Fluid and edema

Question 1

Na +
K +

Cl -
Hco3 -

Bun
Cr

Glucose

Answer 1

Na= 136-145
K= 3.5- 5

Cl = 100-106
Hco3 = 22-26

Bun = 8-25
Creatinin = 0.8-1.2

Glucose = 70-100

Question 2

Estimated osmalirity

2x[?]+ [?] + [?]
18 2.8

Answer 2

2Na + glucose\ 18 + BUN\ 2.8

Normal = around 290 mOsm\kg

Question 3

Osmal gap measrue is less or more Than ?

Answer 3

15

Question 4

What increase the osmoler gap?

Answer 4

Ethanol , methanol, glycol , acetone and mennatol

Question 5

Big regulator of volum regulation

Answer 5

Aldosterone

Anit-diureric hormone (ADH or AVP)

Question 6

3 factors regulating renin

Answer 6

1- perfusion pressure to kidney(decrease stimulates increase)

2- sympathatic stimulation to kidney; increase via beta-1 receptor

3- NA+ delivery to the macula denaa (decrease of na stimulates increase )

Question 7

Regulators of aldosterone

Answer 7

Angiotensin II : stimulates release

Plasma k+ : stimulates realse to remove excessive k

Question 8

ADH regulation

Answer 8

Increase in osmilarity will cause ADH to increase

Blood voulum/ pressure : low will increase

Stress : but not prime

Note : we regulate osmolarity of ECF to regulate the IFS

Question 9

Primary causes for edema

Answer 9

Increase pressure of capillaries (increase filteation) such in heart fail pitting edema( edema mostly water)

Increase oncotics in interseteial fluid : increase proteins will cause myxedema in hypothyriod
Non pitting edema ( cause it water and osmels

Decrease vascular oncotics : liver kidney hypoalbomin

Increase capillary permeability: inflamatory response (TNf-alpha , histamine)

Lymphedema : filarial (w bancorfti ) that cause elephantitis , or streptococcu , tumor , trauma or surgery . Starts as pitting then turns to non pitting

Question 10

Most common cause of pulmonary edema cardiogenic

Answer 10

Cardiogenic shock left ventricle fail

Increase left atrial pressure -> increase venous —-> increase capilary

Question 11

First patient with pulmonary edema

Answer 11

Orthopenea

Question 12

What confirmation for pulmonary edema

Answer 12

Elevated pulmonary wedge pressure

Question 13

Treatment for pulmonary edema

Answer 13

Reduce atrial pressure , by giving diuretic therapy

Question 14

Non cardiogenic cause of pulmonary edema

Answer 14

ADRS ( increase permibilty )
which caused by
Injury to alveolar epithiluim
Most common is Spesis : TNF -alpha

Causes inactivation of surfactant

And pulmonary wedge pressure is normal or low

If high it’s cardiogenic