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2 Endocrine > Sodium and Water Balance > Flashcards

Sodium and Water Balance Flashcards

1
Q

how would you work out the concentration of sodium ions

A

mmol Na / H2O in litres

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2
Q

what 2 factors imbalancing the sodium equation are the causes of hyponatraemia?

A

too little sodium OR

too much water

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3
Q

what 2 factors imbalancing the sodium equation are the causes of hypernatraemia?

A

too much sodium OR

too little water

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4
Q

where is ADH made?

A

posterior pituitary

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5
Q

which part of the pituitary gland has its own blood supply?

A

posterior

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6
Q

below what level is sodium a big problem?

A

120mmol/l

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7
Q

symptoms of low sodium?

A 
DEHYDRATION
nausea
altered consciousness
confusion
vomiting
fitting
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8
Q

when could sodium levels be serious when they are at a normal level?

A

if they have fallen rapidly

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9
Q

most common biochemical abnormality?

A

hyponatraemia

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10
Q

what are the 2 main fluid compartments of the body?

A

extracellular intracellular

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11
Q

what is the extracellular fluid compartment made up of?

A

plasma

interstitial fluid

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12
Q

how big is the ICF compared to the ECF?

A

double the size

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13
Q

what compartment is water confined to?

A

none

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14
Q

what happens to the compartments when water is lost from the body?

A

the loss is distributed through all compartments

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15
Q

what effect does water loss have on the body and why?

A

not very symptomatic because water is spread through all compartments

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16
Q

how much sodium is in the ECF?

A

140mmol/l

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17
Q

how much sodium is in the ICF?

A

4mmol/l

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18
Q

how much potassium is in the ICF?

A

140mmol/l

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19
Q

how much potassium is in the ECF?

A

4mmol/l

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20
Q

main aim of the sodium potassium pump?

A

confine sodium to the ECF and potassium to the ICF

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21
Q

what does the body do if ECF volume is too high?

A

kidneys excrete more sodium so you lose water too

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22
Q

how are sodium and water related?

A

water follows sodium everywhere

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23
Q

what may be the only sign of hyponatraemia caused by excess water?

A

peripheral oedema due to water moving into the ICF

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24
Q

how is hyponatraemia caused by too little sodium treated?

A

IV saline or sodium PO

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25
Q

how is hyponatraemia caused by too much water treated?

A

fluid restriction

26
Q

activity of what hormone controls sodium movement?

A

mineralocorticoids (cortisol and aldosterone)

27
Q

what would happen to sodium if mineralocorticoid activity was low?

A

sodium loss

28
Q

what would happen to sodium if mineralocorticoid activity was too high?

A

sodium retention

29
Q

what would happen to eater if mineralocorticoid activity was low?

A

would lose water

30
Q

what hormone controls water?

A

ADH

31
Q

what kind of stimuli cause the release of ADH?

A

osmotic and non osmotic

32
Q

what does ADH do to the renal tubules?

A

causes them to reabsorb water

33
Q

what would your urine look like if you had alot of ADH?

A

concentrated urine

34
Q

what kind of osmolality would concentrated urine have?

A

high

35
Q

what kind of osmolality would dilute urine have?

A

low

36
Q

how does ADH cause water reabsorption?

A

countercurrent multiplication

37
Q

which limb of the loops of henle is permeable to water?

A

descending

38
Q

what is the only part of the loops of henle that does not extrue NaCl?

A

descending

39
Q

why is the ascending limb of the loops of henle impermeable to water?

A

it extrudes NaCl so it stops water going out with it

40
Q

what do the loops of henle extrude water into?

A

ICF

41
Q

what concentrations are the mediullary ICF and the loops of henle before any gradient is established?

A

both 300 milliosmoles/l

42
Q

when will the ascending limb of the loop of henle stop releasing NaCl?

A

when the ICF is 200 milliosmoles more concentrated than the ascending limb’s fluid

43
Q

when will the descending limb of the loop of henle stop releasing water?

A

until the osmolarities of the fluid in the descending limb and the ICF become equal

44
Q

name some non osmotic stimuli of ADH?

A

hypovolaemia/hypotension
pain
nausea/vomiting

45
Q

most common reason for having too much water in the body?

A

SIADH (failure to excrete water)

46
Q

most common reason for having too little sodium in the body?

A

increased Na loss

47
Q

what tissues is Na most commonly lost from?

A

adrenals
kidney
gut
skin eg burn

48
Q

most likely patients to get SIADH?

A

post op patients

49
Q

above what sodium level is considered to be serious?

A

> 160mmol/l

50
Q

symptoms of hypernatraemia?

A

vomiting
nausea
fitting

51
Q

main causes of hypernatraemia?

A

usually because of too little water:
h20 loss via diabetes insipidus OR
decreased H2O intake in extremes of age

52
Q

how would you know a patient has hyponatraemia from Na loss and not H2O increase?

A

if they are dehydrated and “dry”

53
Q

what happens when Na is low in SIADH?

A

retains water

54
Q

what should you give if hypernatraemia is caused by low water?

A

give water

55
Q

what should you give if there is too little sodium?

A

loop diuretic

56
Q

how does oedema cause electrolyte retention

A 
decreased protein
hydrostatic/oncotic balance disrupted
RAAS switched on =
electrolyte uptake
ADH retention
57
Q

cause of addison’s disease?

A

adrenal insufficiency so can’t make steroids = no mineralocorticoid activity

58
Q

why can’t addisons disease patients retain sodium?

A

dont have mineralocorticoids

59
Q

main clinical feature of addisons disease patients?

A

dehydration

dizziness/hypotension

60
Q

why do addisons disease patients get hypotension?

A

too much fluid lost from ECF

61
Q

main cause of hypernatraemia by too much water

A

ADH secreted in repsonse to non osmotic stimulus so get water retention

2 Endocrine (35 decks)

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