Chapter 046 Sodium and Water (Part 4) ppt

... 273). Another Chapter 046. Sodium and Water (Part 4) Extrarenal Nonrenal causes of hypovolemia include fluid loss from the gastrointestinal tract, skin, and respiratory system and third-space ... plasma volume and hypotension. Hypotension is due to decreased venous return (preload) and diminished cardiac output; it triggers baroreceptors in the carotid sinus and...

Ngày tải lên: 06/07/2014, 15:21

... with a low-Na + diet and thiazide diuretics, as described above. This induces mild volume depletion, which leads to enhanced proximal reabsorption of salt and water and decreased delivery ... are to stop ongoing water loss by treating the underlying cause and to correct the water deficit. The ECF volume should be restored in hypovolemic patients. The quantity of water re...

Ngày tải lên: 06/07/2014, 15:21

... volume contraction, and juxtaglomerular apparatus hyperplasia. Finally, diuretic use and abuse are common causes of K + depletion. Carbonic anhydrase inhibitors, loop diuretics, and thiazides are ... above) is not uncommonly seen in K + depletion and is manifest as polydipsia and polyuria. Glucose intolerance may also occur with hypokalemia and has been attributed to either...

Ngày tải lên: 06/07/2014, 15:21

... hypoaldosteronism is a syndrome characterized by euvolemia or ECF volume expansion and suppressed renin and aldosterone levels (Chaps. 336 and 338). This disorder is commonly seen in mild renal insufficiency, ... hyporeninemic hypoaldosteronism. NSAIDs inhibit renin secretion and the synthesis of vasodilatory renal prostaglandins. The resultant decrease in GFR and K + secretion...

Ngày tải lên: 06/07/2014, 15:21

... excitability and is manifest as weakness, which may progress to flaccid paralysis and hypoventilation if the respiratory muscles are involved. Hyperkalemia also inhibits renal ammoniagenesis and reabsorption ... hyperkalemia result in a prolonged PR interval and QRS duration, atrioventricular conduction delay, and loss of P waves. Progressive widening of the QRS complex and m...

Ngày tải lên: 06/07/2014, 15:21

... disturbed water homeostasis, whereas alterations in Na + content are manifest as ECF volume contraction or expansion and imply abnormal Na + balance. Sodium Intake Chapter 046. Sodium and Water ... cortical and collecting duct to water in the absence of AVP. Abnormalities of any of these steps can result in impaired free water excretion, and eventual hyponatre...

Ngày tải lên: 06/07/2014, 15:21

... Chapter 046. Sodium and Water (Part 11) Potassium: Introduction Potassium Balance Potassium is the major ... membrane potential and is crucial for normal neuromuscular function. The basolateral Na + , K + -ATPase pump actively transports K + in and Na + out of the cell in a 2:3 ratio, and the passive ... filtered K + is reabsorbed by the proximal convoluted tubul...

Ngày tải lên: 06/07/2014, 15:21

... betaine, and glutamine. Chapter 046. Sodium and Water (Part 1) Harrison's Internal Medicine > Chapter 46. Fluid and Electrolyte Disturbances > Sodium and Water Sodium and Water: ... disparities in permeability and the presence of transporters and active pumps. The major ECF particles are Na + and its accompanying anions Cl – and HCO 3 –...

Ngày tải lên: 06/07/2014, 15:21

... nephrogenic) Chapter 046. Sodium and Water (Part 3) Hypovolemia Etiology True volume depletion, or hypovolemia, generally refers to a state of combined salt and water loss exceeding intake, ... Na + and water loss 1. Diuretics 2. Osmotic diuresis 3. Hypoaldosteronism 4. Salt-wasting nephropathies C. Renal water loss 1. Diabetes insipidus (central or...

Ngày tải lên: 06/07/2014, 15:21

... (secondary water gain) 1. Integumentary loss: sweating, burns 2. Gastrointestinal loss: vomiting, tube drainage, fistula, obstruction, diarrhea Chapter 046. Sodium and Water (Part 5) ... solution can be absorbed and result in a dilutional hyponatremia. The metabolism of sorbitol and glycine to CO 2 and water may lead to hypotonicity if the accumulated fluid a...

Ngày tải lên: 06/07/2014, 15:21