Integrative Renal and Cardiac Physiology: An outback adventure gone wrong
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- Byron Sims
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1 Integrative Renal and Cardiac Physiology: An outback adventure gone wrong In this Renal Laboratory Session we will be looking at what happens to renal function, cardiovascular function and urine production in response to drinking a variety of different liquids and foods. We are also looking at what mediates these changes in renal and cardiovascular function and why. Olivia is on an outback adventure in between semesters with 4 of her friends, Sally, Jemima and Indigo. They all promised themselves this trip having done well in their BIO exams but were so busy studying and then preparing for the trip that Olivia forgot to replace the radiator hoses. Half way across Lake Eyre on the way to the Simpson Desert the radiator hoses have blown. Their car has now broken down. Olivia did remember to bring the satellite phone so she has rung for a tow truck and help is on the way. However, they will not arrive for at least 16 hours. They only things they have to eat or drink are the following items. 1. Six cans of Vodka and orange 2. Four cans of artificially sweetened caffeinated energy drink 3. A small bag of salt and vinegar chips 4. 3 Litres of seawater you collected from the beach 2 days ago. Always being wanting to share Olivia decides to allocate each friend to these items. (Olivia thinks it would be wise to allocate herself the six cans of Vodka and orange) She puts her favourite One Direction CD on and they all then consume the items they have been allocated and wait for help to arrive. Help arrives 20 hours later, they are all taken to the nearest hospital for observation and have the following urine and blood results together with blood pressure and heart rate measurements. (The normal ranges provided apply for females aged 20-29) Last updated on 15-May-17 Version: 5.0 Page 1 of 9
2 Olivia (Six cans of Vodka and orange) Blood Normal Ranges Na K Cl Glucose Osmolarity mosm/kg 310 egfr Urine ph Specific gravity Color Light yellow Clear Turbidity Clear or cloudy Clear Ketones None None Blood Pressure 120/80 95/65 Heart Rate bpm 125 Sally: 4 cans of artificially sweetened caffeinated energy drink Blood Na K Cl Glucose Osmolarity mosm/kg 310 egfr Urine ph Specific gravity Color Light yellow Clear Turbidity Clear or cloudy Clear Ketones none Some Blood Pressure 120/80 95/65 Heart Rate bpm 135 Last updated on 15-May-17 Version: 5.0 Page 2 of 9
3 Jemima: A small bag of salt and vinegar chips Blood Na K Cl Glucose Osmolarity mosm/kg 290 egfr Urine ph Specific gravity Color Light yellow Light yellow Turbidity Clear or cloudy Slightly Cloudy Ketones None None Blood Pressure 120/80 125/85 Heart Rate bpm 85 Indigo: 3 Litres of seawater you collected from the beach 2 days ago Blood Na K Cl Glucose Osmolarity mosm/kg 325 egfr Urine ph Specific gravity Color Light yellow Light yellow Turbidity Clear or cloudy Clear Ketones None Some Blood Pressure 120/80 75/40 Heart Rate bpm 135 #Indigo is also suffering from diarrhoea and is very unwell Last updated on 15-May-17 Version: 5.0 Page 3 of 9
4 1. Olivia s nurse says she is very dehydrated. What has caused her dehydration? (Your answer should include the mechanism of how this dehydration was produced). (5 marks) Last updated on 15-May-17 Version: 5.0 Page 4 of 9
5 2. Sally s nurse also says she is also very dehydrated. What has caused her dehydration. (Your answer should include the mechanism of how this dehydration was produced). (5 marks) Last updated on 15-May-17 Version: 5.0 Page 5 of 9
6 3. The nurse reports that Jemima seems quite normal although she reports to be very thirsty. Why is she thirsty but not so dehydrated? Why is her Blood Pressure slightly elevated? (5 marks) Last updated on 15-May-17 Version: 5.0 Page 6 of 9
7 4. The nurse reports that Indigo is extremely dehydrated and is given IV fluids. Why has Indigo lost so much fluid? (Your should include the gastrointestinal AND renal process that have contributed to her dehydration.) (5 marks) Last updated on 15-May-17 Version: 5.0 Page 7 of 9
8 5. Both Olivia, Sally and Indigo have reduced Systolic and Diastolic Blood pressures and they also have elevated Heart Rate. Can you explain why their Blood Pressure is reduced? AND: Why their cardiovascular system has responded to increase their Heart Rate. (Your answer should include and explanation of this cardiovascular reflex). (8 marks) Last updated on 15-May-17 Version: 5.0 Page 8 of 9
9 6. Indigo also has a reduced GFR. Why has her GFR reduced? (Your answer should include an explanation of what nerves and hormones are involved to decrease GFR and why this has happened) (7 marks) Last updated on 15-May-17 Version: 5.0 Page 9 of 9
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