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Pathophysiology > Electrolyte and Acid-Base Imbalances > Flashcards

Electrolyte and Acid-Base Imbalances Flashcards

1
Q

What is the primary cation and where is it located?

A

Na+

extracellular fluid

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2
Q

What is serum level of sodium controlled by?

A

aldosterone action on the kidney

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3
Q

How does sodium move?

A

diffuses between vascular and interstitial fluid
leaks through cell membrane sodium channels
transported from cells by sodium-potassium pump

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4
Q

Sodium potassium pump transports how many sodium ions in and how many potassium ions out?

A

3 sodium ions in

2 potassium ions out

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5
Q

Sodium is important to maintenance of … which affect BP. It also is essential in two other major things.

A

blood volume
maintains membrane potential
nerve impulse conduction

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6
Q

How is Hyponatremia define?

A

serum sodium under 135

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7
Q 
What are some causes of Hyponatremia?
Excessive \_\_\_, \_\_\_, or \_\_\_.
\_\_\_ drugs or low-salt diets. 
\_\_\_ imbalances. Excessive \_\_\_ and insufficient \_\_\_.
Chronic \_\_\_ failure.
Excessive \_\_ intake.
A

sweating, vomiting, or diarrhea

diuretic

hormonal

ADH

aldosterone

kidney

water

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8
Q

What are some effects of Hyponatremia?
Impaired ____ conduction.
Impaired ___ contraction.
Decrease in ___ pressure.

A

nerve

muscle

osmotic

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9
Q

How is Hypernatremia define?

A

when serum sodium is over 145

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10
Q 
Causes of Hypernatremia?
Insufficient \_\_\_\_.
Lost of \_\_\_ mechanism.
Watery \_\_\_.
Ingestion of large amounts of \_\_\_ and not enough water. 
Prolonged periods of rapid \_\_\_\_.
A

ADH

thirst

diarrhea

sodium

respiration

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11
Q 
Effects of Hypernatremia?
Fluid shift \_\_\_ cells.
\_\_\_\_.
Increased \_\_\_.
Increased \_\_\_.
Dry, rough, tongue and mucus membranes.
\_\_\_ and agitation.
A

out

edema

BP

thirst

weakness

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12
Q

What is the major intracellular cation?

A

potassium

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13
Q

Serum levels are …. in regards to potassium.

A

low

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14
Q

What regulates potassium?

A

kidneys

excreted primarily in urine under aldosterone

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15
Q

Levels of potassium are influenced by …. imbalance.

A

acid-base

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16
Q

Acidosis results in ….
alkalosis results in ….
in terms of potassium

A

potassium out of cells=hyperkalemia

potassium into cells=hypokalemia

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17
Q

Potassium regulates …. volume

A

intracellular

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18
Q

Potassium is critical for ___ ___ conduction and ___ contraction.

A

nerve impulse

muscle

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19
Q

Abnormal potassium levels cause what in cardiac function?

A

changes in cardiac conduction, lead to cardiac arrest and are life threatening

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20
Q

When there is a decrease of potassium outside the cell this results in….

A

hyperpolarization; the cell will be less excitable

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21
Q

When there is an increase of potassium outside the cell, this results in…

A

depolarization; the cell is more excitable

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22
Q

Causes of Hypokalemia?
Excessive loss due to ___, ____, ____.
Excessive ____ and ____.

A

diarrhea, diuretics, decreased dietary intake

aldosterone, glucocorticoids (cushings disesase)

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23
Q 
Effects of Hypokalemia?
Cardiac \_\_\_\_ therefore cardiac \_\_\_.
Interference with \_\_\_ function.
Decreased \_\_\_ motility. 
\_\_\_\_.
A

arrhythmias

arrest

neuromuscular

digestive tract

paresthesias

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24
Q

Why are cardiac arrhythmias common with hypokalemia?

A

due to hyperpolarization of resting membrane potential in cardiac myocytes which makes them decreased in excitement

