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MD3002 post MSA > U and Es > Flashcards

U and Es Flashcards

1
Q

what is diabetes insipidus

A

inability to produce or respond to ADH resulting in excessive urine production or thirst

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2
Q

what conditions may cause electrolyte disturbance

A 
haemorrhage
d and v
intake
pyrexia- increased loss
diabetes mellitus or insipidus
diuretic therapy 
endocrine disorder
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3
Q

what is the concentration of extracellular sodium

A

140 mmol/L

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4
Q

what is the extracellular K concentration

A

5 mmol/L

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5
Q

what physiological mechanisms compensate for electrolyte disturbance

A

thirst
ADH
renin

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6
Q

what part of the brain produces ADH

A

median eminence of posterior pituitary gland

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7
Q

in what conditions is urea raised

A

congestive heart failure
shock
MI
severe burns

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8
Q

what is creatinine

A

breakdown product of protein and muscle

higher in males usually

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9
Q

what electrolytes can be measured

A 
sodium
potassium
chloride
bicarb
urea
creatinine
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10
Q

why is electrolyte balance important

A

cellular homeostasis
cardiovascular
renal
electrophysiology

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11
Q

what is the intracellular sodium concentration

A

10 mmol/L

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12
Q

name some isotonic fluids in the body

A

blood, fistula fluid

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13
Q

how much hypotonic fluid loss would be insensible

A

3 L

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14
Q

how might hypotonic fluid loss occur

A

diarrhoea and vomiting

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15
Q

what can cause activation of the RAAS system

A

na depletion

haemorrhage

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16
Q

how do you determine ADH status

A

if urine is a lot more concentrated than plasma then ADH is activated

17
Q

how do you determine RAAS status

A

measure plasma and urine sodium concentration

if urine sodium is less than 10 mmol/L then RAAS is active

18
Q

why should fluid loss of 2L be replaced with isotonic fluid rather than hypotonic fluid

A

will not cause a fall in sodium and will not cause fluid redistribution

19
Q

what tow substances are used as markers of renal function

A

urea and creatinine

20
Q

what factors influence GFR

A

renal perfusion pressure
renal vascular resistance
glomerular damage
post glomerular resistance

21
Q

what is normal GFR

A

90- 150 mL/min
bigger people have higher rate
older people have lower rate

22
Q

what is nephrosis

A

aka nephrotic syndrome
oedema
protein loss
increased glomerular permeability

23
Q

what can cause hyponatraemia

A 
diuretics 
addison's 
Na losing nephritis
nephrosis
vomiting and diarrhoea 
burns 
oedema (increased fluid compartment)
drugs 
hypothyroidism 
Kidney failure
24
Q

what is SIADH

A

syndrome of inapropriate antidiuretic hormone

hormone is produced in the wrong place

25
Q

what is osmotic diuresis

A

too much urine production caused by retention of a substance in the nephron e.g. glucose causing inability to reabsorb enough water

26
Q

what is normal potassium range

A

3.6 - 5

disorders are often iatrogenic

27
Q

what change in pH can cause hyperkalaemia

A

acidosis causing potassium to move out of cells

28
Q

what change in pH can cause hypokalaemia

A

alkalosis which causes potassium to move inside the cells

29
Q

what can cause hyperkalaemia

A 
artifactual
haemolysis 
drug therapy
renal failure 
acidosis 
mineralcorticoid dysfunction 
cell death
30
Q

how can hyperkalaemia be treated

A

correct acidosis
give glucose and insulin
ion exchange resins
dialysis

31
Q

what can cause hypokalaemia

A 
low intake 
increased urine loss 
tubular dysfunction 
vomiting and diarrhoea
fistulae 
alkalosis 
insulin and glucose therapy
32
Q

what are the symptoms of potassium depletion

A 
lethargy
muscle weakness
arrhythmia
polyuria 
alkalosis
33
Q

how is potassium depletion treated

A

supplementation
oral/ iv
monitor

MD3002 post MSA (66 decks)

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