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Pathophysiology > Fluids, Electrolytes, Acids, and Bases > Flashcards

Fluids, Electrolytes, Acids, and Bases Flashcards

1
Q

What does ADH stand for?

A

Antidiuretic Hormone

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2
Q

Where is ADH produced?

A

Hypothalamus

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3
Q

Where is ADH stored and secreted?

A

Posterior Pituitary

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4
Q

T or F:The hypothalamus stores ADH.

A

False. Stored and secreted by the posterior pituitary

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5
Q

What does ADH do?

A

Increases water reabsorption by renal tubules

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6
Q

What hormone increases water reabsorption by the renal tubules?

A

ADH

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7
Q

What are the physiological triggers for release of ADH?

A

Decreased blood volume,
Increased blood osmolarity,
Decreased blood pressure

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8
Q

What does decreased blood volume, increased blood osmolarity, and decreased blood pressure trigger?

A

Release of ADH

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9
Q

T or F:ADH decreases blood osmolarity.

A

True

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10
Q

Does ADH increase or decrease blood osmolarity?

A

Decrease

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11
Q

What is increased blood osmolarity?

A

Increase in blood glucose,

Loss of water, but no loss of sodium

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12
Q

Where is aldosterone produced and secreted?

A

Adrenal Cortex

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13
Q

What hormone is produced in the adrenal cortex?

A

Aldosterone

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14
Q

What does aldosterone do?

A

Increase sodium reabsorption by the renal tubules,

Increase in potassium and hydrogen secretion by the renal tubules

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15
Q

How is the release of aldosterone stimulated?

A

Via renin-angiotensin pathway

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16
Q

What does the renin-angiotensin pathway stimulate?

A

Release of Aldosterone

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17
Q

What hormone increases sodium reabsorption, increase potassium secretion, and increases hydrogen secretion by the renal tubules?

A

Aldosterone

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18
Q

What does decreased kidney perfusion stimulate?

A

Renin Release

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19
Q

What is the stimulus for renin release?

A

Decreased kidney perfusion

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20
Q

What does ECF stand for?

A

Extra-cellular Fluid

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21
Q

What does ICF stand for?

A

Intra-cellular Fluid

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22
Q

What is ECF?

A

All fluid outside of cells

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23
Q

T or F:ECF includes interstitial fluid and plasma?

A

True

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24
Q

What is ECF’s primary cation?

A

Sodium

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25
Q

What is ECF’s primary anions?

A

Chlorine and Bicarbonate

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26
Q

Is bicarbonate a cation or anion?

A

Anion

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27
Q

Is sodium a cation or anion?

A

Cation

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28
Q

What is ICF?

A

All fluid inside cells

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29
Q

What is ICF’s primary cation?

A

Potassium

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30
Q

What is ICF’s primary anions?

A

Hydrogen Phosphate and Proteins

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31
Q

T or F:Proteins have a positive charge.

A

False. Negative Charge

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32
Q

What is hypovolemia?

A

Isotonic Fluid Loss

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33
Q

What is another term for hypovolemia?

A

Dehydration

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34
Q

Dehydration is another term for what?

A

Hypovolemia

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35
Q

What causes hypovolemia?

A

Blood loss,

GI losses-vomiting, diarrhea

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36
Q

What does blood loss and GI losses cause?

A

Hypovolemia

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37
Q

What are some clinical manifestations of hypovolemia?

A

Decreased BP (can be normal for a while with vasoconstriction),
Tachycardia,
Decreased Urine Output,
Increased Hematocrit

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38
Q

Decrease BP, tachycardia, decreased urine output, and increased hematocrit are clinical manifestations of what?

A

Hypovolemia

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39
Q

What is hypervolemia?

A

Isotonic fluid gain

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40
Q

Isotonic fluid gain causes what?

A

Hypervolemia

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41
Q

Isotonic fluid loss causes what?

A

Hypovolemia

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42
Q

What causes hypervolemia?

A

Excessive IV fluids,

Hyperaldosteronism

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43
Q

What is hyperaldosteronism?

A

Sodium and water reabsorption

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44
Q

What is sodium and water reabsorption?

