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Hematology & Anaphylaxis > Fluids, Electrolytes and Acid-Base Balancing > Flashcards

Fluids, Electrolytes and Acid-Base Balancing Flashcards

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1
Q

What constitutes extracellular fluid? (6)

A 
Plasma
Interstitial fluid
Lymph
CSF
Synovial fluid
Humors of the eye
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2
Q

What is intracellular fluid?

A

Water inside the cell

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3
Q

What must exist for homeostasis to happen?

A

A constant balance between the fluids and electrolytes

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4
Q

What are the three things required to maintain the constant balance in homeostasis?

A

Water

Electrolytes

Non-electrolytes

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5
Q

What are three positively charged electrolytes (cations) found in the intracellular space?

A

Potassium K+

Calcium Ca++

Magnesium Mg++

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6
Q

What is one positively charged electrolyte (cation) found in the extracellular space?

A

Sodium Na+

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7
Q

What is one negatively charged electrolyte (anion) in the intracellular space?

A

Phosphate PO4 3-

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8
Q

What are two negatively charged electrolytes (anion) in the extracellular space?

A

Chloride Cl-

Bicarbonate HCO3-

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9
Q

What are two ways that water enters the body?

A

Digestive system

Cellular metabolism

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10
Q

What are the four ways water exits the body?

A

Kidney’s

Lung’s

Sweat

Feces

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11
Q

What is net filtration?

A

Pressure-driven movement of fluid and solutes from blood capillaries into the interstitial fluid

Fluid is moved from blood to interstitial fluid within the capillary bed (filtration) and then reabsorbed as necessary

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12
Q

What are the six forces that affect net filtration?

A

Tonicity
Blood hydrostatic pressure (BHP)
Blood colloid osmotic pressure (BCOP)
Interstitial fluid colloid osmotic pressure (IFCOP)
Interstitial fluid hydrostatic pressure (IFHP)
Membrane permeability

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13
Q

What is the equation for net filtration pressure?

A

NFP=(BHP+IFOP) - (IFHP+BCOP)

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14
Q

What are the three types of fluid in tonicity?

A

Isotonic
Hypotonic
Hypertonic

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15
Q

What is the definition of an isotonic fluid?

A

It has an equal solute concentration

It is the same pressure

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16
Q

What is the definition of a hypotonic fluid?

A

It has a lesser solute concentration

It has less pressure

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17
Q

What is the definition of a hypertonic fluid?

A

It has a higher solute concentration

It has more pressure

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18
Q

What is blood hydrostatic pressure (BHP)?

A

It is the mechanical force of water against cellular membranes

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19
Q

What does the blood hydrostatic pressure represent in the capillary network?

A

The blood pressure of the capillary network

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20
Q

What is the mmHg within the capillary network, caused by blood hydrostatic pressure?

A

25-30 mmHg

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21
Q

Where is the pressure for blood hydrostatic pressure created?

A

The contraction of the left ventricle

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22
Q

What is the blood colloid osmotic pressure?

A

It is the overall osmotic effect of colloids (plasma proteins) in the vasculature

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23
Q

What does the blood colloid osmotic pressure oppose?

A

The filtration of larger solutes

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24
Q

What does the blood colloid osmotic pressure maintain?

