Sodium and Water balance physiology Flashcards

(29 cards)

1
Q

What is water balance controlled by?

A

ADH

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2
Q

What does high ADH lead to in terms of urine?

A

small volume of concentrated urine

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3
Q

What does low ADH lead to in terms of urine?

A

large volume of diluted urine

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4
Q

What is sodium balance controlled by?

A

mineralocorticoid activity

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5
Q

Which hormones possess mineralocorticoid activtiy?

A

aldosterone

cortisol

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6
Q

What does high mineralocorticoid activtiy indicate in terms of sodium?

A

sodium gain

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7
Q

What does low mineralocorticoid activtiy indicate in terms of sodium?

A

sodium loss

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8
Q

What is mineralcorticoid activtiy?

A

Na absorption in the renal tubules in exchange for K/H

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9
Q

What is the normal sodium levels?

A

135-145mmol/L

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10
Q

What can low sodium be due to?

A

low Na

high H20

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11
Q

What can high sodium be due to?

A

high Na

low H20

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12
Q

What are dangerous numbers for sodium levels?

A

<120 or >160

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13
Q

What are the signs of sodium that is too high or low?

A
nausea
altered conciousness
confusion
vomiting
fitting
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14
Q

Where is sodium found?

A

ECF

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15
Q

What follows sodium by osmosis?

A

water

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16
Q

What can cause a decreased Na?

A

SIADH or compulsive water drinking = increasing H20 levels

Sodium loss through skin, kidneys or adrenals

17
Q

What can cause an increased Na?

A

H20 loss from diabetes insipious or just low water intake

increased Na from near drowing, some medication, children being force fed salt

18
Q

What is the management for decreased Na?

A

give 0.9% saline

19
Q

What is the management for increased Na?

A

remove sodium

20
Q

What is the management for increased H20?

A

fluid restrict

21
Q

What is the management for decreased H20?

A

give water in the form of 0.5% dextrose

22
Q

What is the benefit of giving 0.5% dextrose?

A

goes all the way into the ICF, through plasma and ECF

has the same concentration as blood

23
Q

What is oedema due to?

A

an altered balance of starlings forces at capillary level between oncotic forces bringing water in and hydrostatic forces pushing it out

24
Q

Where does water get retained in oedema?

25
What does SIADH mean?
syndrome of innapropriate ADH release | can lead to hypovoleamia, hypotension, pain, nausea and vomiting
26
What is pseudohyponatraemia?
extremely low Na levels caused by increased amount of proteins and lipids the Na:H20 ratio is normal and it will be an incidental finding
27
What is diabetes insipidus due to?
distruption of the pituitary or pituitary stalk meaning ADH cannot be secreted lots of pure water lost in the urine
28
How is diabetes insipidus treated?
desmopressin - exogenous ADH | desmospray, desmopressin oral tables, desmopressin injections
29
How is diabetes insipidus investigated?
nil by mouth for 8-12 hours Urine/serum osmol ratio <2 = DI if improves after desmopressin = cranial DI