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HES 311: Pathophysiology 2.0 > Week 2 - Fluid and Electrolyte Imbalances > Flashcards

Week 2 - Fluid and Electrolyte Imbalances Flashcards

(64 cards)

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1
Q

How much body weight is made up of fluid (water)

A

~60%
- 2/3 intracellular fluid
- 1/3 extracellular fluid

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2
Q

Thirst regulation

A

osmoreceptors in the hypothalamus

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3
Q

What do osmoreceptors measure?

A

blood osmolarity

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4
Q

How do kidneys regulate fluid and electrolytes?

A

by varying the amounts excreted and reabsorbed
- directly and hormone related

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5
Q

Hormones that act on the kidneys to regulate fluids and electrolytes

A
  • Antidiuretic hormone (ADH)
  • Aldosterone
  • Atrial Natriuretic Peptide
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6
Q

What does the Antidiuretic hormone (ADH) regulate?

A

regulates water level

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7
Q

What does Aldosterone regulate?

A

regulates Na+ and water level

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8
Q

What does Atrial Natriuretic Peptide regualte?

A

Regulates Na+ and water level

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9
Q

How does water move between compartments?

A
  • filtration
  • osmosis
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10
Q

What drives filtration?

A

hydrostatic pressure

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11
Q

What drives osmosis?

A

Osmotic pressure

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12
Q

What is filtration?

A

movement of water and solutes from blood (high pressure) to ISF (low pressure) area

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13
Q

What is osmosis?

A

movement of water from low solute concentration (ISF) to high concentration (blood)

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14
Q

What does movement of water depend on?

A

permeability of the compartment barrier to water

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15
Q

diffusion

A

movement of solutes (Na+, glucose) from high concentration to low concentration

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16
Q

Active transport

A

movement of solute using carrier and energy from low concentration (ISF) to high concentration (Cell)

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17
Q

what does the movement of electrolytes between compartments depends on?

A

how ‘permeable’ the membrane barrier is to the electrolyte AND the concentration gradient of the ion

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18
Q

Edema

A

excess fluid in the interstitial compartment
- isotonic, hypotonic, or hypertonic

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19
Q

Possible consequences of edema

A
  • swelling within the tissues (localized or general)
  • functional impairment
  • pain
  • impaired circulation
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20
Q

4 causes of edema

A
  1. high local blood pressure
  2. plasma protein loss
  3. blocked, or missing, lymphatic vessel
  4. increased capillary permeability
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21
Q

Edema - high local blood pressure

A

Increased hydrostatic pressure
- increased net fluid movement into interstitial space

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22
Q

Edema - plasma protein loss

A

(usually albumin - most abundant protein in the blood)
Decreased osmotic pressure in the blood
- Increased net fluid movement into interstitial space

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23
Q

What is the most abundant protein in the blood?

A

Albumin

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24
Q

Edema - blocked, or missing, lymphatic vessel

A

Fluid and protein not filtered into lymphatic drainage for return to circulation
- localized edema

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25
Edema - increased capillary permeability
excess flow of fluid and proteins into interstitial fluid. - protein movement also increases interstitial fluid osmotic pressure
26
Edema - high local BP - Pathological states
- congestive heart failure - severe hypertension - increased blood volume
27
Edema - plasma protein loss - pathological states
- kidney disease (excess protein excretion in urine - malnutrition or malabsorption (impaired protein synthesis)
28
Edema - blocked, or missing, lymphatic vessel - pathological states
- tumor blocking lymphatic drainage - lymph node removal
29
Edema - increased capillary permeability - pathological states
- infection - inflammatory response
30
Dehydration
water loss > water intake
31
Dehydration common causes
- insufficient fluid intake - sweating - vomiting - diarrhea - excess excretion (urine)
32
Dehydration signs and symptoms
- thirst - dry mouth/lips - nausea - fatigue - lightheadedness - irritability - decreased BP, increased HR - vasoconstriction
33
Dehydration net results
- isotonic dehydration - hypotonic dehydration - hypertonic dehydration
34
Isotonic dehydration
water + electrolyte loss
35
Hypotonic dehydration
more electrolytes lost than water
36
Hypertonic dehydration
More water lost than electrolytes
37
Na+
-critical ion for maintaining volume and osmolarity of the extracellular fluid - essential in electrical conduction of nerves, muscle contraction, general cellular function
38
Hyponatremia
- losing more Na+ than water OR gaining more water than Na+
39
Hyponatremia effect
- fluid imbalances (water moves into cells) - skeletal muscle cramps, weakness, fatigue - nausea/vomiting, GI cramping, diarrhea - headache, confusion, seizures, coma
40
Hypernatremia
gaining more Na+ than water OR losing more water than Na+
41
Hypernatremia effects
- fluid imbalances (water moves out of cell) - increased thirst/decreased urine output, dry mucous membrane - rapid HR - Headache, agitation, seizures, coma
42
K+ role
Important role in maintaining cell resting membrane potential, essential function in excitable tissue: nerve conduction, muscle contraction
43
Hypokalemia
due to anything that causes excess K+ loss or inadequate intake, or more K+ entering cells
44
Hypokalemia effects
- cardiac dysrhythmia - muscle weakness, fatigue, paralysis - pins and needles
45
Hyperkalemia
due to anything that causes K+ build up in extracellular fluid, or more K+ to exit cells
46
Hyperkalemia effects
- cardiac dysrhythmia - muscle cramps - pins and needles (paresthesia)
47
Effect of K+ imbalance on AP formation
- Hyperkalemia = hyperexcitable cells - Hypokalemia = less excitable cells
48
What are the 3 mechanisms for acid-base balance?
1. buffer system in the blood 2. respiratory system 3. Kidneys
49
What is the main buffer system in the blood?
Bicarbonate-Carbonic acid buffer system
50
How does the respiratory regulate acid-base balance?
regulation of CO2 level in the blood
51
How do the kidneys regulate acid-base balance?
variable excretion/reabsorption of H+ and HCO3-
52
Respiratory acidosis?
due to increased CO2
53
Metabolic acidosis
due to decrease in HCO3- (excess acid present in the blood)
54
Respiratory alkalosis
due to decreased CO2
55
Metabolic alkalosis
due to increased HCO3- (excess acid loss from the blood)
56
What causes respiratory acidosis?
- acute: pneumonia, airway obstruction, chest injury, drug OD - chronic: emphysema, pulmonary edema due to congestive HF
57
Respiratory acidosis compensation
- Metabolic: kidneys reabsorb HCO3- and excrete H+ - respiratory: increase rate and depth of breathing
58
Metabolic acidosis causes
- excess HCO3- loss from diarrhea - increased buffering due to acid build up (lactic acid, ketoacidosis) - hyperkalemia - kidney disease/failure (decreased excretion of acids/decreased production of HCO3-)
59
Metabolic acidosis compensation
- Metabolic: kidneys reabsorb HCO3- and excrete H+ - Respiratory: hyperventilation to expel more CO2
60
Respiratory alkalosis cause
hyperventilation (anxiety, high fever, aspirin OD)
61
Respiratory alkalosis compensation
Metabolic: kidneys excrete HCO3- and reabsorb H+
62
Metabolic alkalosis causes
- excess HCl loss from the stomach (vomiting) - Hypokalemia (H+/K+ swap in cells) - excess ingestion of antacids
63
Metabolic alkalosis compensation
- Respiratory: hypoventilation to increase CO2 level in blood - metabolic: kidneys excrete HCO3- and reabsorb H+
64

HES 311: Pathophysiology 2.0 (11 decks)

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