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House AMP > Disturbances Of Fluid Balance > Flashcards

Disturbances Of Fluid Balance Flashcards

1
Q

Approx ____% of the normal male body weight is water, that of the female is about ___% because of their _______.

A

60

50

higher fat content

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2
Q

A 70 kg man has ______ of water in his body.
_______ percent of the water is intracellular and remainder is found in the extracellular compartment, mostly as ______ fluid.

A

42 liters

Seventy five

interstitial

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3
Q

There are approximately__-___ liters of lymph in the body, compared to __-___ liters of blood

A

6 to 10

3.5 to 5

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4
Q

Oedema is the term used to describe ______ caused by _____ in the _____ space.

A

swelling of tissue

excess fluid

interstitial

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5
Q

Oedema may be localised or generalised.

T/F

A

T

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6
Q

In generalised oedema, fluid may also accumulate in the body cavities [ _______ ], variously called

_______ or ________ (peritoneal cavity),
_______ or ________ (pleural cavity),_________ or ________ (pericardial sac).

A

effusions

ascites or hydroperitoneum

hydrothorax or pleural effusion

hydropericardium or pericardial effusion

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7
Q

Anasarca is a (mild or severe?) and (localized or generalised?) oedema with profound __________________ swelling.

A

Severe

generalised

subcutaneous tissue

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8
Q

The capillary endothelium is highly permeable to water

T/F

A

T

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9
Q

The capillary endothelium is highly permeable to almost all solutes in plasma with the exception of _________.

A

proteins

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10
Q

The passage of water across the walls of small vessels is determined by the balance between the _____ pressure and _________ pressures.

A

hydrostatic

plasma oncotic

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11
Q

In normal circulation fluid is expelled from the _____ end of the microcirculation and re-enters at the ____ end.

A

arterial

venous

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12
Q

Fluid is constantly removed from the interstitium by the _______.

A

lymphatics

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13
Q

The primary force driving fluid transport between the capillaries and tissues is _______ pressure

A

hydrostatic

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14
Q

hydrostatic pressure can be defined as the pressure of ________________

Blood hydrostatic pressure is the force exerted by the ______ confined within ______________

A

any fluid enclosed in a space.

blood

blood vessels or heart chambers.

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15
Q

Specifically, the pressure exerted by blood against the wall of a capillary is called _______________ (CHP), and is the same as ______________.

A

capillary hydrostatic pressure

capillary blood pressure

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16
Q

_____ is the force that drives fluid out of capillaries and into the tissues.

This process is called ______

A

CHP

filtration

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17
Q

The net pressure that drives reabsorption—the movement of fluid from the interstitial fluid back into the capillaries is called _____ pressure (______ pressure)

A

osmotic

oncotic

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18
Q

Whereas _____ pressure forces fluid out of the capillary, ______ pressure draws fluid back in.

A

hydrostatic

osmotic

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19
Q

Blood oncotic pressure is determined by __________

A

plasma proteins

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20
Q

The plasma proteins can move across the semipermeable capillary cell membrane

T/F

A

F

cannot and so they remain in the plasma.

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21
Q

Arterial end

net filteration pressure =

HP=
COP=

A

10mmHg

35mmHg
25mmHg

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22
Q

Mid capillary

net filteration pressure =

HP=
COP=

A

0mmHg

25mmHg
25mmHg

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23
Q

Venous end

net filteration pressure =

HP=
COP=

A

-7mmHg

18mmHg
25mmHg

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24
Q

Since overall capillary hydrostatic pressure is higher than blood colloidal oncotic pressure (BCOP), net fluid will exit the capillary through _____ at the ______ end than enters through ______ at the ______ end.

Not all fluid is reabsobed, approximately ___ liters per day are filtered, whereas ______ liters are reabsorbed.

This excess fluid is picked up by capillaries of the _____ system drain into the ____ veins in the ____.

A

filtration; arterial; reabsorption; venous

24 ; 20.4

lymphatic; subclavian; neck

25
Q

An important function of the lymphatic system is to ________________.

A

return the fluid (lymph) to the blood

26
Q

Lymph may be thought of as recycled ________

A

blood plasma.

27
Q

Edema fluids and effusions may be

Inflammatory[ ______ ] or Noninflammatory[______]

A

exudate

transudate

28
Q

Inflammatory fluid [exudate] is a _____-rich fluid that accumulates due to increases in ____ caused by ________

A

protein

vascular permeability

inflammatory mediators.

29
Q

Noninflammatory fluid oedema and effusions are _______-poor fluids called ______.

A

protein

transudates

30
Q

Specific gravity of exudate

Specific gravity of transudate

A

Greater than 1.020

Less then 1.012

31
Q

The fluid is an exudate if one of the following Light’s criteria is present

Effusion protein/serum protein ratio is greater than ____

Effusion Lactate dehydrogenase [LDH]/serum LDH ratio is greater than ____
Effusion LDH level greater than _____ the ____ limit of the laboratory’s reference range of serum LDH

A

0.5

0.6

two thirds; upper

32
Q

An increase in the _____ pressure or a fall in ______ pressure will increase the net flow of fluid into the interstitial space.

