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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
What are changes in osmolality detected by?
Osmoreceptors in the hypothalamus.
25
What do changes in osmolality stimulate? | What is the result?
- Pituitary release of vasopressin/ADH | - H2O resorption from renal tubules
26
Changes in volume are detected by what?
Baroreceptors in the kidney and heart.
27
Changes in volume trigger what? | Which causes what?
- Trigger the RAAS to release aldosterone. | - Kidneys resorb Na+ and H2O follows.
28
What are 2 things ADH is secreted in response to?
- Increased osmolality | - Marked decrease in plasma volume
29
What effect does ADH have on the collecting ducts?
Maximizes H2O resorption
30
Aldosterone is secreted in response to what 3 things?
- Angiotensin - ACTH - Hyperkalemia
31
What effect does aldosterone have on the distal renal tubules?
Na+ resorption which is exchanged for K+ or H+.
32
Dehydration is caused by what 2 imbalances?
- Low body water | - High plasma osmolality
33
Dehydration can lead to what 2 clinical signs?
- Increased thirst | - Decreased water excretion leading to concentrate urine
34
Overhydration can be seen with what 2 imbalances?
- Excess body water | - Low plasma osmolality
35
Overhydration can lead to what clinical sign?
Increased renal water excretion which leads to dilute urine.
36
What are 3 things to evaluate on a physical exam to evaluate water balance?
- Skin turgor - CRT - Body weight
37
What is skin turgor?
Interstitial tissue consistency
38
What does CRT assess?
Peripheral vascular blood flow.
39
What can body weight reflect?
Total body water
40
What is the best way to monitor hydration?
Body weight
41
What are 2 things examined in biochemical analysis?
- PCV | - TP
42
T/F: PCV and TP should move proportionally.
True
43
T/F: PCV and TP always reflect mild changes.
False - may not reflect mild changes.
44
PCV and TP can also be affected by what?
Blood loss or protein loss
45
T/F: Na+ and Cl- should move proportionally.
True
46
What can Na+ and Cl- balance also be affected by?
Na+/Cl- consumption and loss.
47
What are 3 other things that can be evaluated with biochemical analysis?
- BUN - Creatinine - Urine Specific gravity
48
When H2O loss is greater than electrolyte loss, the solution is what?
Hypertonic
49
When H2O loss is equal to electrolyte loss, the solution is?
Isotonic
50
When H2O loss is less than electrolyte loss, the solution is what?
Hypotonic
51
What are 2 possible causes of hypertonic dehydration?
- Osmotic diarrhea (lactuose) | - Maldigestion/malabsorption
52
What are 5 examples of maldigestion/malabsorption?
- PLE - Lymphangiectasia - Johne's disease - Proximal enteritis - Eosinophilic enteritis
53
With hypertonic dehydration, which way does water move to maintain volume?
From ICF to ECF
54
What happens to PCV and TP with hypertonic dehydration?
They both increase.
55
What happens to serum Na+ and Cl- with hypertonic dehydration?
They both increase.
56
What are 2 possible causes of isotonic dehydration?
- Some diarrheas | - Some renal diseases
57
What happens to ECF volume with isotonic dehydration?
Decreases
58
With isotonic dehydration, what happens to osmolality and osmotic pressure?
No change
59
Is there a shift between ICF and ECF with isotonic dehydration?
No
60
What happens with PCV and TP with isotonic dehydration?
Both increase.
61
What happens with serum NA+ and Cl- with isotonic dehydration?
They do not change.
62
What is the most common type of diarrhea seen clinically?
Hypotonic dehydration
63
What are 3 causes of hypotonic diarrhea?
- Secretory diarrhea (calf scours) - Vomiting - 3rd space loss (displaced abomasum)
64
What happens to water with hypotonic dehydration?
It shifts from vasculature to cells.
65
Hypotonic dehydration can lead to what 2 conditions?
- Volume depletion | - Cerebral edema
66
Since osmoreceptors are not stimulated with hypotonic dehydration, what happens to ADH?
ADH is not released.
67
What happens to PCV and TP with hypotonic dehydration?
They both increase.
68
What 3 things affect plasma volume in reference to sodium?
- Urine - GI tract - Sweat
69
What are 2 systems that regulate sodium?
- Osmoreceptors in hypothalamus sense increases osmolality and secrete ADH - Baroreceptors (stretch receptors) sense volume changes and activate the RAAS
70
What follow Na+?
Water
71
What percentage of water intake is oral?
80-90%
72
What percentage of water is excreted by the kidneys?
50-70%
73
What is something that influences water output?
ADH
74
What percentage of water output is excreted in the GI tract?
1-3%
75
What percentage of water output is though insensible losses?
40-60%

Mechanisms of Disease (8 decks)

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