Module 13 Electrolytes and Acid-bases Flashcards by Derrick Chuong

What is total body fluid?

40 Liters

How well did you know this?

Not at all

Perfectly

Total body fluid breakdown

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

How well did you know this?

Not at all

Perfectly

Total blood volume

5 liters

How well did you know this?

Not at all

Perfectly

Extracellular components

Plasma and interstitial volume
ratio is 1:4 respectfully

How well did you know this?

Not at all

Perfectly

Fluid compartments ratios:

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

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

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

How well did you know this?

Not at all

Perfectly

two types of chemical substance found in body water

non-electrolytes and electrolytes

How well did you know this?

Not at all

Perfectly

non-electrolytes

uncharged substances that remain intact:

Urea, creatinine, and glucose.

How well did you know this?

Not at all

Perfectly

Electrolytes

dissociate and carry electrical charges

positive charge = cations

Negative charge = anions

How well did you know this?

Not at all

Perfectly

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

Most popular Anion = phosphate

How well did you know this?

Not at all

Perfectly

Electrolyte concentrations are sampled where?

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

How well did you know this?

Not at all

Perfectly

4 important cations in plasma

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

How well did you know this?

Not at all

Perfectly

most abundant intracellular cation and anion in plasma

Potassium (cation)

Sodium (anion)

How well did you know this?

Not at all

Perfectly

most abundant extracellular cation and anion in plasma

Sodium (cation)

Chloride (anion)

How well did you know this?

Not at all

Perfectly

Fluid spacing: first spacing

Normal amount of fluid in both the extracellular and intracellular compartments

How well did you know this?

Not at all

Perfectly

Fluid spacing: second spacing

an excess accumulation of interstitial fluid (edema)

How well did you know this?

Not at all

Perfectly

Fluid spacing: Third spacing*

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

How well did you know this?

Not at all

Perfectly

hypovolemia

when body loses fluid (blood or water).

How well did you know this?

Not at all

Perfectly

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

acid-base regulation

fluid volume maintenance

nerve impulse transmission

muscle contraction

How well did you know this?

Not at all

Perfectly

How do kidneys regulate Na and Cl?

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

How well did you know this?

Not at all

Perfectly

Function of Cl regulation with Na

maintain electro-neutrality

How well did you know this?

Not at all

Perfectly

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?

NaCl Mech
NaHCO3 mech

How well did you know this?

Not at all

Perfectly

Where is Sodium bicarbonate and sodium chloride reabsorbed as solute?

70% is in the Proximal tubule

How well did you know this?

Not at all

Perfectly

Why is Sodium reabsorption coupled with passive water reabsorption?

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

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

How well did you know this?

Not at all

Perfectly

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

Lowers plasma (K+)

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

K+ is largely dependent on what?

Renal excretion

K+ uptake by cells is stimulated by?

insulin Aldosterone B-adrenergic stimulation

B-adrenergic stimulation

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.

All tubulars actively secrete

H+ *except segments of Loop of Henle*

95% of H+ is secreted via ___ and 5% is via ____ *hint which transport primary or secondary?*

95% = secondary active transport -similar to Na reabsorption 5% = primary active primary -more powerful than secondary active transport

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

Urinary phosphate buffers

hypokalemia causes

weak muscle contraction + abnormal cardiac arrhythmias (weak if [K+] is low)

Hyperkalemia causes

Life-threatening cardiac arrhythmias

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

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

Aspects of Alkalosis

Hyperactive nervous system sustain skeletal muscle contractions Cardiac arrhythmias Convulsions

Aspects of Acidosis

Drowsiness, lethargy = depressed CNS Cardiac arrhythmias Coma

Nephrotic syndrome + what causes it?

Loss of plasma proteins into urine -> occurs when glomerular membrane permeability increases -> decrease plasma oncotic pressure -> interstitial edema and fluid accumulation

Dangers of Nephrotic syndrome

interstitial edema and fluid accumulation in: -abdomen (ascites) -pleural space (pleural effusion) -pericardial space (pericardial effusion) -pulmonary edema

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

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

Creatinine [0.6-1.2 mg/dL]

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

Ascites

condition in which fluid collects in spaces within your abdomen.

Law of Electroneutrality

Total # of [+] electrolytes should equal the total # of electrolytes. (normally cations [Na, K] outnumber anions [Cl, HCO3]

Anion gap

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

Normal anion gap?

9-14mEq/l

Why is HCO3 (sodium bicarb) selectively retained?

to normalize pH (buffer system)

Why would a patient manifest hypochloremia?

to maintain electroneutrality

What is hypercarbia and who would have it?

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

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

hypochloremia (Cl decrease) to maintain electroneutrality.

Anion Gap purpose

to determine the cause of metabolic acidosis. Gap reps the unmeasured anion concentration

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

increase in fixed acids (H+) in the blood. i.e lactic acidosis from tissue hypoxia

Anion gap is maintained due to what?

increase in Cl reabsorption (hyperchloremic acidosis)

2 mechanisms of metabolic acidosis

1. Loss of HCO3 2. accumulation of fixed acids

What is diarrhea caused by?

Loss in HCO3

Metabolic acidosis caused by a loss of base if often called____ What happens to Anion Gap as a result?

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

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

HCO3 will decrease, and Cl will increase?

Where is most of the total body water contained?

Intercellular fluid

what is has the highest concentration of Na

Extracellular fluid

What has the highest concentration of K?

Intracellular fluid

What is the normal concentration of CL in extracellular fluid?

105 mEq/L