Total water in body is ___ L
36
Relative raction in ICF and ECF?
ICF - 2/3
ECF - 1/3
ICF is __% of body weight
40
Blood volume is approx. __ L
5
ECF fluid other than blood? (4 examples)
Interstitial
CSF
Intraocular
GI
Primary cations of ECF and ICF?
ECF – Na+
ICF – K+
Primary anions of ECF and ICF?
ECF – Cl- and HCO3-
ICF – PO4-
Isotonic solutions have ______% Sodium or ___% dextrose
0.9% Sodium
5% Dextrose
Of 5 Liters of blood, approx ____ is plasma and _____ is cells
3L Plasma
2L Cells
Difference between plasma and serum?
Plasma – The Liquid part of blood
Serum – Fluid Part of Blood without Clotting Factors or Cells
i.e. Serum lacks clotting factors
Normal Blood/Interstitial Sodium levels
143/140
Normal Intracellular K+ levels
140
Normal Blood/Intracellular protein levels
1.2
4
What is an osmole?
One mole of nonpermeant and non-ionizable substance
Five functional units of a kidney?
Vascular Supply Glomerulus Tubules Interstitium Collecting System
Why does glomerular disease affect tubule bloodflow?
Tubules are supplied only by the efferent arterioles
Decreased blood flow to the kidneys (common in renal disease) will lead to …
Sense low volume/filtrate
Hypertension
Three components of the glomerulus filtration apparatus
Fenestrated Capillary Epithelium
Glomerular Basement Membrane
Epithelial Foot Processes
The basement membrane has acidic glycoproteins that make it ________. Why is this useful?
Negative
Anionics (like albumin) are discluded
Cationics are selectively filtered
Difference in loss seen with alteration of glomerulus BM and foot processes?
BM – Nonselective Loss of Proteins
Foot Processes – Selective Loss of Proteins (albumin)
Filtration layers from blood to bowman’s space (6)
Cap Endothelium Subendothelial Space Glom. BM Subepithelial Space Visceral Epithelium Bowman's Space
Glomerular disease results from…
Disruption of the normal glomerular architecture
Two consequences of glomerular disease?
Loss of GFR
Loss of Selective Permeability
Normal filtrate SHOULD NOT contain….
Proteins or Red Cells
Tubular epithelium is particularly vulnerable to…
ischemic and toxic insults
Selective loss of tubular fxn is associated with…
Production of large amount of dilute urine
Hallmarks of tubular disease:
Loss of concentrating ability
Metabolic Acidosis (w/out anion gap)
Formation of tubular Casts
Collecting system obstruction presents with…
Oliguria and Anuria
Long Term – Ascending Destruction of Renal Compartments
Two things seens with Decrease in GFR
Increased BUN and Creatinine
Decreasing Urine Volumes
Hallmark of gradual development of electrolyte imbalances
Dilutional hyponatremia made worse by sodium loss
Retention of organic acids results in…
Metabolic Acidosis with Anion Gap
Results of Glomerular Disease
Decreased GFR
Altered Membrane filtration
Hematuria and/or proteinuria mean…
Glomerulonephritis
Pre-renal disease is characterized by…
Hypertension
Na Conversation
Azotemia
NO Proteinuria/Hematuria
Causes of interstitial disease?
Infection
Drug Toxicity
Hypersensitivity
How does interstitial disease usually present?
Alongside vascular+tubular disease
Loss of EPO production/anemia
PG loss –> vasoconstriction
Interference with Bloodflow –> Renin/Angio –> hypertension
Loss of ______% results in renal insufficiency. Renal insuffiency is characterized by…
50-80%
Inc. BUN/Creatinine (azotemia)
Anemia
Hypertension
GFR Below ______ = Renal Failure
20-25%
GFR Below _____ = End Stage Renal Disease
5%