Fluids, Electrolytes, Acids, and Bases Flashcards
1
Q
What does ADH stand for?
A
Antidiuretic Hormone
2
Q
Where is ADH produced?
A
Hypothalamus
3
Q
Where is ADH stored and secreted?
A
Posterior Pituitary
4
Q
T or F:The hypothalamus stores ADH.
A
False. Stored and secreted by the posterior pituitary
5
Q
What does ADH do?
A
Increases water reabsorption by renal tubules
6
Q
What hormone increases water reabsorption by the renal tubules?
A
ADH
7
Q
What are the physiological triggers for release of ADH?
A
Decreased blood volume,
Increased blood osmolarity,
Decreased blood pressure
8
Q
What does decreased blood volume, increased blood osmolarity, and decreased blood pressure trigger?
A
Release of ADH
9
Q
T or F:ADH decreases blood osmolarity.
A
True
10
Q
Does ADH increase or decrease blood osmolarity?
A
Decrease
11
Q
What is increased blood osmolarity?
A
Increase in blood glucose,
Loss of water, but no loss of sodium
12
Q
Where is aldosterone produced and secreted?
A
Adrenal Cortex
13
Q
What hormone is produced in the adrenal cortex?
A
Aldosterone
14
Q
What does aldosterone do?
A
Increase sodium reabsorption by the renal tubules,
Increase in potassium and hydrogen secretion by the renal tubules
15
Q
How is the release of aldosterone stimulated?
A
Via renin-angiotensin pathway
16
Q
What does the renin-angiotensin pathway stimulate?
A
Release of Aldosterone
17
Q
What hormone increases sodium reabsorption, increase potassium secretion, and increases hydrogen secretion by the renal tubules?
A
Aldosterone
18
Q
What does decreased kidney perfusion stimulate?
A
Renin Release
19
Q
What is the stimulus for renin release?
A
Decreased kidney perfusion
20
Q
What does ECF stand for?
A
Extra-cellular Fluid
21
Q
What does ICF stand for?
A
Intra-cellular Fluid
22
Q
What is ECF?
A
All fluid outside of cells
23
Q
T or F:ECF includes interstitial fluid and plasma?
A
True
24
Q
What is ECF’s primary cation?
A
Sodium
25
What is ECF's primary anions?
Chlorine and Bicarbonate
26
Is bicarbonate a cation or anion?
Anion
27
Is sodium a cation or anion?
Cation
28
What is ICF?
All fluid inside cells
29
What is ICF's primary cation?
Potassium
30
What is ICF's primary anions?
Hydrogen Phosphate and Proteins
31
T or F:Proteins have a positive charge.
False. Negative Charge
32
What is hypovolemia?
Isotonic Fluid Loss
33
What is another term for hypovolemia?
Dehydration
34
Dehydration is another term for what?
Hypovolemia
35
What causes hypovolemia?
Blood loss,
| GI losses-vomiting, diarrhea
36
What does blood loss and GI losses cause?
Hypovolemia
37
What are some clinical manifestations of hypovolemia?
Decreased BP (can be normal for a while with vasoconstriction),
Tachycardia,
Decreased Urine Output,
Increased Hematocrit
38
Decrease BP, tachycardia, decreased urine output, and increased hematocrit are clinical manifestations of what?
Hypovolemia
39
What is hypervolemia?
Isotonic fluid gain
40
Isotonic fluid gain causes what?
Hypervolemia
41
Isotonic fluid loss causes what?
Hypovolemia
42
What causes hypervolemia?
Excessive IV fluids,
| Hyperaldosteronism
43
What is hyperaldosteronism?
Sodium and water reabsorption
44
What is sodium and water reabsorption?
Hyperaldosteronism
45
What does excessive IV fluids and hyperaldosteronism cause?
Hypervolemia
46
What clinical manifestation does hypervolemia cause?
```
Increased BP,
Weight Gain,
Edema,
Decreased Hematocrit,
Jugular Vein Dystension
```
47
Increased BP, weight gain, edema, decreased hematocrit, and jugular vein distension are clinical manifestations of what?
Hypervolemia
48
What does BHP stand for?
Blood Hydrostatic Pressure
49
T or F:BHP opposes filtration.
False. Favors Filtration
50
What are two reasons BHP decreases along capillaries?
1. more distance from heart
| 2. bc of filtration
51
What causes isotonic fluid gain?
Aldosterone
52
T or F:BHP is exerted by blood on vessel walls.
True
53
What does BOP stand for?
Blood Oncotic Pressure
54
T or F:BOP is exerted by blood on vessel walls.
