z- Test #4 Disorders

Hyponatremia
(hypoaldosteronism)
? Deleptional (Addison’s Disease)
• Due to diet (potassium azide )
• Excessive Sweat
• Prolonged vomiting
• Persistent diarrhea
• Deficiency in absorption
• Net loss of Na+
? Dilutional
• Retention of H2O
• Pregnancy
• Edema
• the amount of sodium you have doesn’t change but the water volume increases
Hypernatremia
? Net gain of Na+ in plasma
• During sweating
• Vomiting
• Diarrhea
• Down ADH
• Cushing syndrome (Hyperaldosteronism)
o Leads to hypernatremia
o They will have hypokalemia
? Will lead to hypernatriuria: overflow of Na in urine
Hypernatriuria
? Up excretion of Na+ -> urine
• Diuretic Therapy
• Adrenal Therapy
• Adrenal Failure
• Salt-losing diseases
Hypokalemia
? found in pts with
• Hypernatremia
• Hypoinsulinemia
• alkalosis (pH that is slightly higher extracellular