A

Hyperaldosteronism

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45
Q

What does excessive IV fluids and hyperaldosteronism cause?

A

Hypervolemia

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46
Q

What clinical manifestation does hypervolemia cause?

A 
Increased BP,
Weight Gain,
Edema,
Decreased Hematocrit,
Jugular Vein Dystension
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47
Q

Increased BP, weight gain, edema, decreased hematocrit, and jugular vein distension are clinical manifestations of what?

A

Hypervolemia

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48
Q

What does BHP stand for?

A

Blood Hydrostatic Pressure

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49
Q

T or F:BHP opposes filtration.

A

False. Favors Filtration

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50
Q

What are two reasons BHP decreases along capillaries?

A
  1. more distance from heart

2. bc of filtration

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51
Q

What causes isotonic fluid gain?

A

Aldosterone

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52
Q

T or F:BHP is exerted by blood on vessel walls.

A

True

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53
Q

What does BOP stand for?

A

Blood Oncotic Pressure

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54
Q

T or F:BOP is exerted by blood on vessel walls.

A

False. Exerted by proteins in the blood

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55
Q

T or F:BOP stays constant along the length of the capillary.

A

True

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56
Q

T or F:BOP opposes filtration.

A

True

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57
Q

What does IFOP stand for?

A

Interstitial Fluid Oncotic Pressure

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58
Q

T or F:IFOP is exerted by proteins in the interstitium.

A

True

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59
Q

T or F:IFOP opposes filtration.

A

False. Favors Filtration

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60
Q

T or F:IFOP stays constant along the length of the capillary.

A

True

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61
Q

What does IFHP stand for?

A

Interstitial Fluid Hydrostatic Pressure

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62
Q

T or F:IFHP favors filtration.

A

True

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63
Q

T or F:IFHP is exerted by proteins in the interstitium.

A

False. Exerted by fluid in the interstitium

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64
Q

Is IFHP a positive or negative pressure?

A

Negitave Pressure

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65
Q

T or F:IFHP opposes filtration.

A

False. Favors Filtration

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66
Q

What pressure systems favor filtration?

A

BHP,
IFHP,
IFOP

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67
Q

What pressure system opposes filtration?

A

BOP

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68
Q

Does BHP, IFHP, IFOP favor filtration or oppose filtration?

A

Favor Filtration

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69
Q

Does BOP favor filtration or oppose filtration?

A

Opposes Filtration

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70
Q

What do alterations in water movement cause?

A

Edema

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71
Q

What causes decreased BOP?

A

Liver Disease-decreased synthesis of oncotic proteins,
Malnutrition-lack of AA to synthesize oncotic proteins,
Some types of kidney disease-increased loss of proteins in urine

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72
Q

What does AA stand for?

A

Amino Acids

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73
Q

What does liver disease, malnutrition, and some types of kidney disease cause?

A

Decreased BOP

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74
Q

Why does liver disease decrease BOP?

A

It decreases synthesis of oncotic proteins

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75
Q

Why does malnutrition decrease BOP?

A

There is a lack of AA to synthesize oncotic proteins

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76
Q

What is an example of oncotic proteins?

A

Albumins

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77
Q

Why do some types of kidney diseases cause BOP?

A

There is an increased loss of proteins in urine

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78
Q

What are some manifestations of decreased BOP?

A

Increased Filtration @ the arterial end of the capillary,

Decreased Reabsorption @ the venous end of the capillary

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79
Q

What causes increased BHP?

A

Hypertension,

Hypervolemia

80
Q

Hypertension and hypervolemia cause what?

A

Increased BHP

81
Q

What are some manifestations of increased BHP?

A

Increased Filtration @ the arterial end of the capillary,

Decreased Reabsorption @ the venous end of the capillary

82
Q

Increased filtration @ the arterial end of the capillary and decreased reabsorption @ the venous end of the capillary are manifestations of what?

A

Decreased BOP,
Increased BHP,
Increases Capillary Membrane Permeability,
Lymphatic Obstruction

83
Q

What causes increased capillary membrane permeability?

A

Anything that causes inflammation,
Decreased BOP-opposes filtration,
Increased IFOP-favors filtration

84
Q

What happens to oncotic proteins when capillary membrane permeability increases?

