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Clinical Pathology Exam 3 > Lecture 7 > Flashcards

Lecture 7 Flashcards

1
Q

Describe the distribution of water in the body

A

60% body weight

 40% intracellular
 20% extracellular
           15% interstitial
            5% intravascular
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2
Q

How do you increase water

A

intake through water and food (GI)

Renal reabsorption

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3
Q

How do you decrease water

A

Excretion through urine, feces, saliva, and sweat

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4
Q

What is the difference between dehydration and hypovolemia

A

Dehydration describes whole body depletion of water while hypovolemia describes only intravascular fluid depletion

Dehydration might occur in a chronic renal failure patient while hypovolemia might occur with a hit by car

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5
Q

What are you measuring when you get a blood sample

A

Electrolytes in extracellular compartment

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6
Q

What is the major extracellular cation?

Major intracellular cation?

A

Sodium- extracellular

Potassium- intracellular

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7
Q

How is the movement of water in the body regulated?

A

Regulated by osmolality- primarily sodium

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8
Q

What is colloid osmotic pressure

A

Pressure caused by colloidal molecules

Holds fluid intravascularly

Due to plasma proteins

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9
Q

How is body water concentration regulated

A

Like movement, it’s measured by osmolality acting on the thirst center and ADH

I.e. high osmolality detected -> thirst increased and ADH released -> water retained

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10
Q

How is body water volume regulated

A

Through the RAAS system

Liver releases angiotensinogen and kidneys amd lungs converts it to angiotensin which acts on adrenal glands to produce aldosterone which increases sodium and decreases potassium

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11
Q

What tests are used for body fluid volume

A

Tests of hydration

Tests of perfusion

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12
Q

What tests are used for body fluid concentration

A

Osmolality
Osmolal gap
Colloid osmotic gap

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13
Q

What tests are used to measure electrolytes

A

Electrolyte concentrations

Sodium: potassium ratio

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14
Q

What physical and laboratory parameters are used to measure hydration

A 
Skin turgor
MM moisture
Body weight
PCV/TS
USG
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15
Q

What physical exam and laboratory findings are used to test perfusion

A 
MM color and CRT
Heart rate and pulse quality
Blood pressure
Central venous pressure
BUN/creatinine
Lactate
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16
Q

When would you use the osmolality test

A

Cases of suspected ethylene glycol intoxication or pseudohyponatremia

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17
Q

What causes hyperosmolality

A

Increased solutes

Decreased water

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18
Q

What causes hypoosmolality

A

Hyponatremia

19
Q

Clinical signs associated with changes in osmolality

A

Are due to cellular dehydration or overhydration

Depends on whether or not fluid shifts occur
Severity of change
Rate of development

20
Q

How do cells compensate for hyperosmolality

A

By producing idiogenic osmoles

21
Q

What is the osmolal gap

A

Difference between measured and calculated osmolality

Useful for ethylene glycol poisoning

22
Q

What regulates colloid osmotic pressure

A

Liver synthesis of albumin

23
Q

When measuring electrolytes, what blood samples should you use and hy

A

Red top tube with no anticoagulant; can use heparinized plasma with horses

Anticoagulants can contaminate sample

24
Q

Functions of sodium

A

Major determinant of osmolality

Essential for control of hydration (RAAS)

25
Q

How is Na concentrated regulated

A

Renal tubular absorption (ADH, RAAS)

Intestinal absorption

26
Q

What causes hypernatremia

A

Increased sodium (salt poisoning, sea water ingestion, iatrogenic)

Decreased water (inadequate intake, loss of sodium poor fluid)

27
Q

What do you see with a masked hyponatremia

A

Normal values in a dehydrated animal

28
Q

What disease states can cause hypernatremia

A

Lack of ADH or resistance (diabetes insipidus)

Hypotonic diarrhea/vomiting

Inappropriately mixed milk replaced

29
Q

What causes hyponatremia

A

Decreased sodium (loss through GI or renal), Addison’s, iatrogenic, sequestration, sweat, deficient intake

Increased water (hyperosmolality not from Na, edma, psychogenic polydipsia, near drowning, iatrogenic, inappropriate ADH secretion

30
Q

Diseases that can cause hyponatremia

A

Addison’s

31
Q

Pseudohyponatremia

A

Hyperosmolality not due to high sodium

Or

Lipemia/severe hyperproteinemia

32
Q

Functions of potassium

A

Cardiac, skeletal, and nerve functions

33
Q

How is potassium concentration regulated

A

Externally- renal, GI, sweat

Internally- shifts between ICF and ECF

34
Q

How does acidosis affect k concentration

A

Brings more K into extracellular space which is then excreted by kidneys and results in total body K depletion

35
Q

What causes hyperkalemia

A

Altered external balance- failure to excrete

Altered internal balance- leakage from damages cells, shifts from ICF to ECF

spurious- hemolysis, thrombocytosis, leukocytosis, EDTA contamination

36
Q

Diseases that cause hyperkalemia

A

Blocked cat

Addisons

37
Q

What causes hypokalemia

A

GI loss, renal excretion, decreased intake, iatrogenic

Alkalosis, iatrogenic

38
Q

What disease states might cause hypokalemia

A

After unblocking blocked cat

While treating diabetic ketoacidosis (because K shifts into cells)

39
Q

What is the sodium:potassium ratio useful for

A

Can be suggestive of Addisons, renal disease, severe diarrhea, repeated chylothorax drainage

40
Q

Major extracellular anion

A

Chloride

41
Q

How is chloride concentration affected

A

Sodium movement, loss of chloride rich fluid, loss of bicarb

42
Q

What causes hyperchloremia

A

Na related increases
Compensation for decreased bicarb
Iatrogenic
Spurious

43
Q

What causes hypochloremia

A

Sodium related decreases
Loss of chloride rich secretions
Iatrogenic
Spurious

Clinical Pathology Exam 3 (8 decks)

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