Renal Flashcards
Total body water is …. .percent of body weight, consists of ….. ECF and …. ICF
ECF is …. plasma & ….. ISF
60 1/3 2/3 1/4 3/4
The osmolarity of plasma is …… than that of ISF, because of …….
higher, plasma proteins
Transcellular fluid includes ……
CSF, ocular, urine ….
Why NaCl solutions is confined to the ECF??
because of the activity of the Na-K pump
What is the function of :
- Isotonic NaCl
- Hypertonic NaCl
- Hypotonic NaCl
- Increases ECF by the same amount administered
- Increases ECF volume by extracting from ICF
- Increases both ECF and ICF
Hypertonic solution of mannitol is used in patients with …..
cerebral edema to mitigate brain swelling
* mannitol acts like NaCl
Edema is caused by movement of fluid from ….. to ……
plasma to ISF , and retention of salt and water by kidney
Distribution of edema depends on …… & …..
- tissue tension: lowest around the eyes and medial side of the ankle
- forces of gravity
Capillary pressure is more affected by increased venous pressure than arterial, because ……….
it is protected from the arterial pressure by the precapillary sphincter (which respond to increased pressure by constriction)
Forces promoting efflux are ……, while the ones promoting influx are …….
Pc & πi
Pi & πc
* π is the oncotic pressure
* fluid movement = Kf [(Pc + πi) - (Pi + πc)]
* Kf is the capillary permeability constant
Why patients with high blood pressure but no heart failure do not develop edema??
because of the presence of the precapillary sphincter. So the venous pressure remains relatively low
* Veins are more permeable than arteries
Anasarca is caused by …….
drop in capillary oncotic pressure
* An increased πi causes localized edema
The main causes of edema are ….. , ….., ….. & ……
increase Pc
decreased πc
increased permeability
blockage of the lymphatic draingae
Glomerulonephritis causes …….. retention due to ……… . The main cause for the retention…..
NaCl & water retention
damaged kidney
reduced GFR
* The water & NaCl retention is primary, not secondary like congestive heart failure
Decreased GFR leads to increased …..
Capillary pressure
- This leads to increased vascular volume, EDV, CO, hypertension, transudation of fluids and edema
- Hypertension inhibits renin release
In glomerulonephritis, increased CVP leads to release of ….. from the atria
ANF, which acts on the collecting duct to inhibit Na reabsorption
Liver cirrhosis may lead to the development of ascites caused by ……
Hypoalbuminemia leads to …..
fibrosis and mechanical venous obstruction
decreased oncotic pressure allowing fluid to leak out of the capillaries, and causing generalized edema
Define nephrotic syndrome
The loss of more than 3.5 g protein/day in urine, which is the maximum amount the liver can produce in an adult
Leads to generalized edema, and secondary salt/water retention
What is the difference between edema in nephrotic syndrome and edema in glomerulonephritis??
Glomerulonephritis: caused by increased Pc
Nephrotic syndrome: decreased πc with secondary decreased Pc
Burns act on the capillary wall causing …… and locally increased ….. in the tissues
increased permeability
πi (from protein transudation)
* This leads to localized edema
Nephritic syndrome is ……
inflammation of the glomerulus allowing proteins and RBC to pass into urine. Signs are hematuria, proteinuria, oliguria, edema, azotemia (reduced waste elimination), hypertension). GFR is reduced
* Proteinuria here is less severe than nephrotic syndrome
Filariasis is caused by ……..
Wuchereria bacrofti
* blocking of the lymphatic channels causes elephantitis
Radical mastectomy involves the removal of …….
the breast, the underlying muscle & axial lymph node
* Leads to local edema
Decreased activity of the Na-K pump leads to ……..
cellular swelling