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Physiology 1 > Consequences Of Fluid Loss From The GI System > Flashcards

Consequences Of Fluid Loss From The GI System Flashcards

1
Q

What are the sites of water loss

A

Skin • Respiratorypassageways • GIT • Urinarytract
Menstraul flow
Trauma

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2
Q

Where is sodium and chloride excretion the highest in conc

A

Excretionisusuallysmall,butlargeindiarrhoea,sweating,vomiting, haemorrhage→lossofwaterandsalts

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3
Q

Definition of diarrhoea

A

↑frequency,with↑volumeandfluidityoffaeces • >3unformedstoolsper24hrs • Changeinbowelmovement

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4
Q

Why dues diarrhoea occur

A

Failureofwaterabsorption • ↑secretionofwater • orbothofabove

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5
Q

Causes of decreased absorption in intestines

A

↑numberofosmoticparticles(osmoticdiarrhoea) • ↑rateofflowofintestinalcontents(derangedmotilitydiarrhoea) • AbnormalincreaseinsecretionsofGIT(secretorydiarrhoea)

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6
Q

What is Osmoticdiarrhoea:

A

Decreasedabsorptionofelectrolytesandnutrients • Disaccharidasedeficiency(disaccharidedeficiency/malabsorption),drug‐
induced,malabsorptionofgalactose);bloating,nausea,watery
diarrhoea

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7
Q

Secretary diarrhoea

A

ACh,substanceP,5‐HTandneurotensinactvia↑[Ca2+]toincreaserateof intestinalsecretion
– Excessivelaxativeuse,defectsindigestionandabsorption;infections
[e.g.cholera(Vibriocholerae)]
• Survivesacidicconditionsofthegut
• Enterotoxinstimulatesadenylatecyclase→↑cAMP→Na+,Cl‐
andwaterloss
• Replacewater,electrolytesandglucose(treatment) Traveller’sdiarrhoea:bacteria
Inflammatoryboweldisease→chronicexudativediarrhoea

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8
Q

Derangedmotilitydiarrhoea:

A

lackofabsorption;someagentsmaypromote secretionaswellasmotility • GIstasismaypromotediarrhoeabystimulatingbacterialovergrowth
Parasiticcausesofdiarrhoea:EntamoebahistolyticaandGiardialamblia

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9
Q

What is Giardia

A

steatorrhoeaandabdominalpain;maldigestion&
malabsorptionoflipids,CHOs,vitA,vitB12,folicacid
– Metronidazoleortinidazole

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10
Q

What is dysentry

A

Dysentery:painful,bloody,lowvolumediarrhoea

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11
Q

Causesofbloodydiarrhoea

A

Chronicdisease • Ulcerativecolitis • Neoplasm

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12
Q

Majorconsequencesofseverediarrhoea ?

A

Consequencesofexcessivelossofwater,nutrients,Na+,K+andHCO3‐: • ↓bloodvolume(hypovolaemia) • Metabolicacidosis–duetolossofHCO3‐e.g.,indiarrhoea
Volumedepletioncouldleadtoacidosis/alkalosis

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13
Q

Consequencesofexcessivevomiting

A

↑saltandwaterloss • Severedehydration • Circulatoryproblems • Metabolicalkalosis–duetolossofgastricacid(HCl)
• Death

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14
Q

Whatislostinvomit?

A

Food • MucuswithNa+,K+,Cl‐,HCO3‐ • Gastricacid • Upperintestinalcontents(incl.bile) • Blood

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15
Q

ConsequencesoffluidlossfromGITract

A

Hypovolaemia • Haemoconcentration/polycythaemia(dehydration)=↑[RBC] • Dehydration • Ionicimbalances;poorperfusionoftissues • Malnutritionand↑mortality

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16
Q

Consequencesofhypovolaemia:

A

↓venousreturn • Arterialhypotension • Myocardialdysfunctiondueto↑myocardialoxygendemand,buttissue
perfusionisreduced
↑anaerobicmetabolism→acidosis
– Acidosisandmyocardialdysfunction→multi‐organfailure

17
Q

Thebody’sresponsetowaterloss?

2

A

Cardiovascularadaptation • Renaladaptation

18
Q

Whatregulateswaterloss?

A

Vasopressin(antidiuretichormone,ADH) • ADHstimulatesthirstmechanism
• Increasedosmolarityofbodyfluids→ADHrelease

19
Q

HowdoesADHwork?

A

ADHactivatestheV2receptorontherenalcollectingducts
Insertswaterchannels(aquaporin‐2)incollectingductofkidney • ThisincreasesthepermeabilityofthecollectingductstoH2Oandresults
inconcentratedurineproduction • IntakeofplainH2O→a↓inosmolarityofbloodandinterstitialfluid
– ThisdecreasesADHsecretionandtheremovalofthewaterchannels • Iftherearenowaterchannels,thiscausesdecreasedpermeabilityof
collectingductstowaterandincreasedwaterloss

20
Q

What are the factors that regulate ash release

A

Largedecreaseinbloodvolume(detectedbybaroreceptors)*
2. Severedehydration:underthiscondition,GFRdecreasescausinglessH2O
inurine*
3. Hyperventilation:resultsinincreasedfluidloss(exhalation)*
4. Vomiting/diarrhoea:causesincreasedfluidlossfromGIT*
5. Fever,heavysweating,andburnscauselargeH2Oloss*
→*Leadtothegenerationofhyperosmolarrenalmedulla
*ADHsecretioninallthesecasesleadstoconservationofbodyH2O • Thisisthroughthesequenceofeventswejusttalkedinthepreviousslide
• Intakeofcopiousamountsofwater:resultsinhighBPwhichcauses
increasedGFRandincreasedH2Oinurine

Physiology 1 (67 decks)

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