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17 Cards in this Set
- Front
- Back
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What do alterations in sodium balance show up as?
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Changes in extracellular volume
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What are changes in water balance measured as?
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Changes in plasma osmolarity...changes in plasma sodium concentration
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Generally, what are causes of edema?
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Shifting of fluids from vascular space due:
increased hydrostatic pressure decreased plasma oncotic pressure increased capillary permeability lymphatic obstruction |
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What is the normal value for FeNa?
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1%
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What is the mechanism of edema in nephrotic syndrome? Physical findings? Labs?
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Decreased oncotic pressure
Foamy urine >3g/day proteinuria, low albumin |
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What is the mechanism of edema in cirrhosis? Physical findings? Labs?
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Increased venous pressure and decreased oncotic pressure
Liver failure, ascites Low albumin, platelets. High INR, billirubin |
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What are the overall treatment principles for managing edema?
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Treat the underlying disease to improve the effective circulating volume
Decrease renal Na and water retention |
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What are some GI causes of sodium loss?
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Upper tract: vomiting, nasogastric suctioning
Lower tract; diarrhea, intestinal fistula |
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What are some cutaneous causes of depleted sodium?
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Burns
Inflammatory skin disease Excessive diaphoresis |
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If someone has normal renal function and sodium loss, what could be a couse?
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Diuretics
Hypoaldosternoism |
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In someone with renal sodium loss and renal impairment, what are some possible causes?
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Salt wasting nephropathy
Diuretic phase of acute tubular necrosis Chronic renal failure |
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What are some physical findings of intravascular extracellular volume depletion?
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tachycardia, weak pulse
Orthostatic blood pressures Hypotension while recumbent Delayed capillary refill |
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What are some physical findings of interstitial extracellular volume depletion?
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Decreased skin tugor
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What are some physical findings of transcellular extracellular volume depletion?
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Dry mouth, mucous membranes
Decreased intraocular pressure |
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What is the definition of orthostatic hypotension?
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Drop in SBP of more than 20 mmHg w/in 3 minutes of standing
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What is an effect of renal artery stenosis?
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Activation of the RAA system-->salt, water retention, secondary HTN
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What is the treatment of renal artery stenosis? When don't you want to do this?
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Ace inhibitor
When there's bilateral stenosis |
