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Mechanisms of Disease > Diarrhea: water balance & electrolyte abnormalities > Flashcards

Diarrhea: water balance & electrolyte abnormalities Flashcards

0
Q

What percentage of body weight is composed of intracellular fluid?
Extracellular fluid?

A
  • ICF: 40%

- ECF: 20%

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1
Q

Total body water usually is equal to what percentage of body weight?

A

60-70%

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2
Q

What percentage of body weight is composed of interstitial fluid?

A

15%

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3
Q

What percentage of body weight is composed of plasma?

A

5%

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4
Q

What are electrolytes?

A

Charged particles in aqueous solution.

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5
Q

Which electrolytes have a positive charge?

A

Cations

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6
Q

Which electrolytes have a negative charge?

A

Anions

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7
Q

When is there electrical neutrality?

A

When cations = anions

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8
Q

What are the 3 major electrolytes of ECF?

A
  • Na+
  • Cl-
  • HCO3-
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9
Q

What are the 4 major electrolytes of ICF?

A
  • K+
  • Mg2+
  • Phosphates
  • Protein
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10
Q

The water volume in each fluid compartment is primarily controlled by the major solutes and driven by what force?

A

Osmotic force

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11
Q

What is osmolality determined by?

A

The number of particles in solution.

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12
Q

What are 6 small solutes that are present in high concentrations which compose about 95% of total osmolality?

A
  • Na+
  • K+
  • Cl-
  • HCO3-
  • Urea
  • Glucose
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13
Q

T/F: Larger molecules contribute majorly to osmolality.

A

False - they contribute minimally.

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14
Q

Do effective osmoles diffuse across membranes?

A

No

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15
Q

What to effective osmoles generate?

A

Osmotic pressure which causes water to shift across the membrane.

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16
Q

What reflects the tonicity of a solution?

A

Effective osmoles

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17
Q

ECF = what?

A

Serum Na+ concentration

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18
Q

How can osmolality be regulated?

A

By adjusting H2O balance.

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19
Q

What percentage of change can osmolality be influenced by?

A

1-2% change

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20
Q

What are 2 things that can result from osmolality change?

A
  • ADH release

- Thirst

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21
Q

What is volume regulated by?

A

Adjusting Na+ concentration

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22
Q

What is volume influenced by?

A

Changes in vascular pressure.

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23
Q

What are 2 results that can be seen with volume change?

A
  • Activation of Renin-Angiotensin-Aldosterone system (RAAS)

- ADH will also be released for hypovolemia

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24
Q

What are changes in osmolality detected by?

A

Osmoreceptors in the hypothalamus.

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25
Q

What do changes in osmolality stimulate?

What is the result?

A
  • Pituitary release of vasopressin/ADH

- H2O resorption from renal tubules

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26
Q

Changes in volume are detected by what?

A

Baroreceptors in the kidney and heart.

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27
Q

Changes in volume trigger what?

Which causes what?

A
  • Trigger the RAAS to release aldosterone.

- Kidneys resorb Na+ and H2O follows.

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28
Q

What are 2 things ADH is secreted in response to?

A
  • Increased osmolality

- Marked decrease in plasma volume

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29
Q

What effect does ADH have on the collecting ducts?

A

Maximizes H2O resorption

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30
Q

Aldosterone is secreted in response to what 3 things?

A
  • Angiotensin
  • ACTH
  • Hyperkalemia
31
Q

What effect does aldosterone have on the distal renal tubules?

A

Na+ resorption which is exchanged for K+ or H+.

32
Q

Dehydration is caused by what 2 imbalances?

A
  • Low body water

- High plasma osmolality

33
Q

Dehydration can lead to what 2 clinical signs?

A
  • Increased thirst

- Decreased water excretion leading to concentrate urine

34
Q

Overhydration can be seen with what 2 imbalances?

A
  • Excess body water

- Low plasma osmolality

35
Q

Overhydration can lead to what clinical sign?

A

Increased renal water excretion which leads to dilute urine.