A

hydrostatic

plasma oncotic

33
Q

Increase hydrostatic pressure

••Impaired venous return caused by:

_________ failure
constrictive _____
liver _______
venous obstruction or compression that could be caused by _____ or _________

••Arteriolar dilatation caused by Heat, neurohumoral dysregulation

A

congestive heart ; pericarditis; cirrhosis

thrombosis; external pressure (eg mass)

34
Q

Reduced plasma oncotic pressure

Protein losing ________ (_______syndrome)
Protein losing __________
Liver ______
___________

A

nephropathy; nephrotic

gastroenteropathy

cirrhosis

Malnutrition

35
Q

Lymphatic obstruction

Causes

Chronic inflammatory lesions of the lymphatics associated with fibrosis ( ______)

_______ lesions can obstruct lymphatic drainage

surgical complication following __________

________ complication

A

filariasis

Neoplastic

removal of lymph nodes

irradiation

36
Q

Inappropriate sodium retention

••Excessive ____ intake with decreased renal function.

••Increased ________ of sodium caused by :

renal ______
increased ________ secretion leading to conservation of sodium and subsequent water retention
renal failure

A

salt

tubular reabsorption

hypoperfusion; renin-angiotensin-aldosterone

37
Q

Oedema in congestive cardiac failure

Low cardiac output → _____ in effective arterial blood vol. (eabv) →____tension →arterial vol. receptors → ______ nerve stimulation →arteriolar vaso_____ → renal hypoperfusion →__________ secretion - ______ retention by the kidneys →increased plasma vol.

A

reduction; hypo; sympathetic; constriction

renin-angiotensin-aldosterone

sodium and water

38
Q

Oedema in congestive cardiac failure

The failing heart can not increase Cardiac Output →increased ____ pressure →_______ →oedema

A

venous

transudation

39
Q

Oedema In cirrhosis

Hypoproteinemia

_____ is synthesised in the liver and it is responsible for ______ pressure.There is ________ in cirrhosis

Oedema occurs when serum albumin level falls below ___ g/l. (normal range __-___ g/liter)

A

Albumin

plasma oncotic

decreased synthesis of albumin

25

35-55

40
Q

Oedema In cirrhosis

Accumulation of vasodilators

The damaged liver fails to ___________ →____tension, reduced eabv → ______ secretion→ Sodium and water retention →oedema.

A

degrade the vasodilators

Hypo

raas

41
Q

Oedema In cirrhosis

Portal hypertension
increases __________

A

hydrostatic pressure

42
Q

Renal Oedema

Acute glomerulonephritis

oedema is a symptom of the disease

oedema is attributable to ____ of _____ by the damaged kidney.

A

retention

salt and water

43
Q

Renal Oedema

Nephrotic syndrome: glomerular disease which results in massive ______

(urinary protein loss of greater than ___g/day), hypoproteinaemia, oedema, hyperlipidemia.

A

proteinuria

3.5

44
Q

Renal oedema

Nephrotic syndrome

Hypoalbuminaemia →decreased _______ →oedema →plasma vol. (contraction or relaxation ?) →renal _____ →secondary _______ secretion → _______ retention →worsening oedema

A

oncotic presssure

Contraction

hypoperfusion

aldosterone

sodium and water

45
Q

Oedema is recognised grossly as _______

Finger pressure displaces the interstitial fluid and leaves a depression called _______

A

swelling

pitting oedema

46
Q

Microscopically oedema fluid is seen as ______ and ___________________.

A

cell swelling

separation of the extracellular matrix elements

47
Q

Subcutaneous oedema

dependent oedema is a feature of ____

generalised body oedema is associated with ____ diseases e.g. _______

A

Congestive cardiac failure

renal

nephrotic syndrome.

48
Q

Pulmonary oedema.

Commonly seen in ________ failure.

Can also occur in ____ failure.

The lungs are increased in ____ and cut sections will show ________ fluid, representing ____,______, and _________

A

left ventricular

renal

Weight

frothy blood tinged

air, fluid and extravasated rbc.

49
Q

Cerebral oedema .

The brain is swollen, the sulci are _____ and the gyri _______

A

narrowed

flattened

50
Q

Brain edema is not life threatening

T/F

A

F

51
Q

Brain oedema

if severe, brain substance can ______ through the _______.

A situation that leads to _____.

A

herniate (extrude)

foramen magnum

death

52
Q

Pulmonary oedema

The Lungs are typically ____ times normal weight
Cross sectioning causes an outpouring of ____, sometimes ______ fluid

A

2-3

frothy

blood- tinged

53
Q

Pulmonary oedema may interfere with pulmonary function

T/F

A

T

54
Q

Causes of Brain edema

Trauma, _____, ______, Infection ( _______ due to say… ________), etc

A

Abscess

Neoplasm

Encephalitis

West Nile Virus

55
Q

The effect of edema ranges from ______ to _______

A

merely annoying to rapidly fatal.

56
Q

Subcutaneous oedema usually points to an underlying disease [_____ or _____ diseases ].

A

cardiac or renal

57
Q

Edema can’t impair wound healing or clearance of Infection.

T/F

A

F

58
Q

Edema Creates a favorable environment for infection.

T/F

A

T

59
Q

Pulmonary oedema may cause death by interfering with ________ and _____

A

Oxygen and Carbon Dioxide exchange.

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