Disturbances Of Fluid Balance

Question 1

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

Answer 1

60

50

higher fat content

Question 2

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.

Answer 2

42 liters

Seventy five

interstitial

Question 3

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

Answer 3

6 to 10

3.5 to 5

Question 4

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

Answer 4

swelling of tissue

excess fluid

interstitial

Question 5

Oedema may be localised or generalised.

T/F

Answer 5

T

Question 6

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

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

Answer 6

effusions

ascites or hydroperitoneum

hydrothorax or pleural effusion

hydropericardium or pericardial effusion

Question 7

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

Answer 7

Severe

generalised

subcutaneous tissue

Question 8

The capillary endothelium is highly permeable to water

T/F

Answer 8

T

Question 9

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

Answer 9

proteins

Question 10

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

Answer 10

hydrostatic

plasma oncotic

Question 11

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

Answer 11

arterial

venous

Question 12

Fluid is constantly removed from the interstitium by the _______.

Answer 12

lymphatics

Question 13

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

Answer 13

hydrostatic

Question 14

hydrostatic pressure can be defined as the pressure of ________________

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

Answer 14

any fluid enclosed in a space.

blood

blood vessels or heart chambers.

Question 15

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

Answer 15

capillary hydrostatic pressure

capillary blood pressure

Question 16

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

This process is called ______

Answer 16

CHP

filtration

Question 17

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

Answer 17

osmotic

oncotic

Question 18

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

Answer 18

hydrostatic

osmotic

Question 19

Blood oncotic pressure is determined by __________

Answer 19

plasma proteins

Question 20

The plasma proteins can move across the semipermeable capillary cell membrane

T/F

Answer 20

F

cannot and so they remain in the plasma.

Question 21

Arterial end

net filteration pressure =

HP=
COP=

Answer 21

10mmHg

35mmHg
25mmHg

Question 22

Mid capillary

net filteration pressure =

HP=
COP=

Answer 22

0mmHg

25mmHg
25mmHg

Question 23

Venous end

net filteration pressure =

HP=
COP=

Answer 23

-7mmHg

18mmHg
25mmHg

Question 24

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 ____.

Answer 24

filtration; arterial; reabsorption; venous

24 ; 20.4

lymphatic; subclavian; neck

Question 25

An important function of the lymphatic system is to ________________.

Answer 25

return the fluid (lymph) to the blood

Question 26

Lymph may be thought of as recycled ________

Answer 26

blood plasma.

Question 27

Edema fluids and effusions may be Inflammatory[ ______ ] or Noninflammatory[______]

Answer 27

exudate transudate

Question 28

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

Answer 28

protein vascular permeability inflammatory mediators.

Question 29

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

Answer 29

protein transudates

Question 30

Specific gravity of exudate Specific gravity of transudate

Answer 30

Greater than 1.020 Less then 1.012

Question 31

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

Answer 31

0.5 0.6 two thirds; upper

Question 32

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

Answer 32

hydrostatic plasma oncotic

Question 33

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

Answer 33

congestive heart ; pericarditis; cirrhosis thrombosis; external pressure (eg mass)

Question 34

Reduced plasma oncotic pressure Protein losing ________ (_______syndrome) Protein losing __________ Liver ______ ___________

Answer 34

nephropathy; nephrotic gastroenteropathy cirrhosis Malnutrition

Question 35

Lymphatic obstruction Causes Chronic inflammatory lesions of the lymphatics associated with fibrosis ( ______) _______ lesions can obstruct lymphatic drainage surgical complication following __________ ________ complication

Answer 35

filariasis Neoplastic removal of lymph nodes irradiation

Question 36

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

Answer 36

salt tubular reabsorption hypoperfusion; renin-angiotensin-aldosterone

Question 37

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.

Answer 37

reduction; hypo; sympathetic; constriction renin-angiotensin-aldosterone sodium and water

Question 38

Oedema in congestive cardiac failure The failing heart can not increase Cardiac Output →increased ____ pressure →_______ →oedema

Answer 38

venous transudation

Question 39

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)

Answer 39

Albumin plasma oncotic decreased synthesis of albumin 25 35-55

Question 40

Oedema In cirrhosis Accumulation of vasodilators The damaged liver fails to ___________ →____tension, reduced eabv → ______ secretion→ Sodium and water retention →oedema.

Answer 40

degrade the vasodilators Hypo raas

Question 41

Oedema In cirrhosis Portal hypertension increases __________

Answer 41

hydrostatic pressure

Question 42

Renal Oedema Acute glomerulonephritis oedema is a symptom of the disease oedema is attributable to ____ of _____ by the damaged kidney.

Answer 42

retention salt and water

Question 43

Renal Oedema Nephrotic syndrome: glomerular disease which results in massive ______ (urinary protein loss of greater than ___g/day), hypoproteinaemia, oedema, hyperlipidemia.

Answer 43

proteinuria 3.5

Question 44

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

Answer 44

oncotic presssure Contraction hypoperfusion aldosterone sodium and water

Question 45

Oedema is recognised grossly as _______ Finger pressure displaces the interstitial fluid and leaves a depression called _______

Answer 45

swelling pitting oedema

Question 46

Microscopically oedema fluid is seen as ______ and ___________________.

Answer 46

cell swelling separation of the extracellular matrix elements

Question 47

Subcutaneous oedema dependent oedema is a feature of ____ generalised body oedema is associated with ____ diseases e.g. _______

Answer 47

Congestive cardiac failure renal nephrotic syndrome.

Question 48

Pulmonary oedema. Commonly seen in ________ failure. Can also occur in ____ failure. The lungs are increased in ____ and cut sections will show ________ fluid, representing ____,______, and _________

Answer 48

left ventricular renal Weight frothy blood tinged air, fluid and extravasated rbc.

Question 49

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

Answer 49

narrowed flattened

Question 50

Brain edema is not life threatening T/F

Answer 50

F

Question 51

Brain oedema if severe, brain substance can ______ through the _______. A situation that leads to _____.

Answer 51

herniate (extrude) foramen magnum death

Question 52

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

Answer 52

2-3 frothy blood- tinged

Question 53

Pulmonary oedema may interfere with pulmonary function T/F

Answer 53

T

Question 54

Causes of Brain edema Trauma, _____, ______, Infection ( _______ due to say... ________), etc

Answer 54

Abscess Neoplasm Encephalitis West Nile Virus

Question 55

The effect of edema ranges from ______ to _______

Answer 55

merely annoying to rapidly fatal.

Question 56

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

Answer 56

cardiac or renal

Question 57

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

Answer 57

F

Question 58

Edema Creates a favorable environment for infection. T/F

Answer 58

T

Question 59

Pulmonary oedema may cause death by interfering with ________ and _____

Answer 59

Oxygen and Carbon Dioxide exchange.