Renal Exam 4 Images Flashcards
All volume contraction and expansion States
KNOW THESE
basic principle
at steady state, ECF osm= ICF osm
to achieve this equality, water shifts b/w ECF and ICF through (aquaporins)
NaCL and mannitol are confined to:
ECF
what is this state?
What happens to ECF/ICF volume and osm?
Blood pressure?
adrenal insufficiency - Loss of NaCl AKA: hyposmotic volume contraction”
Addison’s
- ECF osm decreases (d/t lack of Aldosterone; kidneys excrete more NaCl than water)
- ECF vol decreases. (water shifts IN to the cell)
- ICF osm decreases until = to ECF osm
- ICF vol INCREASES
=BP decreases d/t decrease in ECF
what is this state?
what happens to ECF/ICF volume and osm?
Blood pressure?
-Diarrhea - loss of isotonic fluid “isomotic volume contraction”
**also in burns**
- ECF volume decreases
- ECF and ICF osmolarity does not change
- no shifting of fluid b/w ECF/ICF
- BP = decreases
what is this state?
what happens to ECF/ICF volume and osm?
Blood pressure?
Infusion of isotonic NaCl - addition of isotonic fluid
“Isosmotic volume expansion”
- ECF volume increases
- ECF/ ICF osm does not change (water does not shift b/w compartments)
- RBCs are isotonic (no swelling/shrinking)
- BP increases (b/c ECF vol increases)
what is this state?
what happens to ECF/ICF volume and osm?
Blood pressure?
Excessive sweating - lost in the desert **DIABETES INSIPIDUS**
“Hyperosmotic volume contraction”
- ECF osm increases (sweat is hyposmotic; more water than salt loss)
- ECF vol decreases (loss of water)
- ICF osm increases (water shifts out until osm equal to ECF)
- ICF vol decreases
- both extra and intra cellular dehydration
- BP would likely decrease some
-
what is this state?
what happens to ECF/ICF volume and osm?
Blood pressure?
Excessive NaCl intake - addition of NaCl ; Hyperosmotic volume expansion
“eating a bag of potato chips”
- ECF vol increases
- ECF osm increases
- ICF vol DECREASES (water shifts from ICF to ECF)
- ICF osm increases
what is this state?
what happens to ECF/ICF volume and osm?
Blood pressure?
SIADH - gain of water or infusion of _hypo_tonic solution
“Hyposmotic volume expansion”
- ECF volume increases (d/t water retention)
- EFC osm decreases (d/t water retention)
- ICF volume increases
- ICF osm decreases (until =to ECF osm)
Know what drug works where
Buffer systems
MOA of Acetazolamide
MA of acetazolamide:
INCREASED Na+ excretion due to DECREASED Na+/H+ exchange
