This document discusses disorders of sodium and potassium metabolism, including abnormalities that can cause hyperkalemia or hypokalemia, as well as hyponatremia or hypernatremia. It outlines the major mediators that regulate sodium and water balance, including the renin-angiotensin-aldosterone axis and antidiuretic hormone. It then presents four case studies and the relevant lab results, which illustrate different disorders of electrolyte and fluid balance.
THIS SEMINAR GIVES THE BASIC OVERVIEW THAT HOW YOU CAN MANAGE THE PATIENT WHO COMES TO YOU A FLUID AND ELECTROLYTE IMBALANCE . AND BASIC MECHANISM OF HOMEOSTASTIS
fluid and electrolyte imbalance
normal physiology of fluid regulation
FLUID IMBALANCES- fluid volume excess, fluid volume deficit, third spacing,
ELECTROLYTE IMBALANCES- hypo and hypernatremia, hypo and hyperkalemia, hypo and hypercalcemia
THIS SEMINAR GIVES THE BASIC OVERVIEW THAT HOW YOU CAN MANAGE THE PATIENT WHO COMES TO YOU A FLUID AND ELECTROLYTE IMBALANCE . AND BASIC MECHANISM OF HOMEOSTASTIS
fluid and electrolyte imbalance
normal physiology of fluid regulation
FLUID IMBALANCES- fluid volume excess, fluid volume deficit, third spacing,
ELECTROLYTE IMBALANCES- hypo and hypernatremia, hypo and hyperkalemia, hypo and hypercalcemia
Lecture on DKA in pregnancy - presented at JGH Obstetrics & Gynaecology Teaching Jan 2020. Fictional details have been used to anonymise any resemblance to persons living or passed.
Similar to Disorders Of Sodium And Potassium Metabolism (20)
4. Renin-Angiotensin-Aldosterone Axis Angiotensin II 1. Stimulates production of aldosterone 2. Acts directly on arterioles to cause vasoconstriction 3. Stimulates Na + /H + exchange in the proximal tubule Aldosterone 1. Stimulates reabsorption of Na + and excretion of K + in the late distal tubule 2. Stimulates activity of H + ATPase pumps in the late distal tubule
11. Etiologies of Hypokalemia Poor Intake Increased Urinary Excretion Decreased reabsorption in loop of Henle Furosemide Increased excretion in the late distal tubule Increased delivery of Na + to the late distal tubule Furosemide, thiazides, and acetazolamide Proximal RTA Reduced function of the K + /H + ATPase Distal RTA Hyperaldosteronism Primary hyperaldosteronism Adrenal adenoma Adrenal hyperplasia Secondary hyperaldosteronism Renovascular hypertension Renin-secreting tumor Increased GI Losses Diarrhea Laxative abuse Vomiting / NG drainage Increased Transcutaneous Losses Copious sweating Transmembrane Shift Alkalosis Insulin treatment for DKA High catecholamine states
13. Etiologies of Hyponatremia Poor Intake of Sodium Increased Urinary Loss of Sodium Diuretics Proximal RTA Aldosterone deficiency/resistance Increased GI Loss of Sodium (Fluid loss must be followed by repletion with free water). Vomitting Diarrhea Increased Transcutaneous Loss of Sodium (Fluid loss must be followed by repletion with free water). Excessive Intake of Water (1 ° polydipsia) Psychosis Decreased Urinary Excretion of Water Decreased GFR Increased ADH Decreased effective circulating volume True volume depletion (any cause) Apparent volume depletion Heart failure Cirrhosis SIADH Reset osmostat Transmembrane Shift of Water Hyperglycemia Primary Sodium Loss Primary Water Excess
14. Etiologies of Hypernatremia Primary Sodium Excess Excess Intake of Sodium Decreased Urinary Excretion of Sodium Hyperaldosteronism Primary Water Loss Poor Intake of Water Impaired access to water (i.e. infants, elderly patients with dementia or whom are bedbound) Impaired thirst sensation Hypothalamic lesions Increased Urinary Loss of Water ADH deficiency (Central DI) ADH resistance (Nephrogenic DI) Increased GI Loss of Water Increased Transcutaneous Loss of Water Transmembrane Shift of Water (most often due to rapid production of intracellular lactate)