False. Exerted by proteins in the blood
55
T or F:BOP stays constant along the length of the capillary.
True
56
T or F:BOP opposes filtration.
True
57
What does IFOP stand for?
Interstitial Fluid Oncotic Pressure
58
T or F:IFOP is exerted by proteins in the interstitium.
True
59
T or F:IFOP opposes filtration.
False. Favors Filtration
60
T or F:IFOP stays constant along the length of the capillary.
True
61
What does IFHP stand for?
Interstitial Fluid Hydrostatic Pressure
62
T or F:IFHP favors filtration.
True
63
T or F:IFHP is exerted by proteins in the interstitium.
False. Exerted by fluid in the interstitium
64
Is IFHP a positive or negative pressure?
Negitave Pressure
65
T or F:IFHP opposes filtration.
False. Favors Filtration
66
What pressure systems favor filtration?
BHP,
IFHP,
IFOP
67
What pressure system opposes filtration?
BOP
68
Does BHP, IFHP, IFOP favor filtration or oppose filtration?
Favor Filtration
69
Does BOP favor filtration or oppose filtration?
Opposes Filtration
70
What do alterations in water movement cause?
Edema
71
What causes decreased BOP?
Liver Disease-decreased synthesis of oncotic proteins,
Malnutrition-lack of AA to synthesize oncotic proteins,
Some types of kidney disease-increased loss of proteins in urine
72
What does AA stand for?
Amino Acids
73
What does liver disease, malnutrition, and some types of kidney disease cause?
Decreased BOP
74
Why does liver disease decrease BOP?
It decreases synthesis of oncotic proteins
75
Why does malnutrition decrease BOP?
There is a lack of AA to synthesize oncotic proteins
76
What is an example of oncotic proteins?
Albumins
77
Why do some types of kidney diseases cause BOP?
There is an increased loss of proteins in urine
78
What are some manifestations of decreased BOP?
Increased Filtration @ the arterial end of the capillary,
| Decreased Reabsorption @ the venous end of the capillary
79
What causes increased BHP?
Hypertension,
| Hypervolemia
80
Hypertension and hypervolemia cause what?
Increased BHP
81
What are some manifestations of increased BHP?
Increased Filtration @ the arterial end of the capillary,
| Decreased Reabsorption @ the venous end of the capillary
82
Increased filtration @ the arterial end of the capillary and decreased reabsorption @ the venous end of the capillary are manifestations of what?
Decreased BOP,
Increased BHP,
Increases Capillary Membrane Permeability,
Lymphatic Obstruction
83
What causes increased capillary membrane permeability?
Anything that causes inflammation,
Decreased BOP-opposes filtration,
Increased IFOP-favors filtration
84
What happens to oncotic proteins when capillary membrane permeability increases?
Oncotic proteins shift from blood to the interstitium
85
What causes oncotic proteins to shift from blood to the interstitium?
Increased Capillary Membrane Permeability
86
What are some manifestations of increased capillary membrane permeability?
Increased Filtration @ the arterial end of the capillary,
| Decreased Reabsorption @ the venous end of the capillary
87
What are some manifestations of lymphatic obstruction?
Increased Filtration @ the arterial end of the capillary,
Decreased Reabsorption @ the venous end of the capillary,
Decreased BOP,
Increased IFOP (Proteins collect in interstitium and aren't drained by the lymphatic system)
88
What causes lymphatic obstruction?
Removal of lymph nodes,
| Obstruction of lymph nodes
89
What obstructs lymph nodes?
Bacterial Infections,
Cancer,
Nematodes-small wormy parasites
90
Bacterial infections, cancer, and nematodes do what?
Obstruct lymph nodes
91
What are some metabolic roles of sodium?
Conduction of nerve impulses,
| Maintenance of water content of cells
92
Conduction of nerve impulses and maintenance of water content in cells are metabolic roles of what?
Sodium
93
What is hyponatremia?
When the concentration of sodium in ECF is less than normal
94
What is it called when the concentration of sodium in ECF is less than normal?
Hyponatremia
95
T or F:Hyponatremia is isotonic.
False
96
What causes hyponatremia?
Excessive sodium loss (depletion hyponatremia)
-Sweating, Vomiting, diarrhea
Excessive Water Intake (dilutional hyponatremia)
97
What is depletion hyponatremia?
Excessive sodium loss
98
What kind of hyponatremia is caused by excessive loss of sodium?
Depletion Hyponatremia
99
What kind of hyponatremia is caused by excessive water intake?
Dilutional Hyponatremia
100
What manifestations cause depletion hyponatremia?
