ACUTE HD THEORY CLASS FINAL COMPLETE
COURSE REVIEW GUIDE
◉ Hormones that stimulate adenylyl cyclase.
Answer: Vasopressin (V2) (ADH effect)
Parathyroid hormone
Beta agonists
Some prostaglandins
◉ Hormones that inhibit adenylyl cyclase.
Answer: Some prostaglandins
Alpha 2 adrenergic
Angiotensin II
◉ PLC pathway.
Answer: G protein activates PLC and inhibits adenylyl cyclase
PLC cleaves membrane phospholipids into DAG and IP3
DAG activates PKC (leads to increased Ca)
,IP3 initiates calcium release
◉ Parathyroid hormone.
Answer: Decreased levels of serum calcium stimulate PTH release
PTH acts on bone to mobilize calcium, GI to increase Ca absorbtion,
and on the kidney to increase reabsorbtion while inhibiting
phosphate uptake
Hyperparathyroidism can cause bone disease, systemic toxicity (due
to elevated serum calcium) and hypophosphatemia
◉ Vasopressin.
Answer: Synthesized by hypothalamus and secreted by posterior
pituitary
Linear relationship to plasma osmolality
Exponential relationship to plasma volume
High plasma osmolality or low effective circulating volume induce
ADH release and decrease in water excretion --> water retention and
decrease in osmolality or increase in blood volume
,◉ Stimulators of ADH release.
Answer: Hyperosmolarity
Early brain injury
Pain/stress
Nausea
Blood volume depletion
Infections (esp HIV)
Drugs (anticonvulsants)
◉ Inhibitors of ADH release.
Answer: Hypoosmolality
Blood volume expansion
Late brain injury
Ethanol
ANP
Drugs (Vaptans, opioids)
◉ Aldosterone and adlosterone escape.
Answer: Acts in distal nephron to reabsorb sodium and water while
excreting potassium and ions
Angiotensin II and hyperkalemia are stimulators of aldosterone
, Potassium directly interacts with the zona glomerulosa cells of the
adrenal gland to stimulate potassium release
Aldosterone escape -- spontaneous diuresis ensues after a weight
gain caused by increase in extracellular volume --> increases in
systemic BP, ANP and GFR lead to increased sodium excretion in
urine
◉ ANP.
Answer: Released from myocardial cells in atria in response to
volume expansion
Acts to vasodilate vessels (decreasing BP) and enhancing urinary
excretion of sodium (and water)
◉ FGF (fibroblastic growth factor).
Answer: Released from bone, involved in hypophosphatemia
disorders (rickets)
Co receptor - klotho (found in kidney, parathyroid, choroid plexus
and SA node)
COURSE REVIEW GUIDE
◉ Hormones that stimulate adenylyl cyclase.
Answer: Vasopressin (V2) (ADH effect)
Parathyroid hormone
Beta agonists
Some prostaglandins
◉ Hormones that inhibit adenylyl cyclase.
Answer: Some prostaglandins
Alpha 2 adrenergic
Angiotensin II
◉ PLC pathway.
Answer: G protein activates PLC and inhibits adenylyl cyclase
PLC cleaves membrane phospholipids into DAG and IP3
DAG activates PKC (leads to increased Ca)
,IP3 initiates calcium release
◉ Parathyroid hormone.
Answer: Decreased levels of serum calcium stimulate PTH release
PTH acts on bone to mobilize calcium, GI to increase Ca absorbtion,
and on the kidney to increase reabsorbtion while inhibiting
phosphate uptake
Hyperparathyroidism can cause bone disease, systemic toxicity (due
to elevated serum calcium) and hypophosphatemia
◉ Vasopressin.
Answer: Synthesized by hypothalamus and secreted by posterior
pituitary
Linear relationship to plasma osmolality
Exponential relationship to plasma volume
High plasma osmolality or low effective circulating volume induce
ADH release and decrease in water excretion --> water retention and
decrease in osmolality or increase in blood volume
,◉ Stimulators of ADH release.
Answer: Hyperosmolarity
Early brain injury
Pain/stress
Nausea
Blood volume depletion
Infections (esp HIV)
Drugs (anticonvulsants)
◉ Inhibitors of ADH release.
Answer: Hypoosmolality
Blood volume expansion
Late brain injury
Ethanol
ANP
Drugs (Vaptans, opioids)
◉ Aldosterone and adlosterone escape.
Answer: Acts in distal nephron to reabsorb sodium and water while
excreting potassium and ions
Angiotensin II and hyperkalemia are stimulators of aldosterone
, Potassium directly interacts with the zona glomerulosa cells of the
adrenal gland to stimulate potassium release
Aldosterone escape -- spontaneous diuresis ensues after a weight
gain caused by increase in extracellular volume --> increases in
systemic BP, ANP and GFR lead to increased sodium excretion in
urine
◉ ANP.
Answer: Released from myocardial cells in atria in response to
volume expansion
Acts to vasodilate vessels (decreasing BP) and enhancing urinary
excretion of sodium (and water)
◉ FGF (fibroblastic growth factor).
Answer: Released from bone, involved in hypophosphatemia
disorders (rickets)
Co receptor - klotho (found in kidney, parathyroid, choroid plexus
and SA node)
