U and Es Flashcards

1
Q

what is diabetes insipidus

A

inability to produce or respond to ADH resulting in excessive urine production or thirst

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2
Q

what conditions may cause electrolyte disturbance

A
haemorrhage
d and v
intake
pyrexia- increased loss
diabetes mellitus or insipidus
diuretic therapy 
endocrine disorder
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3
Q

what is the concentration of extracellular sodium

A

140 mmol/L

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4
Q

what is the extracellular K concentration

A

5 mmol/L

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5
Q

what physiological mechanisms compensate for electrolyte disturbance

A

thirst
ADH
renin

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6
Q

what part of the brain produces ADH

A

median eminence of posterior pituitary gland

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7
Q

in what conditions is urea raised

A

congestive heart failure
shock
MI
severe burns

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8
Q

what is creatinine

A

breakdown product of protein and muscle

higher in males usually

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9
Q

what electrolytes can be measured

A
sodium
potassium
chloride
bicarb
urea
creatinine
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10
Q

why is electrolyte balance important

A

cellular homeostasis
cardiovascular
renal
electrophysiology

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11
Q

what is the intracellular sodium concentration

A

10 mmol/L

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12
Q

name some isotonic fluids in the body

A

blood, fistula fluid

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13
Q

how much hypotonic fluid loss would be insensible

A

3 L

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14
Q

how might hypotonic fluid loss occur

A

diarrhoea and vomiting

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15
Q

what can cause activation of the RAAS system

A

na depletion

haemorrhage

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16
Q

how do you determine ADH status

A

if urine is a lot more concentrated than plasma then ADH is activated

17
Q

how do you determine RAAS status

A

measure plasma and urine sodium concentration

if urine sodium is less than 10 mmol/L then RAAS is active

18
Q

why should fluid loss of 2L be replaced with isotonic fluid rather than hypotonic fluid

A

will not cause a fall in sodium and will not cause fluid redistribution

19
Q

what tow substances are used as markers of renal function

A

urea and creatinine

20
Q

what factors influence GFR

A

renal perfusion pressure
renal vascular resistance
glomerular damage
post glomerular resistance

21
Q

what is normal GFR

A

90- 150 mL/min
bigger people have higher rate
older people have lower rate

22
Q

what is nephrosis

A

aka nephrotic syndrome
oedema
protein loss
increased glomerular permeability

23
Q

what can cause hyponatraemia

A
diuretics 
addison's 
Na losing nephritis
nephrosis
vomiting and diarrhoea 
burns 
oedema (increased fluid compartment)
drugs 
hypothyroidism 
Kidney failure
24
Q

what is SIADH

A

syndrome of inapropriate antidiuretic hormone

hormone is produced in the wrong place

25
what is osmotic diuresis
too much urine production caused by retention of a substance in the nephron e.g. glucose causing inability to reabsorb enough water
26
what is normal potassium range
3.6 - 5 disorders are often iatrogenic
27
what change in pH can cause hyperkalaemia
acidosis causing potassium to move out of cells
28
what change in pH can cause hypokalaemia
alkalosis which causes potassium to move inside the cells
29
what can cause hyperkalaemia
``` artifactual haemolysis drug therapy renal failure acidosis mineralcorticoid dysfunction cell death ```
30
how can hyperkalaemia be treated
correct acidosis give glucose and insulin ion exchange resins dialysis
31
what can cause hypokalaemia
``` low intake increased urine loss tubular dysfunction vomiting and diarrhoea fistulae alkalosis insulin and glucose therapy ```
32
what are the symptoms of potassium depletion
``` lethargy muscle weakness arrhythmia polyuria alkalosis ```
33
how is potassium depletion treated
supplementation oral/ iv monitor