Sweating,
Vomiting,
Diarrhea
101
What do sweating, vomiting, and diarrhea cause?
Depletion Hyponatremia
102
What is a consequence of hyponatremia?
ECF becomes Hypotonic,
| -Cells swell (esp. neurons)
103
What happens when ECF becomes hypotonic?
Cells swell
104
What are some clinical manifestations of hyponatremia?
Lethargy,
Generalized Weakness,
Confusion,
Coma
105
What is hypernatremia?
When sodium in ECF is greater than normal
106
What causes hypernatremia?
```
Sodium Gain
-Sea water near drowning (sodium in lungs)
-Excessive IV salts
Water Loss
-Fever
-Burns
-Lack of water intake
```
107
What is it called when sodium in ECF is greater than normal?
Hypernatremia
108
What does sodium gain or water loss cause?
Hypernatremia
109
What are ways water is lost?
Fever,
Burns,
Lack of water intake
110
What does fever cause?
Increased BMR,
Increased water usage,
Hyperventilation
111
What does BMR stand for?
Basal Metabolic Rate
112
Why do burns cause water loss?
The epidermis is where keratin is present and keratin helps keep water in or out.
113
What causes lack of water intake?
Altered consciousness-dementia
Lack of access
Choice to not consume water
114
What are consequences of hypernatremia?
ECF is Hypertonic,
| Cells lose water (crenation)
115
What is crenation?
When cells lose water
116
What is it called when cells lose water?
Crenation
117
What cells are most affected by crenation?
Neurons
118
What are some clinical manifestations of hypernatremia?
```
Lethargy,
Weakness,
Seizures,
Confusion,
Coma
```
119
T or F:The clinical manifestations associated with hyponatremia and hypernatremia are almost identical.
True
120
Where is potassium stored?
Inside Cells
121
What releases potassium?
Damaged Cells
122
T or F:potassium uptake requires ATP and insulin.
True
123
How long does it take for a potassium deficit to occur without potassium intake?
2-3 day
124
How is potassium lost?
Through cells sloughing
125
Where does potassium secretion occur
In the Renal Tubules
126
What hormone promotes potassium secretion?
Aldosterone
127
What does aldosterone do to potassium?
Promotes Secretion
128
T or F:Potassium secretion is NOT flow dependant.
False
129
T or F:More potassium is lost with a faster flow rate of filtrate.
True
130
What is one way to increase flow rate?
Drinking too much water
131
What does drinking too much water do to flow rate of filtrate?
Increases Flow Rate of Filtrate
132
What is hypokalemia?
When potassium in ECF is less than normal
133
What is "actual" hypokalemia?
When potassium is lost from the body
134
What is "relative" hypokalemia?
When potassium shifts from ECF to ICF
135
What is it called when potassium shifts from ECF to ICF?
Relative Hypokalemia
136
When does ECF volume deficit occur?
When Kidney Perfusion Decreases
137
What does renin, angiotensin, and aldosterone do to potassium secretion?
Increases Potassium Secretion
138
What do diuretics do to flow rate in renal tubules?
Increases Flow Rate
139
What increases flow rate in renal tubules?
Diuretics
140
What potassium shift results from increased flow in renal tubules?
Increased Potassium Secretion
141
What does black licorice affect?
Potassium Secretion
142
Does black licorice decrease or increase potassium secretion?
Increase
143
T or F:Black licorice has no effect on potassium secretion?
False. Profound effects on potassium secretion
144
What does insulin administration do to potassium?
Promotes potassium uptake by cells
145
What chemical promotes potassium uptake by cells?
Insulin
146
What effect does new tissue formation have on potassium?
Increases potassium uptake by new cells
147
What are some causes of hypokalemia?
```
Decreased Kidney Perfusion,
Diuretic Use,
Black Licorice,
Insulin Administration,
New Tissue Formation
```
148
Decreased kidney perfusion, diuretic use, black licorice, insulin administration, and new tissue formation are causes of what?
Hypokalemia
149
What consequence does hypokalemia have?
Fewer action potentials will be generated
150
What causes fewer action potentials to be generated?
Hypokalemia
151
What manifestations does hypokalemia cause?
```
Skeletal Muscle Weakness,
Depression of CNS,
Decreased GI motility,
-Nausea, Vomiting bc body doesn't want food
Shallow Respirations,
Cardiovascular Dysrhythmias
-Shallow T wave
-Prominent U wave
```
152
What cardiovascular dysrhythmias does hypokalemia cause?
Shallow T wave,
| Prominent U wave
153
skeletal muscle weakness, depression of CNS, decreased GI motility, shallow respirations, and cardiovascular dysrhythmias are manifestations of what?
