Sodium and Potassium Metabolism (Renin, Angiotensin, Aldosterone, and ADH)

  Рет қаралды 292,345

Strong Medicine

Strong Medicine

Күн бұрын

A review of the normal physiology of sodium, potassium, and water. Major topics covered include the renin angiotensin aldosterone system, the hypothalamic pituitary adrenal axis, ADH (antidiuretic hormone), and the natriuretic peptides.

Пікірлер: 186
@StrongMed
@StrongMed 5 жыл бұрын
Errata: @9:38, juxtaglomerular cells are adjacent to the endothelium, but they themselves are derived from smooth muscle. @17:10, aldosterone's indirect effect on serum potassium is to decrease it, NOT increase it.
@faurloiromero326
@faurloiromero326 4 жыл бұрын
Respected Sir, at 15:22 , it should be that ADH inserts Aquaporins-2 into the Epithelium of collecting tubules and ducts rather than endothelium. Please reply.
@dranubhavgoel491
@dranubhavgoel491 3 жыл бұрын
I was about to write it in comments then I read it😂
@aarondavis176
@aarondavis176 8 жыл бұрын
WOW! What an incredible breakdown! You did great, I was feeling overwhelmed and you summarized it right up.
@VanessaOliveira-nd7yh
@VanessaOliveira-nd7yh 9 жыл бұрын
"In reality the pituitary gland is much much smaller than the brain." A great lecture with some sense of humor! Thank you!
@unreadsymbols
@unreadsymbols 10 жыл бұрын
Better than most, if not all other video tutorials that I've seen. High quality, clear and accurate. Excellent!!
@warwickisaacson9575
@warwickisaacson9575 9 жыл бұрын
Thanks so much for your passion and dedication to teaching others. It is wonderful to have people like you around Eric and I am so appreciative of the amount of thought you have put into summarizing such complex topics.
@nise1069
@nise1069 9 жыл бұрын
Amazing video. You have no idea how much this video has help finally understand the whole mean process. A big thank you sir.
@pharmac.4939
@pharmac.4939 8 жыл бұрын
wooowww! I've read countless times the chapters in Guyton regarding these topics yet i was still confused until i watched this lecture. you're my savior, Sir. continue making videos such as this. it saves a lot of medical students from confusion and doubt. thank you so much. -A medical student from the Philippines.
@StrongMed
@StrongMed 8 жыл бұрын
+aspiring MD I'm glad you found it helpful!
@Crystal_._t.s
@Crystal_._t.s 4 ай бұрын
Yeah true at time guyton gets really confusing
@letrangerjoo1939
@letrangerjoo1939 11 жыл бұрын
Uncomparable quality of lectures.. I have watched your lectures since last year and I never had a chance to express how I appreciate. Thank you so much, professor.
@pauljonelouns2061
@pauljonelouns2061 3 жыл бұрын
The above video is the first I've watched of what you contribute. I was most impressed, it was so way, way cool. Thank you, Paul
@jaquelinemanuel5716
@jaquelinemanuel5716 8 жыл бұрын
THANK YOU SO MUCH for the lectures and your devotion in doing medical videos! I hope you will make more.
@rawdonwaller
@rawdonwaller 9 жыл бұрын
I've admired your dedication to med ed since 2013. Thank you Dr. Eric.
@StrongMed
@StrongMed 9 жыл бұрын
Rawdon Waller You're very welcome!
@sunving
@sunving 4 жыл бұрын
Thank you Doctor Strong , this is a wonderful lecture, unrivaled by any. I listen to this the third time. I listened to this topic many time in my life to a degree :)
@jaekim1085
@jaekim1085 8 жыл бұрын
I greatly enjoy your teaching style and method. Your e-lectures alway have helped me to maintain 4.0 GPA in A&P and Pathophysio. Thank you very much, Dr. Strong!!!!!!!! - a nursing student from the SF Bay Area
@StrongMed
@StrongMed 10 жыл бұрын
That's a great question. I've never been satisfied with published explanations of this phenomenon that I've come across. However, I would hypothesize it's because the H2O retention that comes with SIADH is spread across all body compartments, whereas the H2O retention that is secondary to disorders of sodium retention (e.g.. hyperaldo., etc...) is disproportionately distributed to the intravascular space due to the osmotic pressure of excess Na+, which can't freely move between compartments.
