Fluid Distribution and Edema Flashcards
Causes of isotonic fluid loss?
diarrhea
hemorrhage
vomiting
Causes of loss of hypotonic fluid?
dehydration
diabetes insipidus
alcholism
Causes of gain of isotonic fluid?
isotonic saline
Gain of hypotonic fluid causes?
hypotonic saline
water intoxication
What are the cause loss of hypertonic fluid?
aldosterone or adrenal insufficiency
What are the causes of gain of hypertonic fluid?
hypertonic saline
hypertonic mannitol
Be able to make a diagram of the Basic metabolic profile/ Panel
ECF estimated osmolarity equation
2(Na+)mEq/L + glucose mg%/18 + urea mg%/2.8
What are he 2 primary factors regulating aldosterone release?
plasma angiotensin II (Ang II)
Plasma K+
What is normal osmolar gap?
≤ 15
What are the 2 main regulators of ADH?
plasma osmolality (directly related)
Blood pressure/volume (inversely related)
Renin 3 primary regulators?
- perfusion pressure to kidney (inversely related)
- sympathetic stimulation to the kidney
- Na+ deliver to the macula dense (inversely related)
Pc
hydrostatic pressure in capillary (blood pressure)
πIF
Oncotic (osmotic) force in interstitium
What are the forces for filtration?
Pc and πIF
What are the forces for absorption?
πC oncotic (osmotic) pressure of plasma
PIF = hydrostatic pressure in the interstitium
What is the Starling equation?
Qf = k[(Pc + πIF) - (PIF + πC)]
What are the causes of increased Pc?
increased blood flow
increased venous pressure
elevated blood volume
What are the causes of increased πIF?
primarily thyroid dysfunction but lymphedema as well
Common causes of cardiogenic pulmonary edema?
elevated Pc
Increased left atrial pressure increases venous pressure
What are some causes of non-cardiogenic pulmonary edema?
increased permeability ARDS
sepsis,
bacterial pneumonia,
trauma
gastric aspirations
Some clinical signs of cardiogenic pulmonary edema?
orthopnea
elevated pulmonary wedge pressure
Treatment for cardiogenic Pc?
diuretic therapy to reduce left atrial pressure
Clinical signs of non-cardiogenic pulmonary edema?
pulmonary wedge pressure normal or low
dyspnea of rapid onset, hypoxemia and diffuse pulmonary infiltrates
Volume of compartment formula?
amount of tracer/concentration of tracer in compartment to be measured
Formulas to measure blood volume?
7% of body weight in kg
blood volume = plasma volume/1-hematocrit
ECF tracers?
inulin, mannitol, sodium, sucrose
Property of ECF tracers?
permeable to capillary membranes but no cell membranes
Total body water tracers?
tritiated water, urea