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Pathophysiology (RESP 212) > Module 13 Electrolytes and Acid-bases > Flashcards

Module 13 Electrolytes and Acid-bases Flashcards

1
Q

What is total body fluid?

A

40 Liters

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2
Q

Total body fluid breakdown

A

Plasma volume (3 L)
Red blood cell volume (2 L)
Extracellular volume (15 L)
Intracellular volume (25)

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3
Q

Total blood volume

A

5 liters

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4
Q

Extracellular components

A

Plasma and interstitial volume
ratio is 1:4 respectfully

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5
Q

Fluid compartments ratios:

60% of bw is water, what membranes is it compartmentlike as?

A

2/3 = intracellular fluid space (ICF) - within cells

1/3 = extracellular fluid (ECF) - outside cells

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6
Q

two types of chemical substance found in body water

A

non-electrolytes and electrolytes

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7
Q

non-electrolytes

A

uncharged substances that remain intact:

Urea, creatinine, and glucose.

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8
Q

Electrolytes

A

dissociate and carry electrical charges

positive charge = cations

Negative charge = anions

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9
Q

electrolytes distribution: what is the most abundant intracellular cation and anion

A

Most popular Cation = K+

Most popular Anion = phosphate

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10
Q

Electrolyte concentrations are sampled where?

A

Plasma or serum (intravascular fluid aka whole blood) = reflect ECF not ICF

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11
Q

4 important cations in plasma

A

Sodium (Na+)
Potassium (K+)
Calcium (Ca++)
Magnesium (Mg++)

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12
Q

most abundant intracellular cation and anion in plasma

A

Potassium (cation)

Sodium (anion)

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13
Q

most abundant extracellular cation and anion in plasma

A

Sodium (cation)

Chloride (anion)

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14
Q

Fluid spacing: first spacing

A

Normal amount of fluid in both the extracellular and intracellular compartments

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15
Q

Fluid spacing: second spacing

A

an excess accumulation of interstitial fluid (edema)

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16
Q

Fluid spacing: Third spacing*

A

Fluid accumulation in areas that normally have no fluid or minimal amount of fluids (ascites, edema with burns )

Takes fluid away from normal fluid compartments causing hypovolemia

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17
Q

hypovolemia

A

when body loses fluid (blood or water).

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18
Q

Renal Electrolyte Regulation: Na, K, Cl, H regulation is related to what functions?

A

acid-base regulation

fluid volume maintenance

nerve impulse transmission

muscle contraction

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19
Q

How do kidneys regulate Na and Cl?

A

Active transport.

80% of Na reabsorption by kidneys (filtrate back into the blood)

Cl diffuses with Na (from tubular lumen into blood) to maintain electro-neutrality

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20
Q

Function of Cl regulation with Na

A

maintain electro-neutrality

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21
Q

Kidney chemical mechs: Na enters the Glomerular filtrate where it is captured by the renal tubular cells, what are 2 different mechs that are seen at work here?

A

NaCl Mech
NaHCO3 mech

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22
Q

Where is Sodium bicarbonate and sodium chloride reabsorbed as solute?

A

70% is in the Proximal tubule

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23
Q

Why is Sodium reabsorption coupled with passive water reabsorption?

A

Movement of water balanes osmotic pressure within/across tubule walls.

TLDR: when sodium moves, water moves = maintains extracellular body fluid volume

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24
Q

Why is Ventolin infused in hyperkalemia? what does it do?

A

Lowers plasma (K+)

Ventolin is a beta androgenic agonist = relaxes muscles of airways = widening of airways = easier breathing

25
Q

K+ is largely dependent on what?

A

Renal excretion

26
Q

K+ uptake by cells is stimulated by?

A

insulin
Aldosterone
B-adrenergic stimulation

27
Q

B-adrenergic stimulation

A

TLDR: Regulates cardiovascular function under stress conditions or physical exercise:

Specifics:
produces a positive inotropic (enhanced contraction), lusitropic (faster relaxation),
and chronotropic (increased heart rate) effect.

28
Q

All tubulars actively secrete

A

H+

except segments of Loop of Henle

29
Q

95% of H+ is secreted via ___ and 5% is via ____

hint which transport primary or secondary?

