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Patho > Patho Exam 3 > Flashcards

Patho Exam 3 Flashcards

1
Q

Arginine Vasopressin (AVP)

  • other name?
  • Osmotic release effect?
  • Nonosmotic release effect?
A

Arginine Vasopressin (AVP)

  • Antidiuretic Hormone (ADH)
  • Osmotic release causes 1-2% change in osmolality
  • nonosmotic release causes 6-10% change in osmolality
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2
Q

Water

  • TBW in male?
  • TBW in female?
A

Water

  • 60% of TBW in male
  • 50% of TBW in female
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3
Q

Serum Osmolality Equation

A

(2 x Na) + (Glu/18) + (BUN/2.8)

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4
Q

ECF

  • % of TBW?
  • 3 substances and % ?
A

ECF

  • 40% of TBW
  • Plasma - 20%
  • IF - 80%
  • Transcellulor fluid - <1%
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5
Q

ICF

  • % of TBW
  • 1 substance
A

ICF

  • 60% of TBW
  • cytosol
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6
Q

ECF Osmolality

-concentration of ?

A

ECF Osmolality

-Concentration of Sodium Salts

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7
Q

ICF Osmolality

-concentration of ?

A

ICF Osmolality

-Concentration of Potassium Salts

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8
Q

4 Principles of Regulation

A
  • Homeostatic mechanisms respond to changes in ECF
  • No receptors directly monitor fluid or electrolyte balance
  • Water cannot be moved by active transport
  • Losses do not equal gains cause imbalance
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9
Q

Hypothalmic osmoreceptors

-what do they do?

A

Hypothalmic osmoreceptors

-monitor plasma volume + osmotic concentration

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10
Q

How does water move through membrane?

A
  • water follows salt by osmosis

- other mechanisms - ADH, Thirst Stimulate

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11
Q

Daily Water input

  • Amount total?
  • Amount in Food?
  • Amount in Drink?
  • Amount in Metabolic generation?
A

Daily Water Input

  • 2500ml Total
  • Food-1000ml
  • Drink-1200ml
  • Metabolic generation - 300ml
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12
Q

Daily Water Loss
Sensible- whats it mean?
Urine - Amnt ?
Stool - Amnt ?

A

Daily Water Loss
Sensible - can be measured
Urine - 1200ml
Stool - 150ml

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13
Q

Daily water Loss
insensible - meaning?
Respiratory - amnt?
Transcutuneous evaporation - amnt?

A

Daily Water Loss
Insensible - cannot be measured
Respiratory - 400ml
Transcutaneous evaportation - 750ml

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14
Q

What determines Fluid exchange between plasma and IF

A

-Determined by net colloid osmotic pressure vs. net hydrostatic osmotic pressure

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15
Q

Decreased Net Colloid Pressure

-Disease + Symptoms ?

A

Decreased Net Colloid Pressure

  • Hypoalbunemia - Low Blood Albumin
  • Liver Disease
  • Increased accumulation of IF
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16
Q

Increased Net Hydrostatic Pressure

-Diseases + symptoms + causes ?

A

Increased Net Hydrostatic Pressure

  • Heart Failure
  • Renal Failure (oliguria or anuria)
  • Increased accumulation of IF
  • Lymphatic obstruction
  • Increased capillary permeability
17
Q

Fluid Shifts

  • what speed?
  • in response to what?
  • how long until equilibrium?
  • what direction in relation to osmolality?
A

Fluid Shifts

  • occur rapidly
  • in response to changes in osmotic concentration of the ECF
  • Oppose the change in osmolality
18
Q

Sodium Balance and ECF Volume

-what balances Na+ content in ECF?

A

Sodium Balance and ECF Volume

  • Na content in ECF is balanced between dietary Na intake and Renal Na excretion
  • change in Na content does not equal a change in Na concentration
  • changes in Na content lead to changes in corresponding gain/loss of water which keeps the concentration constant
19
Q

Euvolemia?

Euvolemic?

A

-Normal fluid volume in both TBW and intravascular

20
Q

Hypervolemia

A
  • excess fluid volume
  • in intravascular space and interstitual fluid (edema)
  • AKA fluid overload, volume overload, wet.
21
Q

Hypovolemia

A
  • Decreased fluid volume
  • Total body water (dehydration)
  • Intravascular (volume depleted)
22
Q

Physical Exam Findings

A
  • Behavior
  • Skin turgor
  • Skin moisture
  • Capillary refill
  • mucus membranes
  • peripheral pules
  • extremites
  • Blood pressure
  • Lungs
  • External jugular vein
  • Weight
23
Q

Laboratories Findings

A
  • Serum Sodium
  • Serum Osmolality
  • Urine specific gravity
  • BUN:SCr ratio
  • Hemoglobin/hematocrit
24
Q

Subjective Findings

A
  • Thirst

- Dizziness

25
Q

Dehydration Manifestations

A
  • increased plasma osmolality
  • increased sodium
  • increased BUN:Cr > 20
  • Urine specific gravity >1.020
  • CNS Disturbances
  • -Irritable->hypeirritable->lethargic
  • Excessive Thirst
  • Dry mucous membranes –Decreased skin turgor
  • Concentrated Urine
  • Weight loss
26
Q

TBW Depletion

A

-Loss of hypotonic fluid from all body fluid compartments

27
Q

Dehydration Causes

A
  • Inadequate oral intake in elderly
  • Increased insensible losses
  • Diabetes
  • Insipidus
  • Osmotic diuresis
  • Impaired renal concentrating mechanisms
28
Q

Intravascular Volume depeletion:

ECF Depletion

A
  • Loss of isotonic fluid
  • No primary disturbance of plasma osmolality
  • tends to be more acute and require more aggressive treatment
29
Q

Intravascular Volume depeletion causes

A
  • External fluid losses
  • -burns
  • -hemorrhage
  • -GI Losses
  • Third Spacing
  • -Sepsis
  • -Ascites
30
Q

Intravascular Volume Depletion PE Findings

A
  • Orthostatis
  • Tachycardia
  • Acute Weight loss (3-10%)
  • decreased urine output ->anuria
  • increased hematorcrit
  • BUN:SCr > 20
  • CNS Disturbances
  • -irritable -> hyperirritable -> lethargic
  • Skin tenting
  • Dry mucus membranes
  • Delayed capillary refill (2 to >4 seconds)
  • weak or not palpable pules
  • external jugular vein not visible
31
Q

Intravascular volume depletion labortory findings

A
  • Serum sodium - within normal limites
  • Serum osmolality - WNL
  • Urine specifc gravity - WNL
32
Q

Intravascular Volume Depletion Subjective Findings

A
  • Thirst

- Dizziness

33
Q

Hypervolumia

-symptoms?

A
  • increased blood pressure
  • moist skin
  • jugular venous distension
  • peripheral edema
  • –clinically detectable increased in interstitial fluid volume – at least 2.5-3L excess in adults
  • –usually due to heart, renal, or hepatic failure
  • hypoxia
  • orthopenwa
  • shortness of breath
  • dyspnea on exertion
  • we
34
Q

Peripheral edema

  • whats it found in
  • clincal detections
  • causes
A
  • manifestation of hypervolemia
  • detectable in increased interstitual fluid volume
  • 2.5-3L
  • usually due to heart, renal, or hepatic failure

Patho (5 decks)

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