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Renal Midterm > Body Fluid Compartments > Flashcards

Body Fluid Compartments Flashcards

1
Q

what is the normal osmolality that we should look for

A

290 mOsm

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2
Q

how do you calculate total body water TBW

A

0.6*BW(body weight)

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3
Q

what is the third space

A

transcellular compartment or locations that the body should not have water

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4
Q

how do you calculate ICF or intracellular fluid

A

0.4*body weight OR 2/3 of TBW(total body water)

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5
Q

how do you calculate ECF or extracellular fluid

A

0.2*BW or 1/3 of TBW

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6
Q

how do you calculate interstitial fluid

A

0.75*ECF

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7
Q

how do you calculate plasma volume

A

0.25*ECF

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8
Q

How do you calculate venous volume

A

0.8*plasma volume

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9
Q

how do you calculate ECV or effective circulating volume

A

0.2*plasma volume

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10
Q

what age group has the highest percentage of TBW

A

infants and this goes down with age

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11
Q

where do we gain water input

A

drinking, food, and carb metab

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12
Q

where do we lose water

A

feces, sweating, insensible perspiration, and urine

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13
Q

what are our main extracellular ions

A

Na and Cl

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14
Q

what are our main intracellular ions

A

K

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15
Q

where are protein levels highest

A

in ICF and vascular compartments

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16
Q

what are the main proteins we are concerned with

A

albumin and globulins

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17
Q

what can be used to help measure plasma volume?

A

albumin that is radiolabeled

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18
Q

what can’t we measure directly

A

ICF and ISF

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19
Q

how do we measure TBW experimentally

A

heavy water or antipyrine

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20
Q

how do we measure ECF experimentally

A

heavy Na, l-iothalamate, thiosulfate, inulin

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21
Q

what is the gibbs donnan effect

A

the negative charge of proteins within the vasculature causes the Na+ and K+ concentrations to be slightly higher than expected

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22
Q

what is ECF osmolality driven by

A

Na

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23
Q

where is the most Na found

A

vasc>interstitium>ICF due to action of NaK ATPase

24
Q

what does a disrupted NaK pump cause an increase in

A

ICF [Na] this causes cellular swelling

25
Q

what is ICF osmolality driven by

A

K

26
Q

what are the two ways to estimate plasma osmolality

A

2*[Na]

2*[Na] + glucose/18 + urea/2.8

27
Q

the ECF and ICF are highly permeable to what

A

water but NOT electrolytes

28
Q

the capillary membrane is highly permeable to what

A

small ions which drive the starling forces

29
Q

what main force favors filtration? opposes filtration

A

Pc; Pi_c

30
Q

what are some common causes that increase Pc

A
  • increased arterial pressure
  • increased venous pressure
  • decreased precapillary resistance
  • increased postcapillary resistance
31
Q

almost all capillaries have a precapillary resistance > postcapilllary resistance except for

A

glomerular

32
Q

what decreases Pc

A
  • decreased arterial pressure
  • decreased venous pressure
  • increased precapillary pressure
  • decreased postcapillary pressure
33
Q

how are hepatic capillaries different than renal capillaries

A

hepatic are highly permeable to proteins and Pi_c plays a little role in fluid exchange for them

34
Q

what is the full formula for capillary filtration

A

Kf [(Pc-Pi)-(Pi_c-Pi_i)]

35
Q

what does Kf stand for in capillary filtration

A

permeability coefficient

36
Q

ECF ___________ controls ICF volume

A

osmolality

37
Q

what are some general factors to think of when looking at changes in ECF and ICF

A
  1. All solutes and water that enter or leave the body do so via ECF.
  2. ICF and ECF are in osmotic equilibrium.
  3. Equilibration occurs primarily by shifts of water, not solutes.
38
Q

what are some factors that affect ECF/ICF

A
  • water ingestion
  • dehydration
  • IV infusions
  • diarrhea or vom
  • sweating
  • diuresis
  • disease (IBS, DM, hypoaldosteronism, SIADH)
39
Q

what changes does excessive intake of NaCl and hyperaldosteronism cause to fluid levels

A

increased ECF, which decreases ICF and increased ECF mOsm and ICF mOsm

40
Q

what changes does water gain cause to fluid levels

A

increased ECF and ICF, decreased ECF and ICF mOsmq

41
Q

what changes does dehydration cause to fluid levels

A

decreased ECF and ICF, and increased ECF mOsm and ICF mOsm

42
Q

what change does NaCl loss (adrenal insufficiency) cause to fluid levels

A

increased ICF; decreased ECF, ECF mOsm, ICF mOsm

43
Q

what are the ranges we define as hyper natremia and hyponatremia

A

plasma >146 mEq/L

plasma < 136 mEq/L

44
Q

what changes do we see in the darrow yannet diagrams for fluid retention? excretion

A

fatter and shorter

narrower and taller

45
Q

what type of IV fluids can stay in the ECF or distribute depending on composition? which stay in the vascular space?

A

crystalloid fluids (normal saline, lactated Ringers); dextran or albumin

46
Q

isoosmotic or isotonic solutions have the same osmolatlity as _____

A

the ECF

47
Q

hyperosmotic or hypertonic solutions have an osmality (higher/lower) than the ECF

A

higher

48
Q

hypoosmotic or hypotonic solutions have an osmality (higher/lower) than the ECF

A

lower

49
Q

adding a isoosmotic solution changes what

A

only the volume in the ECF

50
Q

adding hyperosmotic solutions do what

A

increases Osm in the ECF which decreased ICF and increased ECF

51
Q

what do hyposomotic solution do

A

when added to ECF, Osm decreased and water moves out of the ECF and into the ICF to equilibrate which causes both ICF and ECF volumes to increase

52
Q

what would you administer to dilute the ECF and rehydrate cells

A

hypotonic solution

53
Q

what would you administer to replace fluid loss and expand intravascular volume

A

isotonic solution

54
Q

what would you give to treat severe hyponatremia

A

hypertonic solution

55
Q

what happens in CHF that exacerbates the edema issue

A

Pc is already increased so edema occurs, kidneys hold onto more water to increased vascular volume, this causes more edema

56
Q

what happens to fluid levels in renal disease

A

Na and H2O are inappropriately retained which causes an increase in Pc and edema results

57
Q

what causes edema in liver disease, malnutrition, and nephrotic syndrome

A

decreases in Pi_c because protein synthesis is affected

Renal Midterm (8 decks)

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