05.07 - Na Balance (Gyalmani) - PP + Handout, No reading, Not watched Flashcards
Vomitting and diarrhea are examples of loss of ___ fluid
isotonic
Signs of ECFV depletion
Incr HR, Decr BP, Orthostatic incr in HR or Decr in BP
EuvolemicHypo-osmolar Hypo-natremia is due to
Water retention due to autonomous or altered regulation of ADH release
Changes in TBNa are synomymous with changes in
ECFV
How is retained water (no change in TBNa) distributed
2/3 to ICFV and 1/3 to ECFV
Effect of hypotonic fluid loss on TBW, ICFV, ECFV
All decrease
High Pressure Sensors of Decr ECV
Carotid Sinus, Aortic Arch, JGA
__ of TBW and __ of BW is ECFV
1/3 TBW, 0.2 BW
It would take __ liters of pure H2O loss to produce same change in ECFV as 2 liter loss of isotonic fluid
6 liters
___ determines size of ECFV
TBNa
Usually Hyper-Natremia is caused by ___, rather than ____
Excess water loss, rather than by Na gain
How is loss of water (no change in TBNa) distributed
2/3 to ICFV and 1/3 to ECFV
What causes disproportionate increase in BUN relative to Creatinine
Volume depletion
__ of TBW and __ of BW is ICFV
2/3 TBW, 0.4 BW
What type of Hyponatremia does Hypothyroidism cause?
Euvolemic Hypo-osmolar
Main solute in concentrated urine
Urea, not Na
Lab test to measure ECFV
None readily available
Volume response depends on mechanisms that sense changes in
Effect Circulating Volume
What type of Hyponatremia is caused by Severe HypoKalemia
Hypo-volemic Hypo-Osmolar
Na and associated anions __ are major solutes of ECF
Cl and HCO3
What type of Hyponatremia is caused by Acute and Chronic Renal Failure
Hyper-volemic Hypo-osmolar
What % of TBV is in arterial compartment
15%
Gastric losses are rich in __ and would be associated with
HCl, Metabolic Alkalosis
Which is triggers homeostasis first, incr ECF osmolarity or decreased ECV
Incr in Osmolarity
Hyper-Natremia with Uosm less than 300 mOsm/kg is
DI (central/nephrogenic), Water diuresis
Intestinal fluid is rich in ___ and would result in ___
HCO3-, Normal AG Metabolic Acidosis
___osmotic fluid is lost with diarrhea or vomitting
Iso-osmotic
Hyperosmolar Hyponatremia is usually caused by
Hyperglycemia, Hypertonic Mannitol
ICFV change in isotonic losses/volume depletion
None
Isotonic losses or gains change __ but not __
ECFV, but not ICFV
__ of ECFV and __ of BW is PV
1/4 of ECFV, 0.05 BW
Change in ECFV and ICFV due to ingestion of Na
Expansion of ECFV w/ little or no change in ICFV
__ of ECFV and __ of BW is ISFV
3/4 of ECFV, 0.15 BW
Low Pressure Sensors of Decr ECV
Cardiac Atria, Pulmonary Vasculature
Iso-Osmolar Pseudohyponatremia is caused by
Severe hyperlipidemia, Hyperproteinemia
