Renal 1

Question 1

Constant (2)
of body fluid compartments are essential
for homeostasis:

Answer 1

volume and stable composition

Question 2

Constant volume and stable composition
of body fluid compartments are essential
for homeostasis:
“A frequent problem in treating seriously
ill patients is…

Answer 2

maintaining adequate fluids
in one or both of the intracellular and
extracellular compartments.”

Question 3

Water in =

Answer 3

Water out

Question 4

Electrolytes in =

Answer 4

Electrolytes out

Question 5

pH =

Answer 5

7.4

Question 6

Fluid distribution in the body influences — concentrations

Answer 6

electrolyte

Question 7

Electrolyte concentrations influence

Answer 7

fluid distribution in the body.

Question 8

Na+

–Imbalance changes

Answer 8

vascular and total body

volumes

Question 9

K+

–Imbalance alters

Answer 9

cardiac and neural functions

Question 10

Ca++

–Imbalance alters (3)

Answer 10

skeletal muscle, cardiac, neural 
function and bone structure

Question 11

H+ (mainly from metabolism)

–Imbalance alters

Answer 11

multiple systems

Question 12

Total body water

volume is

Answer 12

42L,
~60% body
weight (kg)

Question 13

Plasma & Interstitial fluid mix rapidly (except proteins): (2)

Answer 13

• Hydrostatic and colloid osmotic pressure via capillary pores is
  main force.
• Bulk flow

Question 14

Fluid distribution between ICF & ECF determined by osmotic effect
of small solutes acting across cell membrane: (2)

Answer 14

• Na+ and Cl- (other anions) ≈ 90% of total ECF osmolarity

- K+ and other ions ≈ 90% of total ICF osmolarity.

Question 15

Cell membrane: (2)

Answer 15

• high permeability to H2O;
• relative impermeability to small solutes (Na+, Cl- & other
  electrolytes) .

Question 16

Cell volume is at the

mercy of

Answer 16

ECF tonicity

Question 17

ECF (2) Constantly

Challenged

Answer 17

Osmolarity and

Volume

Question 18

Daily life (2)

Answer 18

Eat and drink

Do not eat and drink

Question 19

skipped

Conditions/Illnesses (4)

Answer 19

Vomiting, diarrhea
Burns and other causes of 
skin loss
Heat-induced sweating
Renal disease

Question 20

Composition and volume of ECF change determines

Answer 20

composition and volume of fluid replacement

Question 21

The kidneys regulate body
fluid volume and composition
by controlling (2)

Answer 21

ECF volume and

composition.

Question 22

Edema

Answer 22

• Too much water in

tissues.

Question 23

— edema
much more common
than —.

Answer 23

Extracellular

intracellular

Question 24

Intracellular Edema

Causes: (3)

Answer 24

1. Hyponatremia.
2. Decreased metabolism (blood flow): Na+/K+
   pump failure.
3. Inflammation (infection, burns) – increased
   membrane permeability and leakage.

Question 25

--- is the most important cation in the body

Answer 25

Na

Question 26

Na salts make ip >---% of osmotically active solute in the ECF

Answer 26

90

Question 27

Na (and hence ECF volume) is highly

Answer 27

regulated

Question 28

too little ECF leads to (3)

Answer 28

volume contraction, hypotension and organ hypoperfusion

Question 29

too much ECF leads to (4)

Answer 29

edema, ascites, pleural effusions, hypertension

Question 30

Hyponatremia (3)

Answer 30

 [Na+]ECF is below normal (<142 mOsm/L)  Na+ input < Na+ output  H2O input > H2O output

Question 31

``` Hyponatremia types (3) ```

Answer 31

1. Hyponatremia-dehydration 2. Hyponatremia-overhydration 3. Hyponatremia–low solute intake

Question 32

Most common electrolyte disorder in clinical practice May account for ---% of hospitalized patients.

Answer 32

Hyponatremia 20-25

Question 33

1. Hyponatremia-dehydration (2)

Answer 33

- Increased NaCl loss - Vomiting, diarrhea; renal disease, diuretics; Addison’s disease (aldosterone deficiency).

Question 34

2. Hyponatremia-overhydration (2)

Answer 34

- Excess H2O retention | - Inappropriate ADH secretion, H2O Toxicity

Question 35

3. Hyponatremia–low solute intake (2)

Answer 35

- Decreased NaCl intake | - Extreme diets

Question 36

Chronic Hyponatremia (5)

Answer 36

```  Gradual decrease in [Na+]ECF  This stimulates transport of Na+, K+, and organic solutes out of the cells  This causes water diffusion out of the cells  With chronic hyponatremia, the brain swelling is attenuated by the transport of solutes from the cells.  Must correct [Na+]ECF slowly to avoid osmotic demyelination ```

Question 37

Acute hyponatremia (4)

Answer 37

 Rapid decrease in [Na+]ECF  Caused by loss of Na+ or excess H2O  H2O into the cells  Swelling of the brain tissue.

Question 38

Increased interstitial fluid volume (swelling) caused | by: (2)

Answer 38

Increased capillary filtration (most common; congestive heart failure) Failure of lymphatics to return interstitial fluid to circulation (lymphedema)

Question 39

Kf α

Answer 39

(SA)(Membrane Permeability)

Question 40

Filtration Rate =

Answer 40

Kf ((Pc + Piif) – (Pif + Pic ))

Question 41

Common Causes of Extracellular Edema (3)

Answer 41

Capillary permeability Increased capillary hydrostatic pressure Decreased capillary colloid osmotic pressure

Question 42

Capillary permeability (3)

Answer 42

–Inflammation (infection, immune reactions) –Burns –Ischemia

Question 43

Increased capillary hydrostatic pressure (2)

Answer 43

–Heart failure (generalized vs left heart failure) | –Renal disease

Question 44

Decreased capillary colloid osmotic pressure (2)

Answer 44

–Renal loss (nephrotic syndrome) | –Liver disease

Question 45

“Potential spaces” – (4)

Answer 45

pleural, pericardial, | peritoneal, synovial cavities.

Question 46

Lining membranes are highly ---.

Answer 46

permeable

Question 47

Lymphatic drainage important for

Answer 47

clearing fluid | and proteins.

Question 48

Ascites is an example of “---.”

Answer 48

effusion