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Renal Final > Fluids and Electrolytes > Flashcards

Fluids and Electrolytes Flashcards

1
Q

Water is mostly where?

A

Intracellular fluid

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2
Q

Intravascular compartment is

A

fluid in the blood vessel

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3
Q

Interstitial fluid compartment

A

Between cells and blood vessels

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4
Q

Transcellular fluid compartment

A

All fluid in pleura, peritoneum and percardium

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5
Q

Starling Forces

A

Capillary hydraulic pressure (force that pushes fluid from blood to extracellular space
Colloid osmotic pressure (the pressure which counters hydraulic and pushes fluid back into blood)

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6
Q

Hypotonic vs isotonic vs hypertonic

A

Iso: same osmolality as our fluids
Hypo: Less osmolality than our fluid, so water moves into the cells (lyse)
Hyper: More, so water moves out of the cells (shrive)

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7
Q

Human body fluid osmolaity leads to changes in the osmoreceptors which does what

A

Activation of vasopressin (blood volume and pressure changes) and thirst which both lead to retention of water

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8
Q

2 locations for receptors

A 
Renal V2 within the thick ascending limb of Henle
Molecular effects (cAMP increases, PKA activation, ion reabsorption transport by the thick ascending limb)
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9
Q

Vasopressin + Water

A

Binds to V2R on principle cells and activates adenylyl cyclase to increase cAMP
Aquaporins allow the water to move more efficiently and can be added and removed from membranes

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10
Q

AVP is the

A

guard of vascular integrity which means it can preserve regular blood pressure even when we are losing water and tissue perfusion

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11
Q

What are the receptors that are highly expressed in the proximal tubules that are very important for HTN pathophysiology?

A

Angiotensin receptors. (distal nephron)

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12
Q

What activates proximal sodium and chloride reabsorption?

A

Ang II and adrenergic receptors

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13
Q

Dopamine does what?

A

Natriuretic effect

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14
Q

***Transudate

A

Fewer proteins

Nothing to do with inflammation

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15
Q

Hypovolemic shock

A

Hypotension, tachycardia, peripheral vasoconstriction, hypoperfusion
Acid/base issues and lactic acidosis

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16
Q

Hypovolemic labs

A 
BUN and creatinine are up due to decreased GFR
Liver function tests and cardiac biomarkers for severe hypoperfusion
Bicarbonate loss (metabolic acidosis)
Lactic acidosis
17
Q

Defense of serum osmolality is

A

Water intake and circulating AVP

18
Q

Major problem with loss is

A

the imbalance between Na and water (is more of one being excreted or kept?)

19
Q

Hyponatremia can only occur if what volume status is achieved?

A

Any volume status; it doesn’t matter, hyponatremia can occur at any point

20
Q

Euvolemia =

A

Normal sodium

High body water

21
Q

Hypervolemia =

A

High water and sodium

More water

22
Q

Hypovolemia =

A

Decreased water and sodium

23
Q

If you are losing sodium renally, you would have sodium _____.

A

In the urine (a lot)

24
Q

Hyponatremia consequence

A

cellular swelling

25
Q

Hypernatremia =

A

> 145 mM of Na

Combined water and electrolyte deficit

26
Q

Central diabetes insipidus

A

Pituitary gland problems

NOT ENOUGH AVP

27
Q

Nephrogenic Diabetes Insipidus

A

Renal resistance to AVP

Through genetics or drugs

28
Q

Hypernatremia consequences

A

Cellular shrinkage

Rhabdomyolysis

29
Q

***Potassium levels

A

3.5-5.0

30
Q

Potassium stuff

A

Healthy individuals excrete their entire daily intake of potassium
Changes in whole body potassium are mediated by the kidney
Problems with potassium usually stem from a change in intra or extracellular K and not an actual change in levels

31
Q

Hypokalemia =

A

Less than 3.6

CAN CAUSE ARRHYTHMIAS

32
Q

Hypokalemia causes

A

abnormal cardiac rhythm, BP and CV morbidity rate

33
Q

Hyperkalemia =

A

> 5.5 mM

Decreased K excretion is the most common cause

34
Q

Severe hyperkalemia can lead to

A

Cardiac arrest
Paralysis and respiratory failure
Affects how cations and anions are transferred through the membrane

Renal Final (9 decks)

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