@fletcherizer
@fletcherizer 8 жыл бұрын
Perfect level of detail for someone with a background!
@danbbarratt
@danbbarratt 9 жыл бұрын
What a brillian summary! Thankyou
@guidostockmans
@guidostockmans 8 жыл бұрын
At 17.20 there is a mistake i guess. Aldosterone leads to a decrease in serum potassium, not an increase as shown. But what a great great video!!!
@StrongMed
@StrongMed 8 жыл бұрын
Thanks! There's an annotation that points this out, but unfortunately annotations don't show up on mobile. Glad to know viewers are keeping me honest! =)
@jinsollee8155
@jinsollee8155 10 жыл бұрын
I am very looking forward to your hypo/hyperkalemia videos! Thank you soooo much! Going from big picture to details is extremely helpful in understanding as a first year medical student. And your diagrams are superb
@jo-mp4kx
@jo-mp4kx 6 жыл бұрын
Subscribed straight away thanks to the channel name "strong medicine" i thought yeah this is something i need
@goonhoongtatt1883
@goonhoongtatt1883 3 жыл бұрын
First week into my Chemical Pathology rotation for my MPath degree. I find this very helpful. Thank you.
@lester_ernesto
@lester_ernesto 7 жыл бұрын
By far the best lecture !!! Thanks ... keep it strong !!!
@sunving
@sunving 4 жыл бұрын
Thank you Dr Strong , you are superb clinician, teacher, instructor. Thanks very much.
@WatchwomanOnTheWall-zk9po
@WatchwomanOnTheWall-zk9po 7 жыл бұрын
Very helpful and detailed. Thank you so much for this educational video.
@laurentiu244
@laurentiu244 8 жыл бұрын
Amazing explanation of a complex and disputed topic .Thank you .
@mistymornings
@mistymornings 7 жыл бұрын
So useful. Thank you Dr. Strong!
@umgrandepino
@umgrandepino 11 жыл бұрын
You have some bad ass videos! Best channel for medical students. Respect!
@sewcrazed6331
@sewcrazed6331 5 жыл бұрын
You're amazing! Thank you so much for sharing your expertise with us!!
@turmamed8855
@turmamed8855 8 жыл бұрын
Best Video ever!!!! I loved, very didactic and complete at the same time.
@igoryankin3156
@igoryankin3156 7 жыл бұрын
By far the best lecture on this topic
@lamoush19
@lamoush19 2 жыл бұрын
9 years later, this is still viewed :) and it's very helpful. Thank you!
@johncarson4839
@johncarson4839 6 жыл бұрын
Thanks Doctor. Greetings from Mexico.
@vikas5080
@vikas5080 10 жыл бұрын
Wow!! So wonderfully simplified! Thank you.
@syakirazahar6079
@syakirazahar6079 8 жыл бұрын
this is really helpful. u simplified it and make it easy to understand! everythg just make sense.. Thank you so much.
@xhensilaelezi1067
@xhensilaelezi1067 7 жыл бұрын
It was very helpful and well explained ,,, thank u !
@EMHamant
@EMHamant 10 жыл бұрын
Perfect! Thank you for all of these!
@lmd742
@lmd742 9 жыл бұрын
Thanks for these series of videos they are very helpful.
@A-N-D-Y-O-U
@A-N-D-Y-O-U 10 ай бұрын
Thank you for your thorough review!
@sunving
@sunving 3 жыл бұрын
Thank you Doctor. This lecture is the best !
@TTOORROONNTTOOful
@TTOORROONNTTOOful 11 жыл бұрын
Thank you so much. Finally, I got right lecture. you relived my symptoms of back itching~~~Thank you again~
@vicachcoup
@vicachcoup 9 жыл бұрын
At first look this seemed too complicated. But your step by step explanation was excellent and the topic is easy to understand. Thanks
@alexhamble
@alexhamble 10 жыл бұрын
That was brilliant - subscribed!
@angelarivera3568
@angelarivera3568 6 жыл бұрын
This is beautiful. Thank you so much!