A

95% = secondary active transport
-similar to Na reabsorption

5% = primary active primary
-more powerful than secondary active transport

30
Q

Besides reacting with bicarbonate ions, excess H+ binds with?

A

Urinary phosphate buffers

31
Q

hypokalemia causes

A

weak muscle contraction + abnormal cardiac arrhythmias

(weak if [K+] is low)

32
Q

Hyperkalemia causes

A

Life-threatening cardiac arrhythmias

33
Q

[pH] speed of blood, lungs, and kidney acid-base correction

A

Blood buffers = seconds
Lungs = minutes
Kidneys = slow, but powerful.

34
Q

Aspects of Alkalosis

A

Hyperactive nervous system
sustain skeletal muscle contractions
Cardiac arrhythmias
Convulsions

35
Q

Aspects of Acidosis

A

Drowsiness, lethargy = depressed CNS
Cardiac arrhythmias
Coma

36
Q

Nephrotic syndrome + what causes it?

A

Loss of plasma proteins into urine
-> occurs when glomerular membrane permeability
increases

-> decrease plasma oncotic pressure -> interstitial
edema and fluid accumulation

37
Q

Dangers of Nephrotic syndrome

A

interstitial edema and fluid accumulation in:

-abdomen (ascites)
-pleural space (pleural effusion)
-pericardial space (pericardial effusion)
-pulmonary edema

38
Q

Blood urea nitrogen (BUN) 8-20mg/dL

A

Urea synthesized in liver from ammonia
–>must be excreted by kidneys!

39
Q

Creatinine [0.6-1.2 mg/dL]

A

constantly formed in muscle tissue
–>increased in muscle + kidney disease

40
Q

Ascites

A

condition in which fluid collects in spaces within your abdomen.

41
Q

Law of Electroneutrality

A

Total # of [+] electrolytes should equal the total # of electrolytes.

(normally cations [Na, K] outnumber anions [Cl, HCO3]

42
Q

Anion gap

A

measures the difference [gap] between [-] and [+] electrolytes in blood.

if anion gap is too high, your blood is acidic, if low it isn’t acidic enough

43
Q

Normal anion gap?

A

9-14mEq/l

44
Q

Why is HCO3 (sodium bicarb) selectively retained?

A

to normalize pH (buffer system)

45
Q

Why would a patient manifest hypochloremia?

A

to maintain electroneutrality

46
Q

What is hypercarbia and who would have it?

A
  1. An increase in carbon dioxide in the bloodstream
  2. Persons with COPD
47
Q

If total cation conc is normal, increase HCO3 (metabolic alkalosis) is always associated with?

A

hypochloremia (Cl decrease) to maintain electroneutrality.

48
Q

Anion Gap purpose

A

to determine the cause of metabolic acidosis.

Gap reps the unmeasured anion concentration

49
Q

Increase in Anion Gap metabolic acidosis (greater than 14) is due to what?

A

increase in fixed acids (H+) in the blood.

i.e lactic acidosis from tissue hypoxia

50
Q

Anion gap is maintained due to what?

A

increase in Cl reabsorption (hyperchloremic acidosis)

51
Q

2 mechanisms of metabolic acidosis

A
  1. Loss of HCO3
  2. accumulation of fixed acids
52
Q

What is diarrhea caused by?

A

Loss in HCO3

53
Q

Metabolic acidosis caused by a loss of base if often called____

What happens to Anion Gap as a result?

A
  1. hyperchloremic metabolic acidosis
  2. Anion Gap would remain normal -> Cl increases to
    replace HCO3
54
Q

high anion gap acidosis = increase in fixed acids = anion gap increase. what happens due to buffering?

A

HCO3 will decrease, and Cl will increase?

55
Q

Where is most of the total body water contained?

A

Intercellular fluid

56
Q

what is has the highest concentration of Na

A

Extracellular fluid

57
Q

What has the highest concentration of K?

A

Intracellular fluid

58
Q

What is the normal concentration of CL in extracellular fluid?

A

105 mEq/L

Pathophysiology (RESP 212) (14 decks)

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