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Urinary > Self Study Of Fluid Movement > Flashcards

Self Study Of Fluid Movement Flashcards

1
Q

What happens to a patients ECF when given an infusion of Sodium chloride 0.9%

A

Volume will increase, osmolality will remain unchanged

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2
Q

when given an infusion of Sodium chloride 0.9% , What will happen to the osmolality of the ICF

A

Remain unchanged

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3
Q

Will water move from ICF compartment to ECF compartment when a patient is given an infusion of 1L sodium chloride 0.9%

A

No

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4
Q

What will happen to plasma protein conc and haematocrit when a patient is given an infusion of 1L sodium chloride 0.9%

A

Nothing

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5
Q

Will a patients RBCs be swollen when a patient is given an infusion of 1L sodium chloride 0.9%

A

No

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6
Q

What will happen to a patients arterial BP when a patient is given an infusion of 1L sodium chloride 0.9%

A

It will increase

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7
Q

What happens to ECF in a patient with severe diarrhoea

A

ECF volume decreases, osmolality increases, water shifts from ICF to ECF

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8
Q

What happens to plasma protein and haematocrit as a result of diarrhoea

A

Will increase

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9
Q

Will a patient with diarrhoea have swollen RBCs

A

No

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10
Q

What does severe diarrhoea do to bp

A

Decrease it

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11
Q

What happens to ECF in a man who consumed an XS amount of NaCl

A

ECF Volume increases, ECF osmolality increases, ICF osmolarity increases, water shifts from ICF to ECF

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12
Q

What is the major cation in sweat

A

Sodium

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13
Q

What happens to ECF as a result of 24 hours in desert with no water

A

Osmolality of ECF will have increased due to loss of fluid in sweat

Water will shift from ICF to ECF, osmolarity of ICF increases, volume of ICF decreases

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14
Q

Osmotic Properties of sweat

A

Hyperosmotic in comparison to plasma

Increased osmotic pressure as a greater amount of solutes in solution than plasma

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15
Q

what happens to ECF in a patient with SIADH

A

Osmolality of ECF will decrease due to increased retention of water

ICF and ECF volumes increase = Hyponatraemia

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16
Q

What happens to ECF protein conc in SIADH

A

Decreases

17
Q

Physical findings expected in a man who has just run a marathon in high heat

A

Dehydrated: conjunctiva and mucous membranes are dry, increased skin turgor

Tachycardia, increased RR,

hyperventilation (respiratory compensation due to acidosis caused by dehydration)

Hypotension

18
Q

What is the effect on blood volume and pressure of a significant decrease in water and salt

A

Bp and BV decrease

Sweat decreases ECF, increases osmolarity

Kidneys retain extra Na+ and water to compensate

Dehydration reduces ECF

19
Q

What causes high pulse rate in dehydration

A

Compensatory mechanism along with vasoconstriction by the sympathetic reflex as a response to decreased circulating volume

20
Q

What causes dizziness and light-headedness in dehydration

A

Reduced brain perfusion

21
Q

How could a dehydrated person develop an AKI

A

Hypovolemic and low BP
Dehydration causes reduced blood flow to kidneys, build up of waste/acid/myoglobin
Renal perfusion is inadequate, acid-base balance not maintained

22
Q

Biochemical changes in AKI

A

Increased: plasma urea, creatinine, urate, potassium, phosphate

Metabolic acidosis

Increased anion gap

Decreased: plasma calcium, sodium

23
Q

What fluid should be given to someone with AKI due to dehydration

A

Not strong hypotonic as would help cells but not blood volume, dont want to exceed sodium and chloride requirements

Want to increase circulating volume, cardiac output and perfusion pressure

Give 0.9% NaCl

24
Q

Why would blood not be the correct treatment for AKI due to dehydration

A

Needs electrolytes and large volumes of fluid not blood

25
Q

What would happen to someone given hypertonic saline

A

Too much NaCL
ECF volume increased
Water drawn out of ICF into ECF
Cell volume decrease
Cell shrinkage

26
Q

Which 2 physiological mechanisms exist to help maintain plasma osmolality

A

Thirst, ADH

27
Q

Which of the two physiological mechanisms that control plasma osmolality is the first line of defence

A

ADH

Osmotic threshold for ADH secretion is lower than thirst

Thirst only invoked if ADH cannot handle alone

28
Q

Where is the hormone that regulates water reabsorption made

A

Hypothalamus

29
Q

Where after synthesis is ADH stored

A

Neuro-hypophysis or posterior pituitary

30
Q

What is the most important physiological effect of ADH

A

Conserve body water by reducing water loss in urine

Increases urea recycling: aids in maintenance of medullary conc. grad so allows maximum water to be reabsorbed from CD

31
Q

Describe action of ADH in kidney

A

Binds to receptor on basolateral membrane of principal cells in CD

Coupled to G proteins, promotes insertion of Aquaporin-2 channels on apical membrane

No ADH = CD virtually impermeable to water, water excreted as dilute urine

Always a little released

Urinary (20 decks)

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