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HES 311: Pathophysiology 2.0 > Week 2 - Fluid and Electrolyte Imbalances > Flashcards

Week 2 - Fluid and Electrolyte Imbalances Flashcards

1
Q

How much body weight is made up of fluid (water)

A

~60%
- 2/3 intracellular fluid
- 1/3 extracellular fluid

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2
Q

Thirst regulation

A

osmoreceptors in the hypothalamus

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3
Q

What do osmoreceptors measure?

A

blood osmolarity

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4
Q

How do kidneys regulate fluid and electrolytes?

A

by varying the amounts excreted and reabsorbed
- directly and hormone related

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5
Q

Hormones that act on the kidneys to regulate fluids and electrolytes

A
  • Antidiuretic hormone (ADH)
  • Aldosterone
  • Atrial Natriuretic Peptide
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6
Q

What does the Antidiuretic hormone (ADH) regulate?

A

regulates water level

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7
Q

What does Aldosterone regulate?

A

regulates Na+ and water level

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8
Q

What does Atrial Natriuretic Peptide regualte?

A

Regulates Na+ and water level

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9
Q

How does water move between compartments?

A
  • filtration
  • osmosis
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10
Q

What drives filtration?

A

hydrostatic pressure

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11
Q

What drives osmosis?

A

Osmotic pressure

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12
Q

What is filtration?

A

movement of water and solutes from blood (high pressure) to ISF (low pressure) area

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13
Q

What is osmosis?

A

movement of water from low solute concentration (ISF) to high concentration (blood)

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14
Q

What does movement of water depend on?

A

permeability of the compartment barrier to water

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15
Q

diffusion

A

movement of solutes (Na+, glucose) from high concentration to low concentration

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16
Q

Active transport

A

movement of solute using carrier and energy from low concentration (ISF) to high concentration (Cell)

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17
Q

what does the movement of electrolytes between compartments depends on?

A

how ‘permeable’ the membrane barrier is to the electrolyte AND the concentration gradient of the ion

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18
Q

Edema

A

excess fluid in the interstitial compartment
- isotonic, hypotonic, or hypertonic

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19
Q

Possible consequences of edema

A
  • swelling within the tissues (localized or general)
  • functional impairment
  • pain
  • impaired circulation
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20
Q

4 causes of edema

A
  1. high local blood pressure
  2. plasma protein loss
  3. blocked, or missing, lymphatic vessel
  4. increased capillary permeability
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21
Q

Edema - high local blood pressure

A

Increased hydrostatic pressure
- increased net fluid movement into interstitial space

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22
Q

Edema - plasma protein loss

A

(usually albumin - most abundant protein in the blood)
Decreased osmotic pressure in the blood
- Increased net fluid movement into interstitial space

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23
Q

What is the most abundant protein in the blood?

A

Albumin

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24
Q

Edema - blocked, or missing, lymphatic vessel

A

Fluid and protein not filtered into lymphatic drainage for return to circulation
- localized edema

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25
Q

Edema - increased capillary permeability

A

excess flow of fluid and proteins into interstitial fluid.
- protein movement also increases interstitial fluid osmotic pressure

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26
Q

Edema - high local BP - Pathological states

A
  • congestive heart failure
  • severe hypertension
  • increased blood volume
27
Q

Edema - plasma protein loss - pathological states

A
  • kidney disease (excess protein excretion in urine
  • malnutrition or malabsorption (impaired protein synthesis)
28
Q

Edema - blocked, or missing, lymphatic vessel - pathological states

A
  • tumor blocking lymphatic drainage
  • lymph node removal
29
Q

Edema - increased capillary permeability - pathological states

A
  • infection
  • inflammatory response
30
Q

Dehydration

A

water loss > water intake

31
Q

Dehydration common causes

A
  • insufficient fluid intake
  • sweating
  • vomiting
  • diarrhea
  • excess excretion (urine)
32
Q

Dehydration signs and symptoms

A
  • thirst
  • dry mouth/lips
  • nausea
  • fatigue
  • lightheadedness
  • irritability
  • decreased BP, increased HR
  • vasoconstriction
33
Q

Dehydration net results

A
  • isotonic dehydration
  • hypotonic dehydration
  • hypertonic dehydration
34
Q

