osmolality?
It is the concentration of sodium compared to the amount of volume (H2O) it is in

What is the normal osmolality?
270-310 mOsm/kg
What % of blodd pumped by the heart each minutes goes to the kidneys?
How is blood delivered to the Glomerulus?
via the afferent tubule
How does blood leave the glomerulus
via the efferent tubule
what is reabsorption?
when a substance is transported from the tubule to the capillary
What is secretion?
When a substanc is transported from the capillary to the tubule
What nephrons are most sensitive to ischemia?
the juxtamedullary nephrons
What are the 2 types of nephrons in the kidney
Cortical nephrons (have short loops of Henle and are locatred near the surface fo the kidney
JUxtamedullary nephrons (have long loops of henle and are located deep int he cortex near the cortical medullary junction
How is the glomerulus bolood supply  different from other capillaries in the body?
it is drained by an efferent arteriole (rather than a vien)
What 2 things make up the renal corpuscle?
glomerulus and Bowman's capsule
HOw much filtrate is poduced by the kidney each day?
How much urine is put out?
180 Liter/day of filtrate (alot of this is reabsorbed)
1-2 Liters/day of urine
What is Glomerular Filtration?
Movement, under pressure, of plasma water and most of its dissolved constituents (except proteins) form the glomerular capillary into the Bowman's capsule; it requires Hydrostatic pressure
Each nephron contains 2 types of capillary beds.  They are:
1.  Glomerulus:  is supplied by afferent arterioles and drained by efferetn arterioles.  Is a high pressure system (highest pressure of any cap. bed in the body).  Supports filtration: plasma water and dissolved contents are pushed into bowman's capsule due to hydrostatic pressure.
2.  Peritubules: low pressure system; support reabsorption
What 2 things are not found in the Ultra-Filtrate (in Bowman's capsule)
protiens and cells
What is the Filtration Membrane made up of (3 things)?
Glomerular endothelium
Basement membrane
What part of the nephron has the maximal ability for reabsorbing glucose
The proximal tubule (uses active transport for glucose reabsorption).  All segements of the the renal tubule beyond the proximal tubule are impermeable to glucose (so it cannot be reabsorbed beyond this point and is excreted in the urine.
Which has greater blood flow, hte kidneys of the pulmonary system?
the pulmonary system
How does ADH affect the collecting tubules
An increase in ADH will increase the permeability to water (increasing hte reabsorptionof water and decreasing the excretion of water)
The amount of filtrate poduces each day is ....... and the amount leaving the body each day is....
180 liters
1.8 liters
HOw do the peritubular capillaries recieve blood?
From the efferent arterioles
What is the pathway of blood from the glomerulus to the venous system?
afferent arterioles - glomerular capillaries-efferent arterioles - peritubular capillaries - drain into the venous system
List 3 drugs that are bad for the kidneys
  • aminoglycosides Abx,
  • Radiocontrast dye
What can cause the release of ADH?
Decrease in Renal Blood Flow
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