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Endocrine > Sodium and Water Balance > Flashcards

Sodium and Water Balance Flashcards

1
Q

What are the sizes of the intracellular and extracellular fluid compartments compared to each other?

A

the intracellular compartment is double the size of the ECF

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2
Q

Why are the sizes of the compartments clinically significant?

A

water loss is distributed across compartments so the cinical signs of water overload or deficit are muted or dilluted- you can lose a lot of water without being clinically dehydrated.

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3
Q

What are the concentraionts of sodium like in the ICF and ECF?

A

sodium in the blood is 140mmol/l whereas in the cells this is 4mmol/l

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4
Q

How do the concentrations of Na in the ICF and ECF compare with K?

A

potassium is the opposite, is very high in the ICF, but low in the ECF

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5
Q

What are the signs of a decreased ECF volume?

A

postural hypotension; increased HR; dry mucous membranes; decreased skin turgorl decreased consciousness; decreased urine output

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6
Q

What does mineralocorticoid activity refer to?

A

sodium retention in exchange for potassium and/or hydrogen ions

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7
Q

What is the main steroid with mineralocorticoid activity?

A

aldosterone

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8
Q

How does renin release lead to aldosterone production?

A

renin converts angiotensinogen to angiotensin 1 which is converted to angiotensin 2 which works on the adrenal gland to stimulate aldosterone production.

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9
Q

What are the effects of angiotensin 2?

A

cardiac and vascular hypertrophy; sympathetic stimulation; causes thirst and acts on pituitary to increase ADH, works on adrenal cortex to release aldosterone–increased blood volume (sodium retention)

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10
Q

What controls water?

A

ADH

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11
Q

What is ADH released in response to?

A

osmotic and non-osmotic stimuli

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12
Q

What is ADH released from?

A

posterior pituitary

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13
Q

What is the other name for ADH?

A

arginine vasopressin

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14
Q

What are the 2 reasons for decreased sodium concentraion?

A

too little sodium or too much water

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15
Q

What are the 2 reasons for increased Na conc.?

A

too little water; too much sodium

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16
Q

What can too much water result from?

A

decreased excretion or increased intake

17
Q

What causes decreased excretion of water?

A

SIADH

18
Q

What hcauses increased intake of water?

A

compulsive water drinking

19
Q

What can too little sodium be caused by?

A

increased sodium loss of decresed sodium intake

20
Q

What are the options for increased sodium loss?

A

gut=obvious- vomiting and diarrhoae; skin- burns; kidneys eg adrenal insufficiency

21
Q

What is too little water caused by?

A

increased water loss; decreased water intake

22
Q

What causes increased water loss?

A

diabetes insipidus- problem with ADH secretion or action

23
Q

What are the causes of too much sodium?

A

very rare- near drowning in sea; infants given high-salt feeds; some IV medications

24
Q

What is Addison’s disease?

A

adrenal insufficiency

25
Q

What causes excessive pigmentation in Addison’s disease?

A

excess ACTH from pituitary (adrenal corticotrophic hormone- to try make more aldosterone) which is degraded into MSH- melanocyte stimulating hormone

26
Q

What are non-osmotic stimuli for ADH release?

A

hypovolaemia/hypotension; pain; N and V

27
Q

What causes diabetes insipidus?

A

there is disruption of the pituitary or infundibulum so patient cant secrete ADH from post. pituitary

28
Q

Why do you get high sodium conc. in diabetes insipidus?

A

no ADH so lose lots of water, but not sodium, so sodsium conc. goes up

29
Q

What does hypovolaemia in hyponatraemia indicate?

A

too little sodium

30
Q

What does oedema signify?

A

circulatin volume depletion

31
Q

What should be measured if adrenal insufficiency is suspected?

A

cortisol and ACTH

Endocrine (27 decks)

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