Patho Exam 3 Flashcards

(34 cards)

1
Q

Arginine Vasopressin (AVP)

  • other name?
  • Osmotic release effect?
  • Nonosmotic release effect?
A

Arginine Vasopressin (AVP)

  • Antidiuretic Hormone (ADH)
  • Osmotic release causes 1-2% change in osmolality
  • nonosmotic release causes 6-10% change in osmolality
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Water

  • TBW in male?
  • TBW in female?
A

Water

  • 60% of TBW in male
  • 50% of TBW in female
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Serum Osmolality Equation

A

(2 x Na) + (Glu/18) + (BUN/2.8)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ECF

  • % of TBW?
  • 3 substances and % ?
A

ECF

  • 40% of TBW
  • Plasma - 20%
  • IF - 80%
  • Transcellulor fluid - <1%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ICF

  • % of TBW
  • 1 substance
A

ICF

  • 60% of TBW
  • cytosol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ECF Osmolality

-concentration of ?

A

ECF Osmolality

-Concentration of Sodium Salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

ICF Osmolality

-concentration of ?

A

ICF Osmolality

-Concentration of Potassium Salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

4 Principles of Regulation

A
  • Homeostatic mechanisms respond to changes in ECF
  • No receptors directly monitor fluid or electrolyte balance
  • Water cannot be moved by active transport
  • Losses do not equal gains cause imbalance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hypothalmic osmoreceptors

-what do they do?

A

Hypothalmic osmoreceptors

-monitor plasma volume + osmotic concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does water move through membrane?

A
  • water follows salt by osmosis

- other mechanisms - ADH, Thirst Stimulate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Daily Water input

  • Amount total?
  • Amount in Food?
  • Amount in Drink?
  • Amount in Metabolic generation?
A

Daily Water Input

  • 2500ml Total
  • Food-1000ml
  • Drink-1200ml
  • Metabolic generation - 300ml
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Daily Water Loss
Sensible- whats it mean?
Urine - Amnt ?
Stool - Amnt ?

A

Daily Water Loss
Sensible - can be measured
Urine - 1200ml
Stool - 150ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Daily water Loss
insensible - meaning?
Respiratory - amnt?
Transcutuneous evaporation - amnt?

A

Daily Water Loss
Insensible - cannot be measured
Respiratory - 400ml
Transcutaneous evaportation - 750ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What determines Fluid exchange between plasma and IF

A

-Determined by net colloid osmotic pressure vs. net hydrostatic osmotic pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Decreased Net Colloid Pressure

-Disease + Symptoms ?

A

Decreased Net Colloid Pressure

  • Hypoalbunemia - Low Blood Albumin
  • Liver Disease
  • Increased accumulation of IF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Increased Net Hydrostatic Pressure

-Diseases + symptoms + causes ?

A

Increased Net Hydrostatic Pressure

  • Heart Failure
  • Renal Failure (oliguria or anuria)
  • Increased accumulation of IF
  • Lymphatic obstruction
  • Increased capillary permeability
17
Q

Fluid Shifts

  • what speed?
  • in response to what?
  • how long until equilibrium?
  • what direction in relation to osmolality?
A

Fluid Shifts

  • occur rapidly
  • in response to changes in osmotic concentration of the ECF
  • Oppose the change in osmolality
18
Q

Sodium Balance and ECF Volume

-what balances Na+ content in ECF?

A

Sodium Balance and ECF Volume

  • Na content in ECF is balanced between dietary Na intake and Renal Na excretion
  • change in Na content does not equal a change in Na concentration
  • changes in Na content lead to changes in corresponding gain/loss of water which keeps the concentration constant
19
Q

Euvolemia?

Euvolemic?

A

-Normal fluid volume in both TBW and intravascular

20
Q

Hypervolemia

A
  • excess fluid volume
  • in intravascular space and interstitual fluid (edema)
  • AKA fluid overload, volume overload, wet.
21
Q

Hypovolemia

A
  • Decreased fluid volume
  • Total body water (dehydration)
  • Intravascular (volume depleted)
22
Q

Physical Exam Findings

A
  • Behavior
  • Skin turgor
  • Skin moisture
  • Capillary refill
  • mucus membranes
  • peripheral pules
  • extremites
  • Blood pressure
  • Lungs
  • External jugular vein
  • Weight
23
Q

Laboratories Findings

A
  • Serum Sodium
  • Serum Osmolality
  • Urine specific gravity
  • BUN:SCr ratio
  • Hemoglobin/hematocrit
24
Q

Subjective Findings

A
  • Thirst

- Dizziness

25
Dehydration Manifestations
- increased plasma osmolality - increased sodium - increased BUN:Cr > 20 - Urine specific gravity >1.020 - CNS Disturbances - -Irritable->hypeirritable->lethargic - Excessive Thirst - Dry mucous membranes --Decreased skin turgor - Concentrated Urine - Weight loss
26
TBW Depletion
-Loss of hypotonic fluid from all body fluid compartments
27
Dehydration Causes
- Inadequate oral intake in elderly - Increased insensible losses - Diabetes - Insipidus - Osmotic diuresis - Impaired renal concentrating mechanisms
28
Intravascular Volume depeletion: | ECF Depletion
- Loss of isotonic fluid - No primary disturbance of plasma osmolality - tends to be more acute and require more aggressive treatment
29
Intravascular Volume depeletion causes
- External fluid losses - -burns - -hemorrhage - -GI Losses - Third Spacing - -Sepsis - -Ascites
30
Intravascular Volume Depletion PE Findings
- Orthostatis - Tachycardia - Acute Weight loss (3-10%) - decreased urine output ->anuria - increased hematorcrit - BUN:SCr > 20 - CNS Disturbances - -irritable -> hyperirritable -> lethargic - Skin tenting - Dry mucus membranes - Delayed capillary refill (2 to >4 seconds) - weak or not palpable pules - external jugular vein not visible
31
Intravascular volume depletion labortory findings
- Serum sodium - within normal limites - Serum osmolality - WNL - Urine specifc gravity - WNL
32
Intravascular Volume Depletion Subjective Findings
- Thirst | - Dizziness
33
Hypervolumia | -symptoms?
- increased blood pressure - moist skin - jugular venous distension - peripheral edema - --clinically detectable increased in interstitial fluid volume -- at least 2.5-3L excess in adults - --usually due to heart, renal, or hepatic failure - hypoxia - orthopenwa - shortness of breath - dyspnea on exertion - we
34
Peripheral edema - whats it found in - clincal detections - causes
- manifestation of hypervolemia - detectable in increased interstitual fluid volume - 2.5-3L - usually due to heart, renal, or hepatic failure