36
Q

What are 3 things to evaluate on a physical exam to evaluate water balance?

A
  • Skin turgor
  • CRT
  • Body weight
37
Q

What is skin turgor?

A

Interstitial tissue consistency

38
Q

What does CRT assess?

A

Peripheral vascular blood flow.

39
Q

What can body weight reflect?

A

Total body water

40
Q

What is the best way to monitor hydration?

A

Body weight

41
Q

What are 2 things examined in biochemical analysis?

A
  • PCV

- TP

42
Q

T/F: PCV and TP should move proportionally.

A

True

43
Q

T/F: PCV and TP always reflect mild changes.

A

False - may not reflect mild changes.

44
Q

PCV and TP can also be affected by what?

A

Blood loss or protein loss

45
Q

T/F: Na+ and Cl- should move proportionally.

A

True

46
Q

What can Na+ and Cl- balance also be affected by?

A

Na+/Cl- consumption and loss.

47
Q

What are 3 other things that can be evaluated with biochemical analysis?

A
  • BUN
  • Creatinine
  • Urine Specific gravity
48
Q

When H2O loss is greater than electrolyte loss, the solution is what?

A

Hypertonic

49
Q

When H2O loss is equal to electrolyte loss, the solution is?

A

Isotonic

50
Q

When H2O loss is less than electrolyte loss, the solution is what?

A

Hypotonic

51
Q

What are 2 possible causes of hypertonic dehydration?

A
  • Osmotic diarrhea (lactuose)

- Maldigestion/malabsorption

52
Q

What are 5 examples of maldigestion/malabsorption?

A
  • PLE
  • Lymphangiectasia
  • Johne’s disease
  • Proximal enteritis
  • Eosinophilic enteritis
53
Q

With hypertonic dehydration, which way does water move to maintain volume?

A

From ICF to ECF

54
Q

What happens to PCV and TP with hypertonic dehydration?

A

They both increase.

55
Q

What happens to serum Na+ and Cl- with hypertonic dehydration?

A

They both increase.

56
Q

What are 2 possible causes of isotonic dehydration?

A
  • Some diarrheas

- Some renal diseases

57
Q

What happens to ECF volume with isotonic dehydration?

A

Decreases

58
Q

With isotonic dehydration, what happens to osmolality and osmotic pressure?

A

No change

59
Q

Is there a shift between ICF and ECF with isotonic dehydration?

A

No

60
Q

What happens with PCV and TP with isotonic dehydration?

A

Both increase.

61
Q

What happens with serum NA+ and Cl- with isotonic dehydration?

A

They do not change.

62
Q

What is the most common type of diarrhea seen clinically?

A

Hypotonic dehydration

63
Q

What are 3 causes of hypotonic diarrhea?

A
  • Secretory diarrhea (calf scours)
  • Vomiting
  • 3rd space loss (displaced abomasum)
64
Q

What happens to water with hypotonic dehydration?

A

It shifts from vasculature to cells.

65
Q

Hypotonic dehydration can lead to what 2 conditions?

A
  • Volume depletion

- Cerebral edema

66
Q

Since osmoreceptors are not stimulated with hypotonic dehydration, what happens to ADH?

A

ADH is not released.

67
Q

What happens to PCV and TP with hypotonic dehydration?

A

They both increase.

68
Q

What 3 things affect plasma volume in reference to sodium?

A
  • Urine
  • GI tract
  • Sweat
69
Q

What are 2 systems that regulate sodium?

A
  • Osmoreceptors in hypothalamus sense increases osmolality and secrete ADH
  • Baroreceptors (stretch receptors) sense volume changes and activate the RAAS
70
Q

What follow Na+?

A

Water

71
Q

What percentage of water intake is oral?

A

80-90%

72
Q

What percentage of water is excreted by the kidneys?

A

50-70%

73
Q

What is something that influences water output?

A

ADH

74
Q

What percentage of water output is excreted in the GI tract?

A

1-3%

75
Q

What percentage of water output is though insensible losses?

A

40-60%

Mechanisms of Disease (8 decks)

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