@iagoink
@iagoink 6 жыл бұрын
great lecture, congratulations and thank you! keep up
@rimshazamir5894
@rimshazamir5894 5 жыл бұрын
Extremely helpful video. Thank you!!
@natalieweeks3062
@natalieweeks3062 10 жыл бұрын
Now I know I will make an A on this next Exam!!! Thank you, Thank you, Thank you.
@sophieclarke3098
@sophieclarke3098 10 жыл бұрын
Thank you! I found this useful even while reviewing for medicine clerkship and step2! (also, sherlock is THE BEST!)
@StrongMed
@StrongMed 10 жыл бұрын
Sophie, that was a very Holmesian observation! Good luck with step 2!
@drkmnahidulhaque
@drkmnahidulhaque 10 жыл бұрын
Thanks you sir for your effort to make these wonderful lectures and make it free for us. Dr. Nahid, Bangladesh.
@easwarps7277
@easwarps7277 4 жыл бұрын
Sir a sublime video for non practitioner too..just as easy you have made👍
@dr.g1203
@dr.g1203 7 жыл бұрын
lot of love and plenty of respect thanks a lot.
@androw4u
@androw4u 7 жыл бұрын
sooo strong , many thanks
@jagjeevandeshmukh2250
@jagjeevandeshmukh2250 3 жыл бұрын
Nice way of explanation with simple & easy way with complete information 🙏🙏
@mozzaneek
@mozzaneek 11 жыл бұрын
Thanks for the Videos and hard work doc!
@cabdirashidcawilcabdulahi208
@cabdirashidcawilcabdulahi208 3 жыл бұрын
Thanks Dr. Easily understandable way of explanation Of this lectures 👍👍
@pnguyen515
@pnguyen515 3 жыл бұрын
You are such a great teacher. I wish you were my attending.
@Andolem
@Andolem 10 жыл бұрын
you are amazing, thanks for dedicating your precious time.
@yztyzt1
@yztyzt1 9 жыл бұрын
I am watching this vid because I am a psychopharmacology fellow. We have a patient on lithium who has long standing borderline high potassium. I am thnking he has hypoaldostertonemia beccause his TTKG is 4.8. I think normal TTKG is 7. And especially in the face of borderline high potassium, that TTKG should be even higher. Those are my thoughts. BTW. u r a god of renal physiology! Holy shiit. U really got that stuff down pat!
@DocHemulin
@DocHemulin 9 жыл бұрын
Hello, Isn't the glucose effecting the Osmotic pressure and not the Oncotic pressure(which is determined by plasma proteins)?
@jemmaworch
@jemmaworch 10 жыл бұрын
Lovely, thank you so much xxx
@cloudsilver7960
@cloudsilver7960 4 жыл бұрын
Thank you! please place more lectures.
@tonibias1348
@tonibias1348 8 жыл бұрын
OMG... You are my guardian angel..... Great breakdown!!!!!!!!!!!!
@MrEvanston
@MrEvanston 8 жыл бұрын
Thank You sooooo much for this lecture. You are the man; You are the doctor!! I have two questions: 1. Where does maxzide act on nephron, in particular, Triamterene, K^+ spare? 2. What's the relationship to ACE Inhibitors and chronic cough?
@DrOscarPacheco
@DrOscarPacheco 5 жыл бұрын
Great video! Thanks!
@chisupreme
@chisupreme 7 жыл бұрын
I LOVE YOU RIGHT NOW!! Thank you!
@khamikos1
@khamikos1 6 жыл бұрын
excellent presentation. thanks
@rizkiadrianhakim
@rizkiadrianhakim 9 жыл бұрын
Great explanation dr. Eric ! Btw, i read an article about hyponatremia, and it's said that ADH also promotes sodium excretion as well as water reabsorption. What's your comment on this?
@bla4327
@bla4327 5 жыл бұрын
I love you man, thank you soo much man, this is priceless
@Malhiu
@Malhiu 9 жыл бұрын
Could you please explain how do the NSAIDS blunt the effect of ACEI/ARBS? Thanks.
