Water and Electrolyte metabolism Flashcards
WATER DISTRIBUTION
TBW- __L
-makes up ___% of body weight in men
-makes up __% of body weight in men
42
60
55
WATER DISTRIBUTION
Out of 42L
in ICF (__L)
in ECF (__L)
in plasma(___ L)
interstitial (__L)
28
14
3.5
11
Main electrolytes found in
ECF Osmolality(__,__,___,___,___)
ICF Osmolality(___,____)
Na, Cl, Hco3-, glucose,urea
K, phosphates
SODIUM DISTRIBUTION
- intake in our western diet is about _____-______
- most sodium is excreted in the ____,___,___
100mmol/day-300mmol/day
kidneys, sweat, feaces
urinary sodium output is regulated by
- _____
- _______
Aldosterone
Atrial Natriuretic peptide
HYPERNATREMIA
-when the value is above __-___
135-145mmol/L
HYPERNATREMIA
CAUSES:
- excessive ___ intake
- inadequate ___ intake
- excessive ___ loss
- diseased state like ____,____,____,____
sodium
water
water
diabetes insipidus, conn, Cushing,uncontrolled diabetes mellitus
HYPERNATREMIA
Clinical presentation
- _____,______,____
- restlessness,agitation, seizures,coma
- increased ___
- ______
Management:
-due to water loss, give __________ or ______
dehydration, fatigue, muscle fatigue
JVP
pulmonary edema
oral fluids slowly or 5% dextrose slowly
HYPONATREMIA
-______ are lost
sodium and water
HYPONATREMIA
diagnosis of hyponatremia: ____,____
hypotension, tachycardia
diagnosis of hyponatremia is similar to that of hypernatremia
T/F
T
hyponatremia in patients without eodema, who have normal serum urea and creatinine and blood pressure have _______ and this is treated by ______
WATER OVERLOAD
fluid restriction
CAUSES of HYPONATREMIA
- excessive sodium loss from the GI like in ___,_____,_____ etc
- excessive sodium loss from the kindey like in ————— or _____
- inadequate sodium intake like in _____
- diseased state like ___,____
diarrhea, vomiting, fistula
adrenal insufficiency or sodium-wasting renal diseases
fasting diets
SIADH, Addison
POTASSIUM HOMEOSTASIS
-total body K= ______
- __%intracellular ;__% extracellular
- intake is about ______/day
- output is mainly by ___
- __% lost in faeces
3600mmol
98;5
30-100mmol
kidneys
5
POTASSIUM HOMEOSTASIS
conc of serum K is __-___/L
- cellular uptake of potassium is stimulated by ____
- reciprocal relationship between K and __ ions
3.5-4.5mmol
insulin
H
HYPERKALEMIA
CAUSES
- increased intake of ___
- ____ hormone deficiency
- tissue ____
- reduced excretion (in __osis)
- ____ disease
- Pseudo hyper K like in ______
K
insulin
breakdown
acid
Addison
a lysed sample
HYPERKALEMIA
Features
- ____ paralysis
- heart ___, ____, etc
flaccid
block
bradycardia
HYPERKALEMIA
Management
- ____ infusion
- infusion of ______ to counter the effects of hyperkalemia
- cation exchange resin like ____
- mild to moderate: _____
- severe: ______
- very severe : _____
insulin
calcium gluconate
resonium A
IV salbutamol
lactate cocktail
hemodialysis
HYPOKALEMIA
CAUSES
- extracellular loss like in cases of ____ or GI Loss
- extrarenal loss
- influx to cell in high ____ situations or ___osis
- PseudohypoK like in _____
burns
insulin
alkal
leukocytosis
HYPOKALEMIA
Features
- _____ paralysis, fatigue, cramps
- constipation, ileus
- poly__, poly__
spastic
polyuria, polydipsia
HYPOKALEMIA
Management
- diuretic K sparing
- IV potassium (note that this should not be given faster than _____/hour and must be given ________)
- oral potassium supplements
22mmol
under monitoring with ECG
ARTERIAL BLOOD GAS VALUES
hydrogen - ___-___/L
Bicarbonate- ___-___/L
PCo2- 4-6kP (__-__mmHg)
PO2- 11-15kP (__-__mmHg)
35-46nmol
22-30mmol
36-46
85-105
IN METABOLIC ACIDOSIS
- Ph is (low or high?)
- H+ is (low or high?)
- primary issue is _____
- secondary response is ___ing the __ levels
low
high
low bicarbonate
reduc; PCo2
IN METABOLIC ACIDOSIS
Causes:
- ______
- ___ failure, ___ acidosis
- ______ acidosis, severe ___
diabetes MELLITUS
renal
lactic
renal tubular
diarrhea
IN METABOLIC ALKALOSIS
- Ph is (low or high?)
- H+ is (low or high?)
- primary issue is _____
- secondary response is ____ing the ___ levels
High
Low
high bicarbonate
Increasing; PCo2
IN RESPIRATORY ALKALOSIS
- Ph is (low or high?)
- H+ is (low or high?)
- primary issue is _____
- secondary response is ____ing the ____ levels
High
Low
low PCo2
decreas
bicarbonate
IN RESPIRATORY ACIDOSIS
- Ph is (low or high?)
- H+ is (low or high ?)
- primary issue is _____
- secondary response is ____ing the ____ levels
Low
High
high PCo2
Increasing
bicarbonate
IN RESPIRATORY ACIDOSIS
Causes
- _____,______,____[
- pulmonary ____, __________ disease , depression of ______
pneumonia , emphysema, asthma
edema
chronic obstructive lung
respiratory center
