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Biochem 2nd Sem Midterms > Fluid And Electrolyte Balance > Flashcards

Fluid And Electrolyte Balance Flashcards

0
Q

Percent of water in older adult

A

45-55%

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1
Q

Percent of water in average adult?

A

60%

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2
Q

Percent of water in newborn

A

78-80%

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3
Q

Percent of water in early human embryo

A

97%

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4
Q

What are the importance of water?

A

Universal biological solvent
Transport gases and substances
Dilute toxic substances and waste products and transports them to the kidney and liver
Medium for all chemical reaction
Minimize temperature changes throughout the body

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5
Q

Importance of water.

Universal solvent due to:

A

Polar asymmetry

High affinity to polar molecule

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6
Q

The total body fluids is distributed mainly between two compartments

A 
Intracellular fluid (ICF)
Extracellular fluid (ECF)
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7
Q

Intracellular fluid

A

40% of the body weight

Fluid found within the cell

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8
Q

Extracellular fluid

A

20% of body weight

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9
Q

Extracellular fluid further subdivided into

A

15% interstitial fluid ( between cells and blood vessels)

5% intravascular fluid ( inside blood vessels )

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10
Q

Sources of wAter

A 
Preformed water (2,100ml)
Metabolic water (200ml)
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11
Q

Total body water =

A

Wt in kg x 0.60

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12
Q

Total body water can change depending on the following factors

A

Age (mas matanda decrease water)
Fats ( obesity, mas mataba decrease ang water)
Gender ( mas madaming tubig ang lalake sa babae 65-55)

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13
Q

Other extracellular fluids

A

Lymph

Transcellular fluids

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14
Q

Water that are found in food and drinks ingested

A

Preformed water

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15
Q

Water produced through the catabolic breakdown of nutrients during cellular respiration.

A

Metabolic water

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16
Q

Net diffusion of water across a selectively permeable membrane from a region of high water concentration to one that has a lower water concentration.

A

Osmosis

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17
Q

Water will diffuse into the cell, causing it to swell

A

If the cell is placed into a hypotonic solution

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18
Q

Water will flow out of the cell into the extracellular fluid, causing cell shrinkage or crenation.

A

If a cell is placed in a hypertonic solution

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19
Q

Factors affecting fluid movement

A

Starlings forces

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20
Q

For filtration forces (pushing forces)

A

Capillary hydrostatic forces

Interstitial fluid colloid osmotic pressure

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21
Q

For absorption forces (pulling forces)

A

Interstitial fluid hydrostatic pressure

Capillary plasma colloid pressure

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22
Q

Capillary hydrostatic forces

Function

A

Outward the capillary membrane

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23
Q

Capillary hydrostatic forces

Arterial end

A

30-40 mmHg (favors filtration)

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24
Q

Capillary hydrostatic forces

Venous end

A

10-15 mmHg (favors re absorption)

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25
Q

Interstitial fluid colloid osmotic pressure

Function

A

Osmosis of water outside

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26
Q

Interstitial fluid colloid osmotic pressure

Pressure

A

8mmHg

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27
Q

Interstitial fluid hydrostatic pressure

If positive

A

Inward

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28
Q

Interstitial fluid hydrostatic pressure

If negative

A

Outward

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29
Q

Interstitial fluid hydrostatic pressure

Pressure

A

3mmHg

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30
Q

Capillary plasma colloid pressure

Function

A

Osmosis of water inward

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31
Q

Capillary plasma colloid pressure

Pressure

A

28mmHg

19mmHg from dissolved proteins
9 mmHg from donnan effect

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32
Q

Extra osmotic pressure caused by?

A

Cations

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33
Q

Summation of starling forces

A

If positive : filtration

If negative: absorption

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34
Q

For arterial end (filtration)

A

Outward force : 41 mmHg
Inward force : 28 mmHg
Net outward force : 13 mmHg

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35
Q

For venous end (reabsorption)

A

Outward force: 21mmHg
Inward force: 28 mmZhg
Net inward force : 7 mmHg

Note: venous end is 10-15 mmHg it is contributing factor only

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36
Q

Normal values of plasma sodium concentration

A

140-145 mEq/L

37
Q

Two primary systems are involved in regulating the concentration of sodium and osmolarity of extracellular fluid

A

The osmoreceptor- ADXh system

Thirst mechanism

38
Q

Regulation of body fluid volume and osmolarity

Center:

A

Hypothalamus

39
Q

Regulation of body fluid volume and osmolarity

Hormones

A

ADH and aldosterone

40
Q

Regulation of body fluid volume and osmolarity

Major determinant of osmolarity

41
Q

Regulation of body fluid volume and osmolarity

Plasma sodium concentration

42
Q

Regulation of body fluid volume and osmolarity

Extracellular fluid osmolarity

A

300 mOsm/L

43
Q

Osmoreceptors -ADH system

Location

A

Hypothalamus

44
Q

Osmoreceptors -ADH system

Function

A

Signals for ADH production

45
Q

Osmoreceptors -ADH system

Signals for ADH production

A

Dehydration (with loss of water)
Relative dehydration (without loss of water but elevated sodium ions)
Increase plasma osmolarity

46
Q

Thirst response system

Location

A

Hypothalamus

47
Q

Thirst response system

Factors for stimulation

A

Increase plasma osmolarity
Dryness of mucosal linings
Stretch receptors of GIT

48
Q

Osmoreceptors common denominator

A

Increased plasma osmolarity

49
Q

When osmolarity (plasma sodium concentration) increase because of water deficit, this feedback system operates

A

Osmoreceptor -ADH feedback System

50
Q

Osmoreceptor -ADH feedback system

A

Increase in extracellular fluid osmolarity
Sending nerve signals to pituitary gland ti posterior pituitary
Release ADH
ADH acts on kidney tubules,
Increased water reabsorption
Correcting the initial excessively concentrated extracellular fluid.