@elevationchemicals9850
@elevationchemicals9850 6 жыл бұрын
fabulous video, thank you
@edwardpinder5634
@edwardpinder5634 10 жыл бұрын
Hi, thanks for the lecture, around about 14.00 I think you say cortisol dilates the afferent arteriole of the kidney would,this not increase exertion in kidneys and reduce blood pressure, when cortisol,increases BP?
@muhammadnada9433
@muhammadnada9433 2 жыл бұрын
Thank you alot .Very informative
@drisleem
@drisleem 6 жыл бұрын
Verry very fantastic. .. thanks alot may allah bless you sir
@preacherjon7311
@preacherjon7311 7 жыл бұрын
And all I am trying to find out is do I need to take in more potassium than sodium. (yea, I know I need to have a low sodium diet. But just how much potassium)
@wahibaramtani6130
@wahibaramtani6130 8 жыл бұрын
very nice explanation
@matadormotri7734
@matadormotri7734 8 жыл бұрын
Aldosterone indirect effect lowers potassium in serum,or not?
@omerelsabbagh8353
@omerelsabbagh8353 2 жыл бұрын
Super excellent Prof
@erichschne
@erichschne 4 жыл бұрын
Very good lecture! Is it possible to add subtitles in order to enhance the good quality?
@azemabok
@azemabok 10 жыл бұрын
Thanks! Good job.
@BipinKumar-xf3xk
@BipinKumar-xf3xk 6 жыл бұрын
A small doubt.. At 19:32, you say Increased serum Glucose leads to increased extra cellular oncotic pressure. Doesn't oncotic pressure depend on the protein content? Glucose being an osmolyte, shouldn't the more appropriate term me "increased osmotic pressure"?
@laidalos
@laidalos 9 жыл бұрын
Hi Dr. Strong. When talking about ABG disturbance causing hypo/hyperkalemia, what are other mechanism of change in plasma potassium beside H+/K+ cellular exchange? Because since H+ concentration is cca 10 milion x lower than plasma K+ concentration, change in pH from e.g. 7,4 (H+ conc. 40nmol/l) to pH 7,3 ( H+ conc. 50nmol/l) means difference of just 10nmol/L, there is also only 10nmol/l change in patassium concentration, which is clinically irrelevant. Therefore I'd say primary potassium disorder can cause ABG disorder but not reverse (by celular exchange of H+/K+). Am I wrong? I hope I just didn't miss something that will cause me to look like a fool :)
@ablaublas1
@ablaublas1 6 жыл бұрын
Does transmembrane H20 shift occur in uremia too?
@ranabhattacharyya2807
@ranabhattacharyya2807 2 жыл бұрын
Extraordinary sir
@lehu8529
@lehu8529 4 жыл бұрын
This video was great and helped me a lot! Thank you! I have a question about loop diuretics - I've read that they can cause both hyponatremia and hypernatremia - hyponatremia from volume depletion causing the release of ADH, and hypernatremia from lowering the corticomedullary osmolar gradient by disrupting countercurrent multiplication; which do you more commonly see in clinical practice?
@StrongMed
@StrongMed 4 жыл бұрын
I have never once seen hypernatremia caused by loop diuretics in clinical practice. In contrast, maybe 1/3-1/2 of all patients on loop diuretics are hyponatremic, though whether the diuretic is the direct cause, or the hyponatremia is being caused by the disease for which the diuretic has been prescribed (e.g. heart failure, cirrhosis) is usually unclear.
@erichschne
@erichschne 4 жыл бұрын
Very good lecture! Is it possible to add English subtitles in order to enhance the good Quality?
@myplantdied
@myplantdied 10 жыл бұрын
Wow! Thank you sir!
@evelynnginsburg3950
@evelynnginsburg3950 10 жыл бұрын
HI Eric, Thanks for the great lectures! What textbook do you recommend specifically for lytes disorders?
