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BLD 416 > Body Water & Electrolytes > Flashcards

Body Water & Electrolytes Flashcards

1
Q

What does TBW stand for?

A

Total Body Water

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2
Q

What is the Total Body Water in Liters?

A

42 Liters

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3
Q

What % of weight is TBW?

A

60%

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4
Q

Total Body Water is made up of what compartments?

A

Intracellular and Extracellular

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5
Q

Extracellular Body Water Compartment is made up of what compartments?

A

Interstitial and Plasma (vascular)

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6
Q

How many liters of water are contained in the Intracellular compartment?

A

28 Liters

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7
Q

How many liters of water are contained in the Extracellular compartment?

A

14 Liters Total, 10 Liters in the Interstitium and 4 Liters in the Vasculature

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8
Q

What method is used to determine Extracellular Water?

A

Indicator Dilution Method

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9
Q

What does the Indicator Dilution Method for determining ECW assume?

A

It assumes:
1) That the indicator is NOT taken up by the cell
2) There is complete diffusion of the indicator
substance
3) The indicator substance is NOT eliminated

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10
Q

How is TBW generally regulated?

A

Through input and output.
Input–> Thirst, IV
Output–> Urinary, Sweat, Vomit, Fecal

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11
Q

What does ADH stand for?

A

Anti Diuretic Hormone

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12
Q

Where is ADH released?

A

Posterior Pituitary

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13
Q

What controls ADH release from posterior pituitary?

A

Hypothalamic Nerve that is in direct contact with venous blood.

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14
Q

How is ADH released?

A

ADH is released by the posterior pituitary in response to the osmolarity of the blood. When the blood is hypertonic, the hypothalamic cells will crenate and signal the posterior pituitary to release ADH. When the blood is hypotonic the hypothalamic cells will stretch and signal the posterior pituitary to decrease ADH production.

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15
Q

Where are receptors located for ADH?

A

In the Brain and Collecting Duct of the Kidney

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16
Q

What effect does ADH have?

A

Main controller of thirst

Stimulates water reabsorption in the collecting duct of the kidneys.

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17
Q

What is the purpose of the Baroreflex?

A

To help maintain blood pressure with the release of Epinephrine from the adrenal glands.

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18
Q

When is the Baroreflex stimulated?

A

In times of hypotension

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19
Q

What is the effect of epinephrine release during a baroreflex response?

A

Epinephrine is released which is cardiotropic and inotropic. Makes the heart beat harder and faster. Also vasoconstricts blood vessels. All of which increase the blood pressure.

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20
Q

What does ANP and BNP stand for?

A

Atrial Natriuretic Peptide and Brain Natriuretic Peptide.

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21
Q

Where is BNP produced?

A

In the ventricle of the heart

22
Q

Where are the receptors for BNP?

A

In the Kidney, causes vasodilation of the renal artery

23
Q

What effect does BNP have on Blood Pressure?

A

Decreases BP

24
Q

Where is Renin produced?

A

Kidneys

25
Q

Where is Angiotensinogen produced?

A

Liver

26
Q

What causes the release of Renin?

A

Low renal perfusion pressure
Sympathetic Nerve Stimulation
Low Na concentration in renal tubule

27
Q

What is Angiotensinogen converted to and what converts it?

A

Angiotensin I by the proteolytic action of Renin

28
Q

What is Angiotensin I converted to and what converts it?

A

Angiotensin II by ACE–> Angiotensin Converting Enzyme

29
Q

Where is Angiotensin Converting Enzyme Located?

A

Surface of the Lungs

30
Q

What are the effects of Angiotensin II?

A

Most potent vasoconstrictor
Thirst
Stimulates release of Aldosterone from the adrenal gland

31
Q

Where is Aldosterone synthesized?

A

Adrenal glands

32
Q

What are the effects of Aldosterone?

A

Increases Na retention
Increases K excretion
Increases H2O retention (due to Na reabsorption)

33
Q

What does Aldosterone act on in the Kidney?

A

Na/K ATPase. Stimulates Na reabsorption and K excretion. Na reuptake brings in lots of H2O.

