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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
how is hyponatraemia caused by too much water treated?
fluid restriction
26
activity of what hormone controls sodium movement?
mineralocorticoids (cortisol and aldosterone)
27
what would happen to sodium if mineralocorticoid activity was low?
sodium loss
28
what would happen to sodium if mineralocorticoid activity was too high?
sodium retention
29
what would happen to eater if mineralocorticoid activity was low?
would lose water
30
what hormone controls water?
ADH
31
what kind of stimuli cause the release of ADH?
osmotic and non osmotic
32
what does ADH do to the renal tubules?
causes them to reabsorb water
33
what would your urine look like if you had alot of ADH?
concentrated urine
34
what kind of osmolality would concentrated urine have?
high
35
what kind of osmolality would dilute urine have?
low
36
how does ADH cause water reabsorption?
countercurrent multiplication
37
which limb of the loops of henle is permeable to water?
descending
38
what is the only part of the loops of henle that does not extrue NaCl?
descending
39
why is the ascending limb of the loops of henle impermeable to water?
it extrudes NaCl so it stops water going out with it
40
what do the loops of henle extrude water into?
ICF
41
what concentrations are the mediullary ICF and the loops of henle before any gradient is established?
both 300 milliosmoles/l
42
when will the ascending limb of the loop of henle stop releasing NaCl?
when the ICF is 200 milliosmoles more concentrated than the ascending limb's fluid
43
when will the descending limb of the loop of henle stop releasing water?
until the osmolarities of the fluid in the descending limb and the ICF become equal
44
name some non osmotic stimuli of ADH?
hypovolaemia/hypotension pain nausea/vomiting
45
most common reason for having too much water in the body?
SIADH (failure to excrete water)
46
most common reason for having too little sodium in the body?
increased Na loss
47
what tissues is Na most commonly lost from?
adrenals kidney gut skin eg burn
48
most likely patients to get SIADH?
post op patients
49
above what sodium level is considered to be serious?
>160mmol/l
50
symptoms of hypernatraemia?
vomiting nausea fitting
51
main causes of hypernatraemia?
usually because of too little water: h20 loss via diabetes insipidus OR decreased H2O intake in extremes of age
52
how would you know a patient has hyponatraemia from Na loss and not H2O increase?
if they are dehydrated and "dry"
53
what happens when Na is low in SIADH?
retains water
54
what should you give if hypernatraemia is caused by low water?
give water
55
what should you give if there is too little sodium?
loop diuretic
56
how does oedema cause electrolyte retention
``` decreased protein hydrostatic/oncotic balance disrupted RAAS switched on = electrolyte uptake ADH retention ```
57
cause of addison's disease?
adrenal insufficiency so can't make steroids = no mineralocorticoid activity
58
why can't addisons disease patients retain sodium?
dont have mineralocorticoids
59
main clinical feature of addisons disease patients?
dehydration | dizziness/hypotension
60
why do addisons disease patients get hypotension?
too much fluid lost from ECF
61
main cause of hypernatraemia by too much water
ADH secreted in repsonse to non osmotic stimulus so get water retention

2 Endocrine (35 decks)

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