Hypokalemia
154
What is it called when potassium in ECF is less than normal?
Hypokalemia
155
What is it called when potassium in ECF is greater than normal?
Hyperkalemia
156
What is hyperkalemia?
When potassium in ECF is greater than normal
157
What causes hyperkalemia?
Decreased Potassium
-Renal Failure
-Aldosterone deficiency
Extensive Tissue Damage
-Potassium spills out of cells when damaged
Insulin Deficit
-Decreased potassium uptake y cells in absence of insulin
158
What decreases potassium in the body?
Renal Failure,
| Aldosterone Deficiency
159
What happens to potassium when there is extensive tissue damage?
It spills out of cells
160
Decreased potassium, extensive tissue damage, and insulin deficit cause what?
Hyperkalemia
161
What consequences are associated with hyperkalemia?
Raise resting membrane potential,
| action potentials are generated more easily
162
What are some manifestations of hyperkalemia?
```
Overstimulation causes muscle fatigue; weakness,
Increased GI motility
-Diarrhea
Cardiovascular Dysrhythmias
-High T wave
-Ventricular Fibrillation
-Can cause Cardiac Arrest
```
163
What is ventricular fibrillation?
When cells in the heart quiver and cannot pump blood
164
How does a defibrillator work?
It overrides the electrical impulses in the heart to try to get myocardiocytes to contract together again
165
What is it called when heart cells quiver?
Ventricular Fibrillation
166
What cardiovascular dysrhythmia is associated with hyperkalemia?
High T wave
167
What is a buffer?
A chemical system used to maintain a constant pH
168
What is a chemical system used to maintain a constant pH?
Buffer
169
Why are buffer systems important?
They help maintain a constant pH
170
What happens if pH changes?
Proteins will be denatured
171
What is the carbonic acid-bicarbonate system?
(CO2)+(H20)--(H2CO3)--(H+)+(HCO3-)
172
What is (CO2)+(H20)--(H2CO3)--(H+)+(HCO3-)?
Carbonic Acid-Bicarbonate System
173
Do strong acids or weak acids dissociate in water more easily?
Strong Acids
174
What does a pH scale measure?
Hydrogen Ion Concentration
175
T or F:Weak acids usually don't dissociate completely.
True
176
What is the pH in the human body?
7.4
177
What is the ratio of bicarbonate:carbonic acid in the human body?
20:1
178
Where is carbonic acid regulated in the body?
Lungs
179
What is regulated in the lungs?
Carbonic Acid
180
Where is bicarbonate regulated in the body?
Kidneys
181
What is regulated in the kidneys?
Bicarbonate
182
What happens to carbonic acid if carbon dioxide increases?
Increases
183
What happens to carbonic acid during hyperventilation?
Decreases
184
What is compensation?
When pH is 7.4 and a 20:1 ratio of bicarbonate:carbonic acid is achieved, BUT the values aren't normal
185
What is correction?
When pH is 7.4 and a 20:1 ratio of bicarbonate:carbonic acid is achieved, AND the values are normal
186
What happens to carbon dioxide and carbonic acid when respiration rate increases?
Carbon Dioxide Increases,
| Carbonic Acid Increases
187
What happens to carbon dioxide and carbonic acid when respiration rate decreases?
Carbon Dioxide Decreases,
| Carbonic Acid Decreases
188
T or F:Bicarbonate MUST bind with hydrogen before reabsorption.
True
189
T or F:Anything that increases hydrogen ions will increase bicarbonate reabsorption.
True
190
What is the phosphate buffer system?
(H2PO4--)--(HPO4)+(H+)
191
What is the equation for protein buffers?
(HHB)--(Hb-)+(H+)
192
Where are protein buffers most important?
In ICF
193
T or F:Protein buffers can NOT donate or accept protons.
False
194
What is metabolic acidosis?
Change in bicarbonate; pH is less than 7.35
195
What imbalance is a change in bicarbonate?
Metabolic
196
What causes metabolic acidosis?
```
Increase in non-carbonic acid
-Lactoacidosis:tissue hypoxia
-Ketoacidosis:excessive fat degradation
-Ingestion of aspirin, antifreeze
Excessive loss of bicarbonate
-Diarrhea:decreased bicarbonate reabsorption in large intestine
Decreased Hydrogen Ion Secretion
-Renal failure
-Hypoaldosteronism
```
197
Increase in non-carbonic acid, excessive loss of bicarbonate, and decreased hydrogen ion secretion causes what?
Metabolic Acidosis