@StrongMed
@StrongMed 10 жыл бұрын
Evelynn, thanks for the feedback. Unfortunately, I'm pretty unimpressed with the available textbooks out there that cover electrolyte disorders, and don't have a specific recommendation. When I was a med student (1998-2003), most students used either Renal Pathophysiology: The Essentials or Fuids and Electrolytes in the Surgical Patient (choice depending upon anticipated specialty); however I was quite underwhelmed by both books. I honestly don't know what most students use these days, other than First Aid for Step 1 (which I don't recommend for the purpose of studying for a physiology course). The professional standard text is Clinical Physiology of Acid Base and Electrolyte Disorders by Burton Rose, but it weighs at at 1000 pages, and I can't imagine a non-nephrologist having enough patience and interest to get through it. If anyone else on here has a recommendation for Evelynn, feel free to list it here!
@4hmarcie
@4hmarcie 10 жыл бұрын
Awesome, thank you!
@trollbeadm3466
@trollbeadm3466 8 жыл бұрын
Wow, great information but also quite overwhelming, need to study more :) Where do you start looking for the right tests? I am chronic low sodium for no obvious reason, (now diagnosed with hashimotos, adrenal fatigue etc.) I personally think, the low sodium and low blood pressure is a key to my health but the GP has no answers. Do I look for a metabolic doctor here in Sydney??
@pubmsu
@pubmsu 7 жыл бұрын
Trollbead M Hi, I am in Sydney with similar issue. Wondering if I can get in touch to help each other.
@dodygoh1407
@dodygoh1407 10 жыл бұрын
thanks doc!
@ritamena6667
@ritamena6667 5 жыл бұрын
Awesum sir.
@talmor8435
@talmor8435 8 жыл бұрын
Dude you are the man - thank you soooooo muchhhhhhhhhhhhhhhhhhhhh
@samirdasgupta8487
@samirdasgupta8487 Жыл бұрын
Hi Simply simplified. One small error, in one of the penultimate charts describing the RAA axis and ADH, under aldosterone , increased potassium is mentioned, should have been decreased. Regards and thanks. Dr Samir Dasgupta MD
@wiltonpt1
@wiltonpt1 9 жыл бұрын
I am just wondering what program you use to build presentations like Dr. Erick's. Does anyone know?
@StrongMed
@StrongMed 9 жыл бұрын
For most videos, I start with creating a slide set in PowerPoint, and export them as high-resolution jpgs. (PowerPoint, at least older versions like mine, defaults to exporting them as low resolution jpgs. Changing them to higher resolution literally requires altering the Windows registry; there are sites on line that explain how to do this - See: support.microsoft.com/kb/827745 , but any manual change of the registry is risky, and you should only attempt it if you know what you are doing) The majority of original images and diagrams I use are drawn directly in PowerPoint (it's actually half decent as a drawing program, once you figure out the work-arounds for things it can't do, like any complex 3 dimensional structure). More complicated pictures are drawn in Adobe Fireworks or Illustrator. I then record the narration using a free program called Audacity, exported as a wav file. The music is arranged and rendered in Finale, and also exported as a wav. The jpg version of the slides, and the wav files for the narration and music are stitched together and synched up in Premiere Pro. For the videos that include animation (e.g. chest X-rays, PFTs), these are created in Premiere itself. Animations in Premiere may be much more limited than in Flash or a dedicated animation program, but are also much simpler/faster to create. I experimented with trying to use Blender with the intention of mind-blowing animations, but quickly realized that if I spent 90% of the creative process on the animation, my priorities were probably misplaced.
@sandraisabel4152
@sandraisabel4152 8 жыл бұрын
best explained
@mariamsaeed4558
@mariamsaeed4558 6 жыл бұрын
Excellent
@madsr66
@madsr66 9 жыл бұрын
Why do people who consume too much salt in their diet have HBP? Wouldn't the body exrete extra sodium and not pick it up unless it sensed a low BP?
@895792
@895792 10 жыл бұрын
I am looking forward
@gunasundar7841
@gunasundar7841 2 жыл бұрын
Thank you sir …
@shamakasuraweera
@shamakasuraweera 10 жыл бұрын
if u could do a seperate lecture on renal physiology that u haven't included in those lectures ,it will be helpful.ex.counter current mechsnism,renal clearence,GFR.
@araratqarachatani3806
@araratqarachatani3806 4 жыл бұрын
Thank you
@nikeshbiswal6656
@nikeshbiswal6656 3 жыл бұрын
Thankyou Sir.
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