The first mechanism is the counterculture multiplier which controls the interaction between the flow of filtrate through the ascending and descending limbs of the neoprene loops in the extraordinary neoprene. The second is through the counterculture exchanger Inch is responsible for the blood flow through the ascending and descending portions of the visa recta. L When the two counterculture mechanisms work together, they both establish and maintain an osmotic gradient from the cortex through the medulla which controls the concentration of the urine. 2. The initial measurements on Alias’s blood and urine suggested that the cause of her Polaris was not primary Polynesia – why not? What additional information, provided by the water deprivation test, confirmed that she did not have primary Polynesia? The initial measurements on Alias’s blood and urine suggested that primary Polynesia was not the cause of the Polaris because even with large amounts of water intake (primary Polynesia) the similarity of Alias’s urine remained unchanged.
Usually when an individual is consuming large amounts of liquid in their diet, the concentration of their urine will decrease which was not evident in Alias’s initial lab results. In addition, after performing a two hour water deprivation test, the urine similarity remained the same while her plasma similarity increased to 325 moms. This further shows that primary Polynesia is not the cause of the excessive drinking and urine output because even when water was removed from her diet, the similarity of her urine remained unchanged.
Normally, when water is removed from the body the kidneys Nor to maintain fluid and electrolyte homeostasis in the body which can lead to changes in the urine output. L Usually, a lack of water leads to an increase in urine similarity while an abundance of water usually leads to a decrease in urine similarity. L Thus, when the urine similarity did not change over the course of two ours without water, it was indicative that perhaps there was another explanation for her symptoms. 3 What important diagnosis, associated Witt Polaris and Polynesia, was ruled out by the absence of glucose in the urine?
Untreated diabetes mellitus is associated Ninth Polaris and Polynesia. The Polaris occurs as a result of osmosis dieresis that IS caused by unabsorbed glucose. Because no glucose was detected in Alias’s urine, it can be concluded that she isn’t undergoing a glucose based osmotic dieresis 3. 4. After the initial blood and urine tests were performed, Alias’s physician suspected hat Lisa had either central or nephritic diabetes insipid. Explain how each of these diagnoses could be consistent with her lab values for plasma and urine similarity.
In central diabetes insipid, DAD secretion from the posterior pituitary is deficient. In the absence of DAD the cells of the distal tubule and collecting ducts are Impermeable to water 4. As a result of this, free water is not reabsorbed in these spots, and the urine is hypotonic. Since free water is excreted, the plasma similarity increases. In nephritic diabetes insipid, DAD is secreted in normal mounts by the posterior pituitary. Except now the renal cells do not respond to the hormone due to defective cell signaling 4.
These cell signaling molecules include DAD receptor, G protein, and densely cycles 4. These cells are not resistant to DAD and so the free water is not reabsorbed in the distal tubule and collecting ducts and urine is once again hypotonic. Excess water is still excreted and the plasma similarity once again increases Just as it would with central diabetes insipid. Both forms of diabetes described here are associated with hypotonic urine and hypertrophies plasma. 5. How did the physician confirm that Lisa had central rather than nephritic diabetes insipid?
The physician knew that Lisa had to have central diabetes insipid rather than nephritic because central diabetes insipid is mainly Characterized by excessive thirst and urine output, caused by a decrease in ‘suppression in the body, which is exactly what Lisa was experiencing. Her body’s response to possessing confirmed this, showing that her urine similarity increased above her plasma similarity level, as it should be. If she had nephritic diabetes Insipid, she would still have excessive thirst and urine output but the injection of ‘suppression would have shown no altered effects, since her neoprene would still be Morning improperly. 5)(6) 5. Although it was not measured, the serum DAD level could also have distinguished between central and nephritic diabetes insipid – how? Measuring DAD levels could have easily shown whether Lisa had central or nephritic diabetes insipid. In central diabetes insipid little or no possessing is produced in the body while nephritic diabetes insipid has normal levels of possessing being produced but he kidneys cannot respond to it for some specified reason.
The level of DAD in the serum shows why excessive urine output and excessive thirst is occurring, whether it be from malfunctioning kidneys unable to detect and properly interpret Dad’s signal or from a lack of DAD production. (5)(6) 7. Why was Dave effective in treating Alias’s central diabetes insipid? Dave was effective in treating Alias’s central diabetes Insipid because nerd body level to possessing/ DAD was low due to anti body to ADD secreting neuron there the reapportion of water throughout the neoprene was minimal.