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Year 1 CPR I. Exam 2 > Session 1 Renal Physiology > Flashcards

Session 1 Renal Physiology Flashcards

1
Q

Osm. Changes from Diarrheas and Burns

ECF Volume

ICF Volume

Osm.

Hct

Plasma Protein

A

Isosmotic volume contraction

ECF Volume: decrease

ICF Volume: No Change

Osm.: No Change

Hct: Increase

Plasma Protein: Increase

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2
Q

Osm. Changes from Sweating, Fever, or DI

ECF Volume

ICF Volume

Osm.

Hct

Plasma Protein

A

Hyperosmotic Volume Contraction

ECF Volume: Decrease

ICF Volume: Decrease

Osm: Increase

Hct: No Change

PLasma Protein: Increase

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3
Q

Osm. Changes from Adrenal Insufficiency

ECF Volume

ICF Volume

Osm

Hct

Plasma Protein

A

Hyposmotic Volume Contraction

ECF Volume: Decrease

ICF Volume: Increase

Osm: Decrease

Hct: Increase

Plasma Protein: Increase

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4
Q

Osm. Changes from Infusion of Isontonic NaCl

ECF Volume

ICF Volume

Osm

Hct

Plasma Protein

A

Isosmotic volume Expansion

ECF Volume: Increase

ICF Volume: No Change

Osm: No Change

Hct: Decrease

Plasma Protein: Decrease

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5
Q

Osm Changes from High NaCl Intake

ECF Volume

ICF Volume

Osm

Hct

Plasma Protein

A

Hyperosmotic Volume Expansion

ECF Volume: Increase

ICF Volume: Decrease

Osm: Increase

Hct: Decrease

Plasma Protein: Decrease

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6
Q

Osm Changes from SIADH

ECF Volume

ICF Volume

Osm

Hct

Plasma Protein

A

Hyposmotic Volume

ECF Volume: Increase

ICF Volume: Increase

Osm: Decrease

Hct: No Change

Plasma Protein: Decrease

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7
Q

What is hyponatremia?

What sx are assx with it?

A

serum Na levels below 130-135

decreases ECF osmotic pressure and water moves into cells

causes hypovolemia and cell swelling, edema, depression, confusion, weakness, cramps, nausea, diarrhea, hypotension, tachycardia, oligouria

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8
Q

What is hypernatremia?

What sx are assx with it?

A

Na levels above 147-150

water moves from ICF to ECF causing cells to shrink

causes edema and HTN, weakness and hyperreflexia, thirst, oligouria, confusion, coma

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9
Q

what is in charge of changing volume status?

What is in charge of changing Na Concentration and Osmolarity?

A

Na balance

H2O balance

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10
Q

What occurs in hyposmotic volume expansion?

A

gain of hypotonic fluid

assx with excessive water drinking and SIADH

increases ECF and ICF, decrease in body osm.

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11
Q

What occurs with hypertonic volume expansion?

A

ECF volume increases, ICF volume decreases, osm increases

tranisently ECF osm. increases so volume shifts from ICF to ECF until equil.

Assx with high NaCl intake

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12
Q

What occurs with Isotonic Volume Expansion?

A

ECF volume expands, ICF does not change, osm. does not change

Assx with isontonuc saline injection of Na Cl

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13
Q

What occurs with hyposmotic volume contraction?

A

ICF volume increases, ECF volume decreases, Osm decreases

Assx. with adrenal insufficiency due to loss of aldosterone leading to excessivr loss of NaCl in urine

Transient response is that ECF osm. decreases and fluid shifts to ICF until osm. equil.

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14
Q

What occurs with hyperosmotic volume contraction?

A

Hypotonic fluid loss conditions like dehydration, DI, and alcoholism

insensible water loss of ECF, solute left behind and becomes concentrated

decrease in ECF volume and ICF volume, with increase in body osm.

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15
Q

What occurs in isosmotic volume contraction?

A

acute fluid loss like hemorrhage, diarrhea, vomiting

diarrhea causes loss of isosmotic fluid from GI tract

decrease in ECF volume and no change in body osmolality and ICF volume

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16
Q

Crystalloid Replacement Therapy do not cross what?

A

Do not cross plasma membranes

Remains in the ECF

Ex: Normal Saline, Lactated Ringers, DSW

17
Q

Colloids Replacement Therapy don’t pass through what?

A

Large molecules in colloids don’t pass through semipermeable membrane

work by drawing fluid from extravascular spaces via their higher oncotic pressure

Ex: HES, albumin

18
Q

ECF volume loss results in increased plasma protein AKA

A

concentration

a gain in ECF volume causes a decreased plasma protein count (dilution)

19
Q

Isotonic

Hypertonic (salty environment)

Hypotonic (watery environment)

A

Isotonic: equal movement of water in and out

Hypertonic: net movement of water out of cells, shrinks

Hypotonic: net movement of water into cells, swells

20
Q

Edema can be caused by alteration in capillary hemodynamics causing fluid to move from vascular spaces into the

A

interstium

has to increase by 2-3 L

compensatory renal retention of Na nad water to maintain plasma volume in response to underfilling of vasculature must occur to cause the edema

Ex: CHF

21
Q

Edema caused by renal retnetion of dietary Na and water causing an expansion of ECF volume is often due to

A

inappropriate renal fluid retention

usually increases BP, expands plasma and intersitital volume

assx with primary renal desease

causes non-pitting edema (increased ICF volume) or pitting edema (increased interstitial ICF vlume)

tx with diuretics

22
Q

Gibbs Donnan Effect

A

Protein particles create an oncotic gradient favoring the movement of water into cells

negative charges on proteins create an electrical environment favoring movement of charges into the cell

Cumulative effect is the Gibbs Donnan Effect

23
Q

Calculate Osm

A

2[Na] + Glucose/18+BUN/2.8

or 2xNa

24
Q

60-40-20

A

60% of body weight is total body water

40% of body weight (2/3 of TBW) is ICF

20% of body weight (1/3 of TBW) is ECF

25
Q

What are the four mechanisms that can cause polyuria?

A
  1. increased intake of fluids (psych, anxiety, stress)
  2. increased GFR from hyperthyroid, hypermetabolic, fever
  3. increased output of solutes from DM, hyperthyroid, hyperparathyroid, diuretics
  4. inability of kidney to reabsorb water in DCT from CDI, NDI, drugs, and CRF
26
Q

What is water diuresis?

A

increased water excretion without correspoding increase in salt excretion

assx with polydipsia and DI

27
Q

What is solute diuresis?

A

increased water excretion concurrent with increased salt excretion

caused by increased salt present in tubular fluid from IV NaCl, hyperglycemia, high protein intake, recovery from AKI

Year 1 CPR I. Exam 2 (33 decks)

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