Isotonic dehydration

A

water + electrolyte loss

35
Q

Hypotonic dehydration

A

more electrolytes lost than water

36
Q

Hypertonic dehydration

A

More water lost than electrolytes

37
Q

Na+

A

-critical ion for maintaining volume and osmolarity of the extracellular fluid
- essential in electrical conduction of nerves, muscle contraction, general cellular function

38
Q

Hyponatremia

A
  • losing more Na+ than water OR gaining more water than Na+
39
Q

Hyponatremia effect

A
  • fluid imbalances (water moves into cells)
  • skeletal muscle cramps, weakness, fatigue
  • nausea/vomiting, GI cramping, diarrhea
  • headache, confusion, seizures, coma
40
Q

Hypernatremia

A

gaining more Na+ than water OR losing more water than Na+

41
Q

Hypernatremia effects

A
  • fluid imbalances (water moves out of cell)
  • increased thirst/decreased urine output, dry mucous membrane
  • rapid HR
  • Headache, agitation, seizures, coma
42
Q

K+ role

A

Important role in maintaining cell resting membrane potential, essential function in excitable tissue: nerve conduction, muscle contraction

43
Q

Hypokalemia

A

due to anything that causes excess K+ loss or inadequate intake, or more K+ entering cells

44
Q

Hypokalemia effects

A
  • cardiac dysrhythmia
  • muscle weakness, fatigue, paralysis
  • pins and needles
45
Q

Hyperkalemia

A

due to anything that causes K+ build up in extracellular fluid, or more K+ to exit cells

46
Q

Hyperkalemia effects

A
  • cardiac dysrhythmia
  • muscle cramps
  • pins and needles (paresthesia)
47
Q

Effect of K+ imbalance on AP formation

A
  • Hyperkalemia = hyperexcitable cells
  • Hypokalemia = less excitable cells
48
Q

What are the 3 mechanisms for acid-base balance?

A
  1. buffer system in the blood
  2. respiratory system
  3. Kidneys
49
Q

What is the main buffer system in the blood?

A

Bicarbonate-Carbonic acid buffer system

50
Q

How does the respiratory regulate acid-base balance?

A

regulation of CO2 level in the blood

51
Q

How do the kidneys regulate acid-base balance?

A

variable excretion/reabsorption of H+ and HCO3-

52
Q

Respiratory acidosis?

A

due to increased CO2

53
Q

Metabolic acidosis

A

due to decrease in HCO3- (excess acid present in the blood)

54
Q

Respiratory alkalosis

A

due to decreased CO2

55
Q

Metabolic alkalosis

A

due to increased HCO3- (excess acid loss from the blood)

56
Q

What causes respiratory acidosis?

A
  • acute: pneumonia, airway obstruction, chest injury, drug OD
  • chronic: emphysema, pulmonary edema due to congestive HF
57
Q

Respiratory acidosis compensation

A
  • Metabolic: kidneys reabsorb HCO3- and excrete H+
  • respiratory: increase rate and depth of breathing
58
Q

Metabolic acidosis causes

A
  • excess HCO3- loss from diarrhea
  • increased buffering due to acid build up (lactic acid, ketoacidosis)
  • hyperkalemia
  • kidney disease/failure (decreased excretion of acids/decreased production of HCO3-)
59
Q

Metabolic acidosis compensation

A
  • Metabolic: kidneys reabsorb HCO3- and excrete H+
  • Respiratory: hyperventilation to expel more CO2
60
Q

Respiratory alkalosis cause

A

hyperventilation (anxiety, high fever, aspirin OD)

61
Q

Respiratory alkalosis compensation

A

Metabolic: kidneys excrete HCO3- and reabsorb H+

62
Q

Metabolic alkalosis causes

A
  • excess HCl loss from the stomach (vomiting)
  • Hypokalemia (H+/K+ swap in cells)
  • excess ingestion of antacids
63
Q

Metabolic alkalosis compensation

A
  • Respiratory: hypoventilation to increase CO2 level in blood
  • metabolic: kidneys excrete HCO3- and reabsorb H+
64
Q
A

HES 311: Pathophysiology 2.0 (11 decks)

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