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MS3 - Clinical biochem > Fluids and electrolytes > Flashcards

Fluids and electrolytes Flashcards

1
Q

Body fluid distribution

A

40% Solid
60% Water

67% inracellular
33% extracellular

20% plasma
80% interstitial

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2
Q

Causes of Hyponatraemia

A
  1. Pseudo-hyponatraemia
  2. Compensatory hyponatraemia
  3. Normal total body volume hyponatraemia
  4. Depleted volume
  5. Volume expanded hyponatraemia
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3
Q

Pseudo-hyponatraemia

A

High lipid/protein in blood
In 1L plasma, there’s less Na (but Na hasnt gone down)
Low osmolarity, low [Na]
Unchanged osmolality

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4
Q

Compensatory hyponatraemia

A

Hyperglycaemia
Water enters vessels
Na level unchanged
But [Na] reduced

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5
Q

Types of Volume depleted hyponatraemia

A

Renal

Extra-renal

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6
Q

Causes of Renal Volume depleted hyponatraemia

A

Diuretics

Addison’s

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7
Q

Urine [Na] in Renal Volume depleted hyponatraemia

A

> 30

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8
Q

Causes of Extra-renal Volume depleted hyponatraemia

A

Diarrhoea

Vomiting

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9
Q

Urine [Na] in Extra-renal Volume depleted hyponatraemia

A

< 30

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10
Q

Mx of Volume depleted hyponatraemia

A

Normal saline

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11
Q

Causes of Euvolaemic hyponatraemia

A

SIADH

Hypothyroidism

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12
Q

Urine [Na] in Euvolaemic hyponatraemia

A

> 30

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13
Q

Mx of Euvolaemic hyponatraemia

A

Fluid restriction

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14
Q

Causes of Volume expanded hyponatraemia

A

Nephrotic
Cirrhosis
Heart failure

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15
Q

Urine [Na] in Volume expanded hyponatraemia

A

< 30

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16
Q

Mx of Volume expanded hyponatraemia

A 
Fluid restriction
Aldosterone antagonist (Spironolactone)
Loop diuretics
17
Q

SIADH

A

High ADH

Diagnosis of exclusion

18
Q

Causes of SIADH

A

Neoplasia - pancreatic, bronchial
Pulmonary disorders - pneumonia, TB, bronchiectasis
Neurological disorders - encephalitis, meningitis
Head injury
Porphyria

19
Q

Mx of SIADH

A 
Treat underlying cause
Fluid restriction
Demeclocycline
Tolvaptan - V2 antagonist
Hypertonic saline - ery slow to avoid cerebral dehydration

MS3 - Clinical biochem (11 decks)

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