34
Q

Which ions are used as adjusters to keep electroneutrality in the body?

A

Na, Cl, and HCO3

35
Q

Which ions constitute a “short set of lytes”?

A

Na, K, Cl, HCO3

36
Q

What makes up the Anion Gap?

A

Na - Cl - HCO3

37
Q

What is Hyponatremia?

A

Low plasma Na

38
Q

Water excess causes hyponatremia because it dilutes out the amount of Na in the plasma. What causes water excess and ultimately hyponatremia?

A

1) Water Intoxication
2) Congestive Heart Disease–> Cardiac Output is falling, as a result you get epinephrine and renin release and ultimately aldosterone release. Aldosterone brings in a lot of water effectively diluting the plasma.
3) Renal Failure–> Lose serum proteins, then you lose hydrostatic pressure, this results in hypotension, this causes renin and epinephrine release, pulling water back in and diluting plasma.
4) SIADH–> Excessive ADH production causes water retention in kidneys and dilutes the plasma.

39
Q

Hyponatremia is caused by a Na deficit. What causes this Na deficit?

A

1) GI abnormalities causing Diarrhea

2) Hypoaldosteronism

40
Q

Hypernatremia is caused by having an excess of Na. What causes this Na excess?

A

1) Ingestion or administration of excess NaCl or NaHCO3

2) Primary Hypoaldosteronism

41
Q

Hypernatremia is caused by having a water deficit. What causes this water deficit?

A

1) Water and Food deprivation
2) Excessive sweating
3) Osmotic Diuresis–> If urine is hypertonic there will be no water reabsorption in the kidney
4) Actual or Apparent ADH deficiency (Diabetes Insipidus)
5) Hyperventilation

42
Q

What are the two syndromes associated with hyperaldosteronism?

A

1) Conn’s Syndrome

2) Barter’s Syndrome

43
Q

Which syndrome causing hyperaldosteronism is due to an adrenal tumor?

A

Conn’s Syndrome

44
Q

What will aldosterone and renin levels be in a person exhibiting Conn’s Syndrome?

A

Increased Aldosterone

Normal Renin

45
Q

Which syndrome causing hyperaldosteronism is due to a renin producing tumor?

A

Barter’s Syndrome

46
Q

What will aldosterone and renin levels be in a person exhibiting Barter’s Syndrome?

A

Increased Renin
Increased Aldosterone
Increased Ag I & Ag II also–> Due to increased renin!

47
Q

How can you distinguish Conn’s Syndrome from Barter’s Syndrome?

A

Conn’s syndrome is an adrenal tumor so there will be an increase in aldosterone but not renin.
Barter’s Syndrome is a renin producing tumor so there will be an increase in renin, Ag I, Ag II, and aldosterone.

48
Q

Diabetes Insipidus is caused by an “Actual” or “Apparent” ADH deficiency. What does this mean?

A

Actual ADH Deficiency–> Refers to an actual deficiency in ADH due to a stroke or some trauma causing pituitary loss and ultimately a decrease in ADH.
Apparent ADH Deficiency–> Due to a congenital defect in the ADH receptor.

49
Q

What causes Hypokalemia?

A

Decreased K intake
Increased GI loss of K
Increased Urinary loss of K
1) Primary Hyperaldosteronism
2) Adrenal Hyperplasia
3) Renal Disease-> GFR and tubular defects
4) Diuretics
5) Alkalosis-> K competes with H for binding sites on proteins. If alkalotic, more K is binding to intracellular proteins, this decreases the intracellular free K, extracellular K moves into the cell which decreases extracellular K leading to Hypokalemia.
6) Insulin increases activity of Na/K ATPase. If you have an insulinoma, could be hypokalemic.

50
Q

What causes Hyperkalemia?

A 
Increased K intake
Decreased Urinary Excretion
   1) Renal Failure
   2) Hypoaldosteronism
   3) Diuretics
   4) Acidosis-> K competes with H for binding site on intracellular proteins. If acidotic, less K is binding to proteins which increases intracellular free K, Intracellular K then moves out of the cell and ultimately leads to hyperkalemia.

BLD 416 (5 decks)

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