A

Oncotic proteins shift from blood to the interstitium

85
Q

What causes oncotic proteins to shift from blood to the interstitium?

A

Increased Capillary Membrane Permeability

86
Q

What are some manifestations of increased capillary membrane permeability?

A

Increased Filtration @ the arterial end of the capillary,

Decreased Reabsorption @ the venous end of the capillary

87
Q

What are some manifestations of lymphatic obstruction?

A

Increased Filtration @ the arterial end of the capillary,
Decreased Reabsorption @ the venous end of the capillary,
Decreased BOP,
Increased IFOP (Proteins collect in interstitium and aren’t drained by the lymphatic system)

88
Q

What causes lymphatic obstruction?

A

Removal of lymph nodes,

Obstruction of lymph nodes

89
Q

What obstructs lymph nodes?

A

Bacterial Infections,
Cancer,
Nematodes-small wormy parasites

90
Q

Bacterial infections, cancer, and nematodes do what?

A

Obstruct lymph nodes

91
Q

What are some metabolic roles of sodium?

A

Conduction of nerve impulses,

Maintenance of water content of cells

92
Q

Conduction of nerve impulses and maintenance of water content in cells are metabolic roles of what?

A

Sodium

93
Q

What is hyponatremia?

A

When the concentration of sodium in ECF is less than normal

94
Q

What is it called when the concentration of sodium in ECF is less than normal?

A

Hyponatremia

95
Q

T or F:Hyponatremia is isotonic.

A

False

96
Q

What causes hyponatremia?

A

Excessive sodium loss (depletion hyponatremia)
-Sweating, Vomiting, diarrhea
Excessive Water Intake (dilutional hyponatremia)

97
Q

What is depletion hyponatremia?

A

Excessive sodium loss

98
Q

What kind of hyponatremia is caused by excessive loss of sodium?

A

Depletion Hyponatremia

99
Q

What kind of hyponatremia is caused by excessive water intake?

A

Dilutional Hyponatremia

100
Q

What manifestations cause depletion hyponatremia?

A

Sweating,
Vomiting,
Diarrhea

101
Q

What do sweating, vomiting, and diarrhea cause?

A

Depletion Hyponatremia

102
Q

What is a consequence of hyponatremia?

A

ECF becomes Hypotonic,

-Cells swell (esp. neurons)

103
Q

What happens when ECF becomes hypotonic?

A

Cells swell

104
Q

What are some clinical manifestations of hyponatremia?

A

Lethargy,
Generalized Weakness,
Confusion,
Coma

105
Q

What is hypernatremia?

A

When sodium in ECF is greater than normal

106
Q

What causes hypernatremia?

A 
Sodium Gain
-Sea water near drowning (sodium in lungs)
-Excessive IV salts
Water Loss
-Fever
-Burns
-Lack of water intake
107
Q

What is it called when sodium in ECF is greater than normal?

A

Hypernatremia

108
Q

What does sodium gain or water loss cause?

A

Hypernatremia

109
Q

What are ways water is lost?

A

Fever,
Burns,
Lack of water intake

110
Q

What does fever cause?

A

Increased BMR,
Increased water usage,
Hyperventilation

111
Q

What does BMR stand for?

A

Basal Metabolic Rate

112
Q

Why do burns cause water loss?

A

The epidermis is where keratin is present and keratin helps keep water in or out.

113
Q

What causes lack of water intake?

A

Altered consciousness-dementia
Lack of access
Choice to not consume water

114
Q

What are consequences of hypernatremia?

A

ECF is Hypertonic,

Cells lose water (crenation)

115
Q

What is crenation?

A

When cells lose water

116
Q

What is it called when cells lose water?

A

Crenation

117
Q

What cells are most affected by crenation?

A

Neurons

118
Q

What are some clinical manifestations of hypernatremia?

A 
Lethargy,
Weakness, 
Seizures,
Confusion,
Coma
119
Q

T or F:The clinical manifestations associated with hyponatremia and hypernatremia are almost identical.

A

True

120
Q

Where is potassium stored?

A

Inside Cells

121
Q

What releases potassium?

