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Renal > Phys 1 > Flashcards

Phys 1 Flashcards

1
Q

What is the 60-40-20 rule?

A

60% of body weight is fluid
40% of body fluid is ICF
20% of body fluid is ECF

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2
Q

Where do all solutes and water that enter the body have to go first?

A

the ECF

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3
Q

What is the relationship between ECF and ICF?

A

they are in osmotic equilibrium (fluid moves between them with osmotic pressure gradient)

*equilibrium is typically reach by moving water, not solutes

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4
Q

What is third spacing?

A

problematic–>too much fluid shifts from the blood vessels into the nonfunctional area of cells

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5
Q

ECF vs. ICF in solute concentration

A

ECF: Na+, Cl-
ICF: K+

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6
Q

What is an electrolyte? non electrolyte?

A

a. dissociate into ions in water

b. contain covalent bonds that prevent them from dissociated in solution and therefore have no electrical charge

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7
Q

What is osmolality? osmolarity?

A
  1. measure of the number of osmotically active particles per kilogram H2O
  2. number of osmotically active particles per liter of total solution
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8
Q

What are the normal ranges of: Na+? Cl-? K+? Albumin? Creatinine?

A
  1. 135-147 mEq/L
  2. 95-105 mEq/L
  3. 3.5-5 mEq/L
  4. 3.5-5.5 g/dl
  5. .6-1.2 mg/dl
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9
Q

Blood contains ICF and ECF, what components do they represent?

A
  1. ECF: fluid in plasma
  2. ICF: fluid in RBCs

*decreased ECF–>{increased plasma protein]

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10
Q

Normal values of hematocrits

A

men: .40
women: .36

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11
Q

How does gains/losses of ECF and ICF affect hematocrit?

A
  1. ECF gain: decrease
  2. ECF loss: increase
  3. ICF gain: increase
  4. ICF loss: decrease
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12
Q

Gibbs-Donnan Effect

A

Presence of negatively charged proteins creates two events

  1. Protein particles create an oncotic gradient favoring the movement of water into the cell
  2. Negative charges on proteins creates an electrical environment, favoring movement of charges into the cell
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13
Q

How do we counteract the Gibbs-Donnan Effect?

A

Na/K ATPase (pumps Na out of the cell, so water doesn’t flood the cell)

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14
Q

What two factors make the free movement of fluid possible?

A
  1. water molecules diffuse through capillary walls faster than blood
  2. there is a pressure difference between the inside and outside of the vessels
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15
Q

What way does hydrostatic pressure move fluid? plasma colloid osmotic pressure?

A
  1. capillary–>interstitial fluid (called filtration)

2. interstitial fluid–>capillary (called absorption; helped by albumin)

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16
Q

Define: isotonic, hypertonic, hypotonic

A
  1. isotonic: cell environment has a NaCl concentration equal to .85%
  2. hypertonic: cells environment has a NaCl concentration greater than .85% (in hypertonic solution, cells shrink)
  3. hypotonic: cells environment has a NaCl concentration less than .85% (in hypotonic solution, cells swell)
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17
Q

What is dextrose 5% in water (DSW) used for?

A

it’s isotonic, so for fluid loss, dehydration, hypernatraemia

18
Q

What is .9% sodium chloride used for?

A

it’s isotonic, so shock, hyponatraemia, blood tranfusions, resuscitation, fluid challenges, diabetic keto acidosis

19
Q

What is Lactated Ringer’s used for?

A

it’s isotonic, so dehydration, burns, lower GI fluid loss, acute blood loss, hypovolemia due to th ird spacing

20
Q

Osmolarity=

A

(2Na) + (glucose/18) + (BUN/2.8)

*easiest: plasma osmolality=2Na

21
Q

Hypotonic dehydration

A
  • loss of Na is greater than the loss of water in ECF
  • serum sodium [] in the ICF is greater than that of the ECF
  • water shifts from ECF to ICF, and serum sodium/osmolality will be less than the normal range
22
Q

Hypertonic dehydration

A
  • loss of water is great than loss of Na+ in ECF
  • serum Na [] in the ECF is greater than in the ICF, so water shifts from the ICF to the ECF
  • serum osmolality will exceed 300, and sodium 150
23
Q

Hyponatremia

A
  • serum sodium level below 130-150mEq/L
  • water moves form the ECF to the cells, and this increased ICF leads to edema, brain cell swelling, depression, nausea…
24
Q

Hypernatremia

A
  • serum sodium is above 147-150mEq/L

- water moves ICF–>ECF, which causes intracellula dehydration and this causes edema and increased BP

25
Q

what is volume contraction? volume expansion?

A
  1. decrease in ECF volume (decreased BV and BP)

2. increase in ECF volume (increased BP and edema)

26
Q

What changes are seen with: iso-osmotic volume contraction? hyper-osmotic volume contraction?

A
  1. decreased ECF

2. decreased ECF and ICF volume, but increased osmolality

27
Q

What changes are seen with: iso-osmotic volume expansion? hyper-osmotic volume expansion?

A
  1. increased ECF

2. increased ECF and ICF, but decreased osmolality

28
Q

Markers for: total body water

A

3h2o, 1h2o, antipyrine

29
Q

Markers for: ECF

A

inulin, thiosulfate, 22Na, 125 I-iothalamate

30
Q

Markers for: ICF

A

TBW-ECF

31
Q

Markers for: plasma

A

125-albumin, evans blue dye (T-1824)

32
Q

Markers for: blood

A

51Cr labeled RBCs, or BV=plasmaV/(1-hematorcrit)

33
Q

Markers for: interstitial fluid

A

ECF-plasma

34
Q

ECF is normally regulated by changes in what? serum osmolarity?

A
  1. Na+ balance (changes volume status)

2. H2O (changes in water–>changes in osmolarity and Na+ concentration)

35
Q

Volume contraction

A

decrease in ECF–>decreased BP/BV

36
Q

Volume expansion

A

increase in ECF–>increased BP and edema

37
Q

Examples of iso osmotic volume contraction

A

hemorrhage, diarrhea, vomitting

38
Q

Examples of Hyper-osmotic volume contraction

A

dehydration, diabetes insipidus, alchoholism

39
Q

Examples of iso osmotic volume expansion

A

infusion with isotonic saline solution

40
Q

Examples of hypo osmotic volume expansion

A

excess water drinking, SIADH

Renal (8 decks)

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