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25
How is the neuromuscular function interfered with as part of Hypokalemia?
skeletal muscles are hyperpolarized and they are less responsive to stimuli
26
``` Causes of Hyperkalemia? Renal ___ Deficit of ___ ___ ____ ___ Leakage of ___ ___ Displacement of ___ by severe or prolonged acidosis. ```
failure aldosterone potassium sparing diuretics intracellular potassium potassium
27
Effects of hyperkalemia? Cardiac ____ Generalized ___ ____ ___ and ____
arrhythmias muscle weakness fatigue and parethesias
28
Why are cardiac arrhythmias also common in hyperkalemia? | Due to ___ of resting membrane potential of cardiac myocytes.
depolarization
29
Important extracellular cation?
calcium
30
Functions of calcium?
structural strength for bones and teeth, muscle contractions, stability of nerve membranes, enzyme reactions, signal transduction
31
What controls calcium?
parathyroid hormone and calcitonin
32
When there is parathyroid hormone activations what happens to calcium?
there is an increase of calcium in blood, resorption from bone, by kidneys and in intestine
33
What happens when there is calcitonin activations?
calcium decreases, is inhibited in bone and kidney resorption
34
Vitamin .... promotes Ca absorption in intestine.
D
35
.... levels influence Ca levels reciprocally.
phosphate
36
``` Causes of hypocalcemia: Hypo____ Malabsorption of ___ and ____. Deficiency in ____ Renal ____ Acidosis or alkalosis? ```
hypoparathyroidism Ca and vitamin D albumin renal failure alkalosis
37
Why would renal failure be a cause of hypocalcemia?
because of retention of phosphate and Vitamin D not activated.
38
Why would alkalosis be a cause of hypocalcemia?
free Ca binding to albumin which causes a negative charge
39
Effects of hypocalcemia: | ___ activation of heart muscle and ____ activation of skeletal muscle.
decreased | increased
40
Why does hypocalcemia increase activation of skeletal muscle?
increases excitability of nerve membranes due to decrease in threshold for nerve excitation. results in hyperactive reflexes
41
Signs of hypocalcemia?
Chvosteck's sign | Trousseau's sign
42
What is Chvosteck's sign?
spasm of lip or face when the face is tapped in front of the ear.
43
What is Trousseau's sign?
atypical contraction of the fingers when blood pressure cuff blocks circulation to the hand
44
``` Causes of hypercalcemia: ____ ____of Ca ions from bones. ____ from immobility. Hyper____ ____ Ca intake. ```
uncontrolled release demineralization hyperparathyroidism increased
45
Effects of hypercalcemia: ____ cardiac contractions. ____neuromuscular activity ____effects.
increased strength depresses renal
46
Important intracellular cation?
magnesium
47
Serum levels of Mg is related to ... and ...
K and Ca
48
Mg is in ... reactions including DNA and protein synthesis, ... and ....
enzyme glycolysis oxidative phosphorylantion
49
Mg is important in ... and ... transport across plasma membrane.
K and Ca
50
Mg is important in .... conduction and ... contraction.
nerve impulse | muscle
51
Causes of hypomagnesemia?
GI, kidney
52
Effects of Hypomagnesemia: ____ hyperirritability with tremors. Heart_____.
neuromuscular heart arrhythmia
53
Causes of hypermagnesemia: ___failure
renal
54
Effects of hypermagnesemia: ___neuromuscular function. | ___reflexes.
depressed decreased
55
``` Phosphate important in ___ and ___ mineralization. ____ ____system. Cell____. Excreted by _____ Reciprocal relationship with ____. ```
bone and tooth metabolism (ATP) buffer integral part of cell membrane kidneys calcium
56
Hypophosphatemia is due to ___syndromes. ___ And hyper_____.
malabsorption diarrhea hyperparathyroidism
57
Hyperphosphatemia is due to ___ failure. ___ damage (intracellular release during chemo). Manifests like ____.
renal tissue hypocalcemia
58
A major extracellular anion
chloride
59
Chloride levels follow ... levels.
sodium
60
Chloride ions and .... ions complement each other's levels. Why?
bicarbonate | to maintain electroneutrality in ECF, most abundant anions, RBC as storage
61
Hypochloremia is due to loss of:
body fluids- excessive perspiration and early stages of vomiting
62
Hyperchloremia is due to excessive: Loss of: Rapid infusion of:
sodium chloride intake, bicarbonate (diarrhea and later stages of vomiting) isotonic saline which leads to hyperchloremic acidosis
63
Buffer pairs in the blood respond to pH level changes...
immediately
64
Respiratory system can alter levels of ...
carbonic acid through changes in CO2
65
Kidneys can modify the excretion rate of acids through
reabsorption or excretion of bicarbonate ions
66
Is respiratory system or kidneys the most effective in control of serum pH? But is is also the...
kidneys | slowest
67
A buffer is a combo of ...
weak acid and its alkaline salt.
68
What is the major ECF buffer? What is it controlled by?
sodium bicarbonate-carbonic acid buffer | respiratory system and kidneys
69
Other buffering systems?
phosphate, hemoglobin, plasma proteins
70
What is the base to acid ratio in the bicarbonate-carbonic acid buffer system?
20:1
71
pH imbalances compensation mechanisms, compensation is ... and usually ....
limited and short term
72
Goal of pH imbalances?
balance the relative proportion of carbonic acid and bicarbonic ions
73
Compensation requires function of ...
function of the organ not involved in the cause
74
Decompensation occurs when ....
causative problem becomes more severe and compensation mechanisms are exceeded or fail
75
Respiratory acidosis results from what diseases?
pneumonia, airway obstruction, chest injuries, drugs
76
Chronic respiratory acidosis is common in what disease?
COPD
77
Excessive loss of bicarbonate ions in what two fluid loss conditions?
diarrhea, vomiting
78
Increased serum bicarbonate is due to...
too much lactic acid produced, diabetic ketoacidosis
79
Renal disease or failure decreases... which affects acid/base balance.
excretion of acids, and production/retention of bicarbonate ions
80
Effects of Acidosis in regards to K:
hyperkalemia
81
Respiratory alkalosis is due to...
hyperventilation
82
Metabolic alkalosis is due to retention of: Excessive ingestion of: Loss of:
retention of bicarbonate, excessive ingestion of antacids, loss of hydrochloric acid from early stage vomiting
83
Effects of alkalosis on K levels:
hypokalemia

Pathophysiology (20 decks)

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