A

Damaged Cells

122
Q

T or F:potassium uptake requires ATP and insulin.

A

True

123
Q

How long does it take for a potassium deficit to occur without potassium intake?

A

2-3 day

124
Q

How is potassium lost?

A

Through cells sloughing

125
Q

Where does potassium secretion occur

A

In the Renal Tubules

126
Q

What hormone promotes potassium secretion?

A

Aldosterone

127
Q

What does aldosterone do to potassium?

A

Promotes Secretion

128
Q

T or F:Potassium secretion is NOT flow dependant.

A

False

129
Q

T or F:More potassium is lost with a faster flow rate of filtrate.

A

True

130
Q

What is one way to increase flow rate?

A

Drinking too much water

131
Q

What does drinking too much water do to flow rate of filtrate?

A

Increases Flow Rate of Filtrate

132
Q

What is hypokalemia?

A

When potassium in ECF is less than normal

133
Q

What is “actual” hypokalemia?

A

When potassium is lost from the body

134
Q

What is “relative” hypokalemia?

A

When potassium shifts from ECF to ICF

135
Q

What is it called when potassium shifts from ECF to ICF?

A

Relative Hypokalemia

136
Q

When does ECF volume deficit occur?

A

When Kidney Perfusion Decreases

137
Q

What does renin, angiotensin, and aldosterone do to potassium secretion?

A

Increases Potassium Secretion

138
Q

What do diuretics do to flow rate in renal tubules?

A

Increases Flow Rate

139
Q

What increases flow rate in renal tubules?

A

Diuretics

140
Q

What potassium shift results from increased flow in renal tubules?

A

Increased Potassium Secretion

141
Q

What does black licorice affect?

A

Potassium Secretion

142
Q

Does black licorice decrease or increase potassium secretion?

A

Increase

143
Q

T or F:Black licorice has no effect on potassium secretion?

A

False. Profound effects on potassium secretion

144
Q

What does insulin administration do to potassium?

A

Promotes potassium uptake by cells

145
Q

What chemical promotes potassium uptake by cells?

A

Insulin

146
Q

What effect does new tissue formation have on potassium?

A

Increases potassium uptake by new cells

147
Q

What are some causes of hypokalemia?

A 
Decreased Kidney Perfusion,
Diuretic Use,
Black Licorice,
Insulin Administration,
New Tissue Formation
148
Q

Decreased kidney perfusion, diuretic use, black licorice, insulin administration, and new tissue formation are causes of what?

A

Hypokalemia

149
Q

What consequence does hypokalemia have?

A

Fewer action potentials will be generated

150
Q

What causes fewer action potentials to be generated?

A

Hypokalemia

151
Q

What manifestations does hypokalemia cause?

A 
Skeletal Muscle Weakness,
Depression of CNS,
Decreased GI motility,
-Nausea, Vomiting bc body doesn't want food
Shallow Respirations,
Cardiovascular Dysrhythmias
-Shallow T wave
-Prominent U wave
152
Q

What cardiovascular dysrhythmias does hypokalemia cause?

A

Shallow T wave,

Prominent U wave

153
Q

skeletal muscle weakness, depression of CNS, decreased GI motility, shallow respirations, and cardiovascular dysrhythmias are manifestations of what?

A

Hypokalemia

154
Q

What is it called when potassium in ECF is less than normal?

A

Hypokalemia

155
Q

What is it called when potassium in ECF is greater than normal?

A

Hyperkalemia

156
Q

What is hyperkalemia?

A

When potassium in ECF is greater than normal

157
Q

What causes hyperkalemia?

A

Decreased Potassium
-Renal Failure
-Aldosterone deficiency
Extensive Tissue Damage
-Potassium spills out of cells when damaged
Insulin Deficit
-Decreased potassium uptake y cells in absence of insulin

158
Q

What decreases potassium in the body?

A

Renal Failure,

Aldosterone Deficiency

159
Q

What happens to potassium when there is extensive tissue damage?

A

It spills out of cells

160
Q

Decreased potassium, extensive tissue damage, and insulin deficit cause what?

A

Hyperkalemia

161
Q

What consequences are associated with hyperkalemia?

A

Raise resting membrane potential,

action potentials are generated more easily

162
Q

What are some manifestations of hyperkalemia?

A 
Overstimulation causes muscle fatigue; weakness,
Increased GI motility 
-Diarrhea
Cardiovascular Dysrhythmias
-High T wave
-Ventricular Fibrillation
-Can cause Cardiac Arrest
163
Q

What is ventricular fibrillation?

A

When cells in the heart quiver and cannot pump blood

164
Q

How does a defibrillator work?

A

It overrides the electrical impulses in the heart to try to get myocardiocytes to contract together again

165
Q

What is it called when heart cells quiver?

A

Ventricular Fibrillation

166
Q

What cardiovascular dysrhythmia is associated with hyperkalemia?

A

High T wave

167
Q

What is a buffer?

A

A chemical system used to maintain a constant pH

168
Q

What is a chemical system used to maintain a constant pH?

A

Buffer

169
Q

Why are buffer systems important?

A

They help maintain a constant pH

170
Q

What happens if pH changes?

A

Proteins will be denatured

171
Q

What is the carbonic acid-bicarbonate system?

A

(CO2)+(H20)–(H2CO3)–(H+)+(HCO3-)

172
Q

What is (CO2)+(H20)–(H2CO3)–(H+)+(HCO3-)?

A

Carbonic Acid-Bicarbonate System

173
Q

Do strong acids or weak acids dissociate in water more easily?

A

Strong Acids

174
Q

What does a pH scale measure?

A

Hydrogen Ion Concentration

175
Q

T or F:Weak acids usually don’t dissociate completely.

A

True

176
Q

What is the pH in the human body?

A

7.4

177
Q

What is the ratio of bicarbonate:carbonic acid in the human body?

A

20:1

178
Q

Where is carbonic acid regulated in the body?

A

Lungs

179
Q

What is regulated in the lungs?

A

Carbonic Acid

180
Q

Where is bicarbonate regulated in the body?

A

Kidneys

181
Q

What is regulated in the kidneys?

A

Bicarbonate

182
Q

What happens to carbonic acid if carbon dioxide increases?

A

Increases

183
Q

What happens to carbonic acid during hyperventilation?

A

Decreases

184
Q

What is compensation?

A

When pH is 7.4 and a 20:1 ratio of bicarbonate:carbonic acid is achieved, BUT the values aren’t normal

185
Q

What is correction?

A

When pH is 7.4 and a 20:1 ratio of bicarbonate:carbonic acid is achieved, AND the values are normal

186
Q

What happens to carbon dioxide and carbonic acid when respiration rate increases?

A

Carbon Dioxide Increases,

Carbonic Acid Increases

187
Q

What happens to carbon dioxide and carbonic acid when respiration rate decreases?

A

Carbon Dioxide Decreases,

Carbonic Acid Decreases

188
Q

T or F:Bicarbonate MUST bind with hydrogen before reabsorption.

A

True

189
Q

T or F:Anything that increases hydrogen ions will increase bicarbonate reabsorption.

A

True

190
Q

What is the phosphate buffer system?

A

(H2PO4–)–(HPO4)+(H+)

191
Q

What is the equation for protein buffers?

A

(HHB)–(Hb-)+(H+)

192
Q

Where are protein buffers most important?

A

In ICF

193
Q

T or F:Protein buffers can NOT donate or accept protons.

A

False

194
Q

What is metabolic acidosis?

A

Change in bicarbonate; pH is less than 7.35

195
Q

What imbalance is a change in bicarbonate?

A

Metabolic

196
Q

What causes metabolic acidosis?

A 
Increase in non-carbonic acid
-Lactoacidosis:tissue hypoxia
-Ketoacidosis:excessive fat degradation
-Ingestion of aspirin, antifreeze
Excessive loss of bicarbonate 
-Diarrhea:decreased bicarbonate reabsorption in large intestine
Decreased Hydrogen Ion Secretion
-Renal failure
-Hypoaldosteronism
197
Q

Increase in non-carbonic acid, excessive loss of bicarbonate, and decreased hydrogen ion secretion causes what?

A

Metabolic Acidosis

Pathophysiology (6 decks)

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