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phase 2a > Water balance, diabetes Insipidus and hyponatraemia > Flashcards

Water balance, diabetes Insipidus and hyponatraemia Flashcards

1
Q

what is the volume of extracellular fluid in the body?

A

1/3 of total body water
14L

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2
Q

what is the volume of intravascular fluid in the body?

A

1/4 ECF 3.5 L

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3
Q

what is the volume of interstitial fluid in the body?

A

3/4 ECF 10.5 L

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4
Q

what is the volume of intracellular fluid in the body?

A

2/3 total body water 28L

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5
Q

what controls the release of vasopressin ( ADH)?

A

osmoreceptors
baroreceptors

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6
Q

when and where do osmoreceptors control the release of vasopressin ADH ?

A

in hypothalamus controls release day to day

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7
Q

when and where do baroreceptors control the release of vasopressin ADH ?

A

in brainstem and great vessels release ADH in emergencies

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8
Q

define osmolality

A

concentration per kilo – in plasma very similar to osmolarity but concentration slightly different.

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9
Q

what are the causes of cranial diabetes insipidus- lack of vasopressin?

A

Idiopathic
Trauma
Tumours
Genetic
Vascular – aneurysms, infarction

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10
Q

how are cranial diabetes insidious managed

A

Treat any underlying condition
Desmopressin
Tablets
Nasal spray
Injection

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11
Q

define hyponatraemia

A

serum sodium <135mmol/l

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12
Q

define severe hyponatraemia

A

serum sodium <125mmol/l

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13
Q

what is the normal serum sodium range?

A

137-144 mmol

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14
Q

signs and symptoms for hyponatraemia

A

Headache
Lethargy
Anorexia and abdominal pain
Weakness
Confusion/ hallucinations

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15
Q

what tests can you do to test for hyponatraemia?

A

Plasma osmolality
Urine osmolality
Plasma glucose
Urine sodium
Cortisol

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16
Q

what ions does the ECF contain?

A

large amounts of
sodium
chloride
bicarbonate ions

17
Q

what ions does the ICF contain?

A

contains potassium, magnesium and phosphate ions

18
Q

During conditions of water excess there is?

A
  1. there is a fall in plasma osmolality, and an influx of water into the cells, increasing the intracellular water content.
  2. This reduces thirst and suppresses the release of vasopressin, decreasing water intake and increasing water excretion by the kidney, respectively.
    3.This decreases the amount of water within the body, correcting the water excess.1
19
Q

During conditions of water deprivation there is?

A

fall in plasma osmolality, and a decrease in cellular hydration.1,2
This stimulates thirst and the release of vasopressin, increasing water intake and reducing water excretion by the kidney.
This increases the amount of water within the body, correcting the water deficit.

20
Q

what is the main driver for fluid intake ?

A

thirst

21
Q

what are the main drivers of variable water excretion by kidney ( urine output)?

A

Glomerular filtration rate (GFR)
Vasopressin (AVP)

22
Q

what influences urine concentration and dilution?

A

Glomerular filtration rate
Sodium reabsorption
Water reabsorption
Vasopressin

23
Q

how does vasopressin directly control water excretion in the kidneys

A

by binding to the v2 receptor

24
Q

what does the coupling of vasopressin to v2 receptors stimulate?

A

stimulates an intracellular signalling cascade, leading to the insertion of aquaporins (AQPs) into the apical membrane of the renal collecting duct principle cells

25
Q

what affects osmolality?

A

sodium, potassium, chloride, bicarbonate, urea and glucose
present at high enough concentrations to affect osmolality

alcohol, methanol, polyethylene glycol or manitol -
exogenous solutes that may affect osmolality

26
Q

what is cranial diabetes insidious

A

lack of vasopressin
AVP deficiency
uncommon but life threatening

27
Q

what is nephrogenic diabetes insipidus?

A

resistance to action of vasopressin
app resistance
not common but life threatening

28
Q

name 3 diseases associated with the posterior pituitary

A

cranial diabetes insipidus
nephrogenic diabetes insipidu
syndrome of anti-diuretic hormone secretion – SIAD

phase 2a (67 decks)

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