A

It maintains levels of intravascular fluids

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25
What is the interstitial fluid colloid osmotic pressure? (IFOP)
IFOP pulls fluid out of the capillaries into the interstitial fluid
26
Why is interstitial fluid colloid osmotic pressure present?
It is present due to the solute concentration in the interstitium
27
What is interstitial fluid hydrostatic pressure?
IFHP pushes fluid from interstitial spaces back into the capillaries
28
What is the membrane permeability?
It allows only a small portion of plasma proteins to cross the capillary membranes
29
What are three factors that change the amount of total body water?
Age Sex Fat content
30
What is ADH?
Anti-diuretic hormone
31
What is water balance and the perception of thirst regulated by?
ADH
32
What are the three reasons ADH is released?
Increased plasma osmolality Decreased circulating blood volume Lowered venous and arterial pressure
33
What happens after the release of ADH?
Water is reabsorbed from the renal tubules and collecting ducts of the kidneys
34
What does aldosterone regulate? (3)
Na+ K+ Water retention
35
Where does aldosterone stimulate the secretion of K+?
The tubular lumen
36
When aldosterone stimulates Na+ and water, what happens?
The water reabsorption from the gut, salivary and sweat glands in exchange for K+
37
What is regulated when aldosterone stimulates H+?
H+ is secreted in the collecting duct, regulating plasma bicarbonate (HCO3-) levels and its acid/base balance
38
What gland does aldosterone stimulate to release ADH?
Posterior pituitary gland
39
What is RAAS?
Renin-Angiotensin-Aldosterone-System
40
What is the natriuretic hormone?
It promotes urinary secretion of Na, decreasing tubular reabsorption and supports water and Na excretion
41
What are the basic steps of RAAS? (4)
1. Decrease in renal perfusion is detected and the juxtaglomerular apparatus activates renin 2. The renin meets with angiotensinogen from the liver to form Angiotensin I 3. The pulmonary and renal endothelium release ACE to meet with angiotensin I to create angiotensin II 4. Angiotensin II acts in the following five areas: It increases sympathetic activity, Tubular Na+, Cl- reabsorption and K+ excretion, H20 retention, aldosterone is secreted, arteriolar vasoconstriction increasing blood pressure, the posterior lobe of the pituitary gland secretes ADH
42
What is hypervolemia?
Overhydration
43
What is isotonic hypovolemia (dehydration)?
``` It is an excessive loss of equal amounts of Na and water It can be caused by the following: - Severe or long term vomiting/diarrhea - Systemic infection - Intestinal obstruction ```
44
What is hyponatremic hypovolemia?
It is a serum decrease in Na due to excessive loss of Na or a decrease in Na relative to water
45
What are the causes of hyponatremic hypovolemia? (5)
``` Use of salt-washing diuretics Excessive perspiration Salt losing renal disorders Increased water intake Excessive use of water enemas ```
46
What are the signs and symptoms of hyponatremic hypovolemia? (7)
``` Muscle cramps N/V Postural BP changes Poor skin tugor Fatigue Dyspnea Confusion, hemiparesis, seizures and coma ```
47
What are the causes of hypernatremic hypovolemia?
It is an elevation of serum levels due to loss of water in excess of Na, or elevated Na levels
48
What are the causes of hypernatremic hypovolemia? (7)
``` Lack of fluid intake Diabetes insipidus CHF Renal failure Excessive misuse of diuretics Na intake in absence of water Profuse watery diarrhea ```
49
What are the signs and symptoms of hypernatremic hypovolemia? (5)
``` Similar to hyponatremia Thirst Disorientation Lethargy Seizures ```
50
What is over hydration?
It is an increased body water with a decrease in solute concentration
51
What are the four causes of over hydration?
Excessive IV fluid administration Impaired cardiac function Impaired renal function Endocrine dysfunction
52
What is the role K+?
Nerve, muscle and cardiac function
53
What is the role of Ca++? (6)
``` Neurotransmission Cell membrane permeability Hormone secretion Growth Ossification of bones Muscle contractions ```
54
What is the role of PO42-?
Used for buffering
55
What is the role of Mg+?
Activates enzymes Nervous system effects MSK effects similar to Ca++
56
What is one of the most important balances in the body hemostatic mechanisms?
The acid-base balance
57
What are acids (proton donators)?
Hydrogen ions (H+)
58
What are bases (protons acceptors)?
Hydroxide ions (OH-)
59
What is the pH scale? (4)
It is a hydrogen ion concentration It is measured in moles/L Acidity/alkalinity increases tenfold with every unit change The extremes of the pH scale are 0-14
60
What is a normal pH scale?
7.35-7.45
61
What is considered compatible with life with the pH scale?
6.7-7.9
62
If the pH is below 7, what is it considered?
Acidemia
63
If the pH is above 7, what is it considered?
Alkalemia
64
What are the chemical buffering systems to maintain the pH? (3)
Carbonic acid Phosphate buffering Protein buffering
65
What are the physiological buffering systems in maintaining pH? (2)
Respiratory buffering | Renal buffering
66
What is the normal carbonic acid to bicarbonate ratio?
1:20
67
What does carbonic anhydrase cause?
CO2 to dissolve in water of blood to form carbonic acid (H2CO3)
68
What is the chemical composition of carbonic acid?
H2CO3
69
What does H2CO3 break down into?
H+ and HCO3-
70
What is an increase of H2CO3?
Acidosis
71
What is an increase in HCO3-?
Alkalosis
72
What is protein buffering?
Negative charges allow proteins to serve as buffers for alterations in H+
73
Where does protein buffering primarily occur?
Intracellularly
74
What is renal buffering?
It is the recovery of bicarbonate and filtered into the tubules
75
What are metabolic causes?
HCO3- ion
76
What are respiratory causes?
CO2
77
What is a mnemonic to remember acidosis/alkalosis?
``` ROME Respiratory Opposite (pH and HCO3-/CO2 opposite) ``` Metabolic Equal (pH and HCO3-/CO2 equal)
78
What is the metabolic balance equation?
H+ + HCO3- H2CO3 CO2 + H2O
79
What is metabolic acidosis?
It is caused by excessive accumulation of acid or deficiency in the base It affects the bicarbonate side of the equation
80
What are common types of metabolic acidosis? (4)
Lactic acidosis Diabetic ketoacidosis Renal failure Ingestion of toxins
81
What is respiratory alkalosis?
It results from decreased PCO2 through hyperventilation
82
What are some causes of respiratory alkalosis? (6)
``` Sepsis Peritonitis Shock CO poisoning Head injury DKA ```
83
What does a blood gas analysis determine? (2)
Blood oxygenation | Acid-base balance

Hematology & Anaphylaxis (8 decks)

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