51
Q

Extracellular fluid becomes too dilute

A

Hypo osmotic
Excess water
Less ADH is formed

52
Q

Baroreceptors location

A

Atria of the heart,

Pulmonary artery and vein

53
Q

Barorecptors

Message are relayed to the hypothalamus via the

A

Vagus nerve

54
Q

Barorecptors

ADZh secretion is stimulated by

A

Changes in circulating volume of body fluids

55
Q

Barorecptors

Reduction of around how many volume of water due to hemorrhage or excess perspiration will result in ADH secretion

56
Q

Connected to the response of the osmorecptors

A

Thirst response

57
Q

Center of thirst?

A

Hypothalamus

58
Q

Other factors involved in osmorecptors

A

Degree of dryness of mucosal linings of mouth and pharynx

Stretch receptors in the GIT

59
Q

Loss of more solute specially sodium than water in ECF

A

Hypotonic dehydration

60
Q

Hypotonic dehydration

Fluid shift

A

Blood stream to cells

61
Q

Hypotonic dehydration

Results

A

Decrease vascular fluid volume
Shock
Cellular swelling
Cerebral edema (headache, IICP and confusion)

62
Q

Hypotonic dehydration

Seen in

A

Heat stroke or exhaustion

63
Q

Hypotonic dehydration

Manifestation

A 
Hypotension
Tachycardia
Low serum sodium
Low urine specific gravity
Increase urine volume
64
Q

Uncommon

A

Hypotonic dehydration

65
Q

Most common form of dehydration

A

Isotonic dehydration

66
Q

Isotonic dehydration

A

Equal loss of solutes and water

67
Q

Isotonic dehydration

Fluid shift

68
Q

Isotonic dehydration

Cause

A 
Diuretic therapy 
Vomiting
Urine loss
Hemorrhage
Decrease fluid intake
69
Q

Isotonic dehydration

Manufestation increase

A 
Hematocrit
Protein
BUN
Urine specific gravity
Dryness
70
Q

Isotonic dehydration

Manifestation decrease

A 
Body weight
Blood pressure( orthostatic hypotension)
Pulse
Urine volume and output (oliguria)
Skin tugor
71
Q

Isotonic dehydration

If severe

A

With shock

72
Q

2nd most common

A

Hypertonic dehydration

73
Q

Hypertonic dehydration

A

Loss of more water than solute in ECF

74
Q

Hypertonic dehydration

Fluid shift

A

Blood stream

75
Q

Hypertonic dehydration

Result

A

Cell shrinkage

76
Q

Hypertonic dehydration

Cause

A 
Excess fluid loss
Hyperventilation
Watery diarrhea
Diabetic ketoacidosis
Diabetes insipidus
Latrogenic (tube feeding without inadequate water)
77
Q

Hypertonic dehydration

Manifestation

A

Thirst
Decrease skin tugor
Increase urine specific gracity
Sign of shock are usually not present

78
Q

Isotonic expansion of the ECF

A

Isotonic overhydration

79
Q

Isotonic over hydration

A

Interstitial fluid=intravascular fluid

Fluid overload or hyper volemia

80
Q

Isotonic over hydration

Rarely happen in persons with

A

Normal heart and kidneys

81
Q

Isotonic over hydration

Causes

A

IV isotonic fluids
Saline enemas
Increase sodium intake resulting in compensatory water retention

82
Q

Isotonic over hydration

Manifestation

A 
Hypertension
Crackles in lungs
Distended neck veins
Elevated respiration
Polyuria
Weight gain
Increase respiration
83
Q

Hypotonic expansion of ECF

Decrease serum osmolarity

A

Hypotonic overhydration

84
Q

Hypotonic overhydration

Fluid shift

A

Blood stream to cell

85
Q

Hypotonic overhydration

Result

A

Cell swelling
Interstitial edema
Electrolyte dilution

86
Q

Hypotonic overhydration

Cause

A

IV D5W (increase glucose metabolism)
Patient in NPO with ice chips
Tap water enemas
Excess plain water

87
Q

Hypotonic overhydration

Manifestation

A 
Photophobia
Muscle twitching leading to convulsion
Diorientation
Polyuria
Hyperiritability
88
Q

Hypertonic expansion of the ECF

Increase serum osmolarity

A

Hypertonic overhydration

89
Q

Hypertonic overhydration

Fluid shift

A

Cell to blood stream

90
Q

Hypertonic overhydration

Result

A

Cell shrinkage
Hypertension
Increase cardiac work load leading to congestive heart failure

91
Q

Hypertonic overhydration

Causes

A

Administrations of hypertonic ( IV fluids, enemas, tube feedings)
Sea water ingestion

Biochem 2nd Sem Midterms (10 decks)

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