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Y1S3 Medicine > GUT- Consequences of Fluid Loss from the GI Tract > Flashcards

GUT- Consequences of Fluid Loss from the GI Tract Flashcards

1
Q

what is the total body water intake in an adult individual

A

Total - 2550ml

made from liquids - 1200ml
food- 1000ml
metabolically produced 350ml

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2
Q

what is the total body output in an adult individual

A

total - 2550ml

made from
sweat - 50ml
faeces- 100ml
urine- 1500ml

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3
Q

what are the sites of water loss

A

skin, respiratory passages, GIT tract, Urinary tract, Trauma, Menstrual flow

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4
Q

what is the daily intake of NaCl

A

food - 10.5 g

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5
Q

what is the daily output of NaCl

A

sweat - 0.25g
faeces- 0.25g
urine 10g - varies considerable

total - 10.5 g

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6
Q

what alters excretion of NaCl

A

kidneys

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7
Q

outline ways which fluid is lost from the body

A 
defecation - diarrhoea
vomiting
urination
ventilation
sweating
menstruation
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8
Q

outline ways in which fluids are gained by the body

A

drinking

metabolism

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9
Q

what is diarrhoea

A

increase in frequency and increase in fluidity of faeces
>3 unformed stools in 24 hours
change in bowel movement

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10
Q

how does diarrhoea occur

A

via the failure of water absorption

increased secretion of water

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11
Q

what are causes of decreased water absorption

A

osmotic diarrhoea
deranged motility of diarrhoea
secretory diarrhoea

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12
Q

what is osmotic diarrhoea

A

increase in number of osmotic particles

decreases absorption of electrolytes and nutrients
disaccharides deficiency - drug induced, malabsorption of galactose, bloating, nausea, watery diarrhoea

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13
Q

what is deranged motility diarrhoea

A

increased rate of flow of intestinal contents

lack of absorption of nutrients; some agents may promote secretion as well as motility

GI stasis may promote diarrhoea by stimulating bacterial overgrowth

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14
Q

what is secretory diarrhoea

A

abnormal increase in secretions of GIT

ACh and substrate P act via increasing calcium concentration to increase rate of intestinal secretion

excessive laxative use; defects in digestion and absorption ; infection

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15
Q

what are the causes of bloody diarrhoea

A

chronic disease
ulcerative colitis
neoplasm

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16
Q

what is lost in vomiting

A

food, mucus, Na,K,Cl, biacronate, gastric acid
upper intestinal contents
blood

17
Q

what are the consequences of severe diarrhoea

A

decrease in blood volume (hypovolemia)
metabolic acidosis - due to loss of bicarbonate
volume depletion could lead to acidosis / alkalosis

18
Q

what are the consequences of excessive vomiting

A 
increased salt and water loss
severe dehydration
circulatory problems
metabolic alkalosis (due to loss of gastric acid)
death
19
Q

what are the consequences of fluid loss from GI tract

A

hypovolemia
haemoconcentration / polycythaemia (dehydration) - increased RBC concentration
dehydration
ionic imbalances; poor perfusion of tissues
malnutrition and increased mortality

20
Q

what are the consequences of hypovolaemia

A

decrease venous return
arterial hypotension
myocardial dysfunction due to increased myocardial oxygen demand but tissue perfusion is reduced

increased anaerobic metabolism –> acidosis - build up of lactic acid
acidosis and myocardial dysfunction –> multi organ failure

21
Q

outline cardiovascular adaptations to water loss

A

increased Na and H2O loss due to diarrhoea
decreased plasma volume
decreased venous pressure

adaptations:
decreased venous return
decreased atrial pressure
decreased ventricular end diastolic volume
decreased stroke volume
decreased cardiac output
decreased arterial blood pressure
22
Q

outline renal adaptions to water loss

A

increased Na and H2O loss due to diarrhoea
decreased plasma volume
decreased venous pressure

increased activity of renal sympathetic nerves
increased constriction of renal arterioles
decreased net glomerular filtration pressure
decreased GFR
decreased Na and water secretions

23
Q

how does the renal system promote decreased sodium and water excretion

A

increase in plasma aldosterone causes a decrease in sodium excretion

increase is plasma vasopressin causes a decrease in water secretion

24
Q

how does the RAAS cascade respond the hypovolemia

A

a decrease in plasma volume causes a decrease in arterial pressure

this causes an increase in renin secretion - therefore an increase in plasma renin

causing an increase in plasma angiotensin II
causing an increase in aldosterone secretion
causing an increase in sodium reabsorption

25
Q

how does ADH cause water reabsorption

A

an increase in osmolarity of body fluids causes ADH release
this activates V2 receptors on the renal collecting ducts of the kidney
this increases the permeability of the collecting ducts to water and results in a concentrated urine production

26
Q

how does drinking water affect water reabsoprtion

A

intake of water causes a decrease in osmolarity of blood and intersitital fluid - decreases ADH secretion and the removal of water channels so collecting duct permeability to water is decreased

27
Q

what factors regulate ADH release

A

large decrease in blood volume (detected by baroreceptors)
severe dehydration
hyperventilation - results in increased fluid loss
vomiting
diarrhoea
fever - heavy sweating

28
Q

what factors control the thirst response

A

decreased plasma volume detected by baroreceptors - increase angiotensin II which triggers thirst further
increased plasma osmolarity detected by osmoreceptors
dry mouth/ throat

the metering of water intake by the GI tract decreases the thirst response- avoids over hydration

29
Q

what are the consequences of dehydration

A 
nausea
headaches
irrationality
cramps
increased temperature
dizziness
30
Q

effects of dehydration

A

imbalance of electrolytes in the blood stream - decrease in Na and K+ but increase in Ca

31
Q

what risks does hypercalcaemia have

A

risk of kidney stones, kidney failure, arrythmia

32
Q

what are the symptoms of hypercalcaemia

A

nausea, vomiting, constipation, abdominal pain, fatigue, lethargy, joint pain, confusion

Y1S3 Medicine (14 decks)

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