Fluid Distribution

Question 1

Intercellular Fluid = what fraction of TBW?

Answer 1

2/3

Question 2

ECF= what fraction of TBW?

Answer 2

1/3

Question 3

ECF is divided into what fractions?

Answer 3

1. Interstitial Fluid (3/4)

2. Vascular Volume (1/4)

Question 4

Water moves in what direction?

Answer 4

Higher water concentration –> lower water concentration

Question 5

Define osmolarity?

Answer 5

Number of particles per liter of water/solution (mOsm/L)

Question 6

Define Osmolality?

Answer 6

Number of particles per kg of solution/water (mOsm/Kg)

Question 7

What is an effective osmole? Provide example.

Answer 7

Osmole that does not easily cross membrane (proteins)

Question 8

Normal range for sodium (Na)?

Answer 8

135-145 (140) mEq/L

Question 9

Normal Range for Potassium (K)?

Answer 9

3.5-4.5 (4) mEq/L

Question 10

Normal Range for Chloride?

Answer 10

100-105 (103) mEq/L

Question 11

Normal Range for Bicarbonate (HCO3-) ?

Answer 11

22-26 (24) mEq/L

Question 12

Normal Range for BUN??!!

Answer 12

8-25 (15) mg/dL

Question 13

Normal Range for Creatine (Cr)?

Answer 13

0.8-1.2 mg/dL

Question 14

Compounds that increase osmolar gap? Name 5.

Answer 14

EEMMA

1. Ethanol
2. Ethylene Glycol
3. Methanol
4. Mannitol
5. Acetone

Question 15

Loss of Isotonic Fluid examples ??

Answer 15

Acute hemorrhage
Acute diarrhea
Acute vomiting
Isotonic urine

Question 16

What happens to water compartments and osmolality when you loose isotonic water?

Answer 16

ECF ⬇️ Osmolality ↔️ and ICF ↔️

Question 17

What happens to water compartments and osmolality when you loose hypotonic (net loss of water)?

Answer 17

ECF ⬇️ Osmolality ⬆️ and ICF ⬇️

Question 18

What happens to water compartments and osmolality when you loose hypertonic water?

Answer 18

ECF ⬇️Osmolality ⬇️ and ICF ⬆️

Question 19

What happens to water compartments and osmolality when you gain isotonic water?

Answer 19

ECF ⬆️ Osmolality ↔️ and ICF ↔️

Question 20

What happens to water compartments and osmolality when you gain hypotonic (net water)?

Answer 20

ECF ⬆️ Osmolality ⬇️ and ICF ⬆️

Question 21

What happens to water compartments and osmolality when you gain hypertonic water?

Answer 21

ECF ⬆️ Osmolality ⬆️ and ICF ⬇️

Question 22

Loss of Hypotonic Fluid examples ?? (Net Water Loss)

Answer 22

Diabetes Insipidus ⬇️ ADH
Alcoholism
Dehydration (sweat)
Not drinking water

Question 23

Loss of Hypertonic Fluid examples ??

Answer 23

Adrenal insufficiency (hypoaldosteronism)

Question 24

Gain of Isotonic Fluid examples ??

Answer 24

Isotonic saline infusion

Hyperaldosteronism ⬆️ (Conn’s Syndrome )

Question 25

Gain of Hypotonic Fluid examples ??

Answer 25

Hypotonic saline infusion

SIADH

Question 26

Gain of Hypertonic Fluid examples ??

Answer 26

Hypertonic saline infusion
Hypertonic Mannitol
Salt
Hypertonic colloid infusion (dextran)

Question 27

Primary factors that stimulate aldosterone ?

Answer 27

1. RAAS

2. K+

Question 28

Factors that affect ADH secretion?

Answer 28

1. Plasma Osmolality
2. Plasma pressure/ volume
3. CRH (corticotropin releasing hormone)

Question 29

Factors that influence renin secretion?

Answer 29

1. Perfusion pressure Kidney
2. Sympathetic stimulation
3. Na+ levels mácula densa

Question 30

Non- pitting edema is a result of the alteration of which starling force (s)?

Answer 30

⬆️Interstitial Oncotic Pressure

1. Lymphedema
2. Hypothyroidism (⬆️muccopolysaccharides)

Question 31

Following IV fluids distribute in intravascular compartment only:

Answer 31

1. Blood
2. Plasma
3. Dextran in saline

Question 32

Following IV fluids distribute in ECF compartment only:

Answer 32

1. Saline

2. Mannitol

Question 33

Following IV fluids distribute in TBW:

Answer 33

1. D5W-5% dextrose in water