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SDL Electrolyte homeostasis


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U&Es
Measures Na+, K+, (Cl-), (bicarb), urea, creatinine; estimates water
ECF
Plasma + Interstitial (19L)
ICF
Intracellular (23L)
140
Extracellular [Na] = ____ mmol/L
increase
dehydration will _______ the concentration of any solute
excretion
increased _______ will decrease the concentration of a solute
isotonic
loss of ________ solutions (e.g. haemorrhage) - loss from ECF, no change in [Na], no fluid redistribution
hypotonic
loss of ________ solutions (e.g. insensible loss) - greater loss from ICF than ECF, small increase in [Na], fluid redistribution; for gain , greater to ICF than ECF with small decrease in [Na]
ADH
produced by median eminence and release increases when osmolality rises; decreases renal water loss & increases thirst
RAAS
Activated by reduced intravascular volume (e.g. Na depletion or haemorrhage); causes renal Na retention (active if urine [Na] <10mmol/L)
hyponatraemia
Too little Na or excess water in extracellular fluid
hypernatraemia
Too little water or too much Na in extracellular fluid
dehydration
water deficiency or fluid (Na and water) depletion
3.6 - 5.0
Serum potassium reference range: _._ - _._ mol/L ; extreme values can cause cardiac conduction defects and abnormal neuromuscular excitability; intracellular - 150mmol/L
serum potassium
_____ _________ does not reflect body potassium (a very small proportion)
hyperkalaemia
consequence of acidosis on serum potassium (H+/K+ exchange)
hypokalaemia
consequence of alkalosis on serum potassium (H+/K+ exchange)
Artefactual
cause of hyperkalaemia: delayed sample analysis, haemolysis or excess drug therapy
Renal
cause of hyperkalaemia: acute or chronic _____ failure
Acidosis
cause of hyperkalaemia: due to intracellular exchange
Mineralocorticoid
cause of hyperkalaemia: ____________ dysfunction (adrenocortical failure or __________ resistance - e.g. spironolactone)
cell death
cause of hyperkalaemia: ____ _____ - e.g. cytotoxic therapy or trauma
glucose & insulin
Treatment of hyperkalaemia: drives potassium into cells
intake
cause of potassium depletion: low _______
urine
cause of potassium depletion: ↑ _______ loss (diuretics, osmotic diuresis, tubular dysfunction, mineralocorticoid excess)
GI
cause of potassium depletion: ___ losses (vomiting, diarrhoea, laxatives, fistulae)
depletion
causes of hypokalaemia without __________: alkalosis, insulin/glucose therapy