Hey, it's Dr. Gil Perot here, and today we are going to be talking about natuoretic peptides.

And unlike some guys I grew up with, gambling is not one of my hobbies. So don't get me wrong,

I am completely in favor of legal gambling because I think it's the only way to tax stupidity, but despite my enthusiasm for

gambling, I'm going to make a bet with you that for most physicians, nurses, nurse practitioners

that regularly see hospitalized medical patients, there almost is never a week that goes by where one of your

patients doesn't have a natuatic peptide lab for you to interpret. And they're becoming ever more

important in therapeutics. So having a deeper understanding of natuatic peptides not only will help with patient care,

but also make work more interesting.

Now, there are different kinds of natuetic peptides.

And like many folks out there, I routinely order brain natuatic peptides or BNPs in cases of dysmia.

It's confusingly called brain because it was first found

in the porosine brain. Now we know it is mostly synthesized in the ventricular myocardium,

so when the ventricular myocardium is overloaded by volume, B&P is made and we can easily measure the level in routine blood tests.

There is also AMP, or atrial natuoretic peptide. When the atrium gets distended by volume overload,

A&P is released. Yet the reason the body makes A&P and BNP is not so they can be measured. They actually have a purpose. That

purpose is to travel to the kidney and promote diureesis and natuoresis. So how are we going to define

natuoresis? And the definition is the excretion of abnormal amounts of sodium into the urine.

So these natuoretic hormones get rid of salt and water when the heart is stressed by too much

fluid volume. And that's an important and often underappreciated job. We never give enough credit

to the underappreciated jobs out there.

Next time you see a porta potty, stop and think about how many of them there are and how many

people out there have a profession to clean them, or maybe even worse, cleaning football stadium stalls.

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