Patho Module 2 - Fluid Balance And Acid-Base

Front 1

Total body water =

Back 1

ICF + ECF

Front 2

What is ICF?

Back 2

all fluids within cells

Front 3

What is ECF?

Back 3

interstitial + intravascular + misc.

Front 4

what is blood plasma?

Back 4

liquid portion of blood, no cells

Front 5

What is edema?

Back 5

excessive accumulation of fluid in the interstitial spaces

Front 6

causes of edema?

Back 6

1. venous obstruction - Increases capillary hydrostatic pressure. 2. loss of albumin - decreases plasma oncotic pressure. 3. Increase in capillary permeability - allows leakage into IS spaces (Shock, allergies)

Front 7

What is ascites?

Back 7

Accumulation of protein-containing fluid in peritoneal space; portal HTN

Front 8

What are the hormones that regulate fluid balance?

Back 8

ADH - ↓ water loss; Aldosterone - reabsorb Na, excrete K; ANP, BNP - stimulate renal elimination of Na+

Front 9

↑ Aldosterone = ??

Back 9

Increase BP

Front 10

↑ ADH = ??

Back 10

Increase BP

Front 11

↑ ANP = ??

Back 11

Decrease BP

Front 12

↑ BNP = ??

Back 12

Decrease BP

Front 13

What are the normal values for Na+?

Back 13

136-145 mEq/L

Front 14

Facts about Na+

Back 14

Major cation outside of the cell; maintains ECF osmotic balance

Front 15

Function of Na+?

Back 15

Maintain Tonicity of ECF; Facilitate nerve conduction and glandular secretions

Front 16

What qualifies hyponatremia?

Back 16

<135 mEq/L

Front 17

Causes of hyponatremia?

Back 17

vomiting, diarrhea, diuretics, decrease Na in diet, prolonged sweating, total body weight increases more than Na increases - kidney, heart, liver dysfunction

Front 18

s/sx hyponatremia?

Back 18

lethargy, headaches, confusion, restlessness, irritability, muscle weakness, spasms, coma

Front 19

What is hypernatremia?

Back 19

> 147 mEq/L

Front 20

Causes of hypernatremia?

Back 20

↑ Na: oversecretion of aldosterone, Cushings; too little H2O; diabetes insipidus: ↓ ADH

Front 21

S/sx hypernatremia

Back 21

thirst, restlessness, dry mucous membranes, oliguria, tachycardia, muscle twitching, hyperreflexia, convulsions

Front 22

What is SIADH?

Back 22

Syndrome of Inappropriate ADH Secretion - excessive secretion of ADH

Front 23

Causes of SIADH

Back 23

Idiopathic; brain injury; infection; trauma; stroke; hemorrhage; ADH Secreting tumor

Front 24

S/sx SIADH

Back 24

electrolyte imbalance; hyponatremia

Front 25

Testing for SIADH

Back 25

↓ serum osmolarity vs ↑ urine osmolarity - more concentrated; CT/MRI of tumor

Front 26

What is diabetes insipidus

Back 26

Lack of ADH

Front 27

Causes of DI

Back 27

neurogenic - absence of ADH; nephrogenic - inadequate response of renal tubules to ADH; Psychogenic - excessive fluid intake that suppresses ADH

Front 28

S/sx DI

Back 28

Excessive urination and thirst; excretion of large volume dilute urine, dehydration

Front 29

Testing DI

Back 29

↑ serum osmolarity vs ↓ urine osmolarity; plasma ADH levels

Front 30

What are the normal values for K+?

Back 30

3.5-5 mEq/L

Front 31

K+ facts

Back 31

Major cation inside the cell

Front 32

Function of K+

Back 32

maintains ICF osmotic balance; glycogen/glucose deposition; transmission of nerve impulses; maintenance of normal cardiac rhythms, skeletal and smooth muscle contractions

Front 33

what is Hypokalemia

Back 33

<3.5 mEq/L

Front 34

Causes of hypokalemia

Back 34

reduced intake of K, increased entry of K into cells; Increased losses of body K: vomiting, diarrhea, diuretics.

Front 35

S/sx hypokalemia

Back 35

muscle weakness and cramps; arrhythmias - shallow T wave

Front 36

What is hyperkalemia?

Back 36

>5.5 mEq/L

Front 37

Causes of hyperkalemia?

Back 37

increased intake of K; increased exit of K from cells; decreased renal excretion of K

Front 38

S/sx of hyperkalemia

Back 38

weakness, paralysis, arrhythmias - widened QRS and Tall peaked T wave

Front 39

What is a normal pH?

Back 39

7.4

Front 40

what is a normal pH range?

Back 40

7.35-7.45

Front 41

What's the formula for acid-base balance?

Back 41

CO2 + H2O (lungs) <---> H2CO3 <---> H+ + HCO3- (kidneys)

Front 42

What is the function of bicarbonate?

Back 42

chemical buffer to regulate pH balance; carbon dioxide is converted to bicarbonate

Front 43

Respiratory Acidosis

Back 43

hypoventilation: COPD, pneumonia, non-pulmonary causes

Front 44

Metabolic Acidosis

Back 44

Shock; diabetic ketoacidosis; renal failure

Front 45

Respiratory Alkalosis

Back 45

Hyperventilation

Front 46

Metabolic Alkalosis

Back 46

Vomiting: acid loss; Gastric Suctioning; Diuretics; antacids; Hypokalemia

Front 47

Metabolic Acidosis process

Back 47

Decrease in HCO3, increase in H2CO3

Front 48

S/sx metabolic acidosis

Back 48

lethargy, HA, Coma, N/V, Abdominal pain

Front 49

Compensation for metabolic acidosis

Back 49

respiratory - Kraussmaul respiration, deep and rapid to blow off CO2 and to reduce H2CO3; Kidneys - conserve HCO3 and excrete H+ in acidic urine

Front 50

Metabolic Alkalosis process

Back 50

increase in HCO3, excessive loss of H+

Front 51

s/sx metabolic alkalosis

Back 51

weakness, mm cramps, tetany, hyperreflexive, confusion, convulsions, atrial tach.

Front 52

Compensation for Metabolic Alkalosis

Back 52

respiratory - suppressed breathing to retain CO2; kidneys - conserve H+ and excrete HCO3 in alkaline urine

Front 53

Respiratory Acidosis process

Back 53

PaCO2 > 45 mmHg, hypercapnia, depressed ventilation, RETAIN CO2

Front 54

s/sx Respiratory Acidosis

Back 54

HA, blurred vision, restlessness, lethargy, mm. twitch, tremors, convulsions, coma, warm flushed skin

Front 55

compensation Respiratory Acidosis

Back 55

kidneys - conserve HCO3 and excrete H+ in acidic urine

Front 56

Respiratory Alkalosis process

Back 56

PaCO2 < 35 mmHg; hypocapnia, hyperventilation, blowing off CO2

Front 57

s/sx respiratory alkalosis

Back 57

vertigo, confusion, paresthesia, convulsions, coma, tetany, carpopedal spasm, cerebral vasoconstriction

Front 58

compensation respiratory alkalosis

Back 58

kidneys - conserve H+ and excrete HCO3 in alkaline urine

Front 59

pH Metabolic Acidosis?

Back 59

↓

Front 60

PaCO2 metabolic acidosis?

Back 60

↓

Front 61

HCO3 metabolic acidosis?

Back 61

↓

Front 62

pH metabolic alkalosis?

Back 62

↑

Front 63

PaCO2 metabolic alkalosis?

Back 63

normal or ↑ due to compensation

Front 64

HCO3 metabolic alkalosis

Back 64

↑

Front 65

pH Respiratory acidosis

Back 65

↓

Front 66

PaCO2 respiratory acidosis?

Back 66

↑

Front 67

HCO3 respiratory acidosis?

Back 67

normal or ↑ due to compensation

Front 68

pH respiratory alkalosis

Back 68

↑

Front 69

PaCO2 respiratory alkalosis

Back 69

↓

Front 70

HCO3 respiratory alkalosis

Back 70

normal or ↓ due to compensation

Front 71

anion gap is a ddx in what?

Back 71

metabolic acidosis