Jan8 M2-Edema and Diuretics Flashcards
(36 cards)
2 components to edema pathophysiology
- alteration in capillary hemodynamics favoring Na and water mvmt to interstitium
- renal retention of dietary Na and water with ECF expansion
2 components to edema pathophysiology
- alteration in capillary hemodynamics favoring Na and water mvmt to interstitium
- renal retention of dietary Na and water with ECF expansion
example of cause of edema
low oncotic pressure (ex. loss of albumin in nephrotic syndrome)
example of cause of edema related to lymphatics drainage
lymph node infection, blockage, breast cancer surgery
example of cause of edema related to high capillary hydrostatic pressure
rise in venous pressure
urine protein and urine Na in nephrotic syndrome and why
above 3g protein/day
less than 15 meq/L U Na (holding on to Na)
hormones activated in nephrotic syndrome and why
- RAAS because low IV volume so low renal perfusion (renin activated)
- ADH (low IV volume)
condition where Na retention, edema and RAAS and ADH always active and why
CHF. low CO = sensed hypovolemia, state of volume contraction
what hormones act on the kidney in CHF
- NE and AT2 for proximal Na reabso
- ADH distally
- aldo distally
example of cause of edema
low oncotic pressure (ex. loss of albumin in nephrotic syndrome)
example of cause of edema related to lymphatics drainage
lymph node infection, blockage, breast cancer surgery
example of cause of edema related to high capillary hydrostatic pressure
rise in venous pressure
urine protein and urine Na in nephrotic syndrome and why
above 3g protein/day
less than 15 meq/L U Na (holding on to Na)
hormones activated in nephrotic syndrome and why
- RAAS because low IV volume so low renal perfusion (renin activated)
- ADH (low IV volume)
condition where Na retention, edema and RAAS and ADH always active and why
CHF. low CO = sensed hypovolemia, state of volume contraction
what hormones act on the kidney in CHF
- NE and AT2 for proximal Na reabso
- ADH distally
- aldo distally
SV as fct ov LVEDP curves: how does it change in heart failure and how kidney can change it
curve drops. lower SV for a same LVEDP. kidney retains water and sodium so increases it and moves the curve up
why K sparing diuretics called like that
because don’t cause hypoK
ascites in what disease and why
fibrotic liver so blood coming from splanchnic circulation is turned away and liver loses serous fluid in peritoneal cavity
where to look for edema
feet, hands, face, around the eyes, pulmonary, abdomen
normal urine output (per 8 hour shift)
300-400 cc
if notice edema, next step in physical exam
weigh the patient
limiting factors in thiazides (2)
- they have unknown mechanisms to lower BP
- low Na reabso there
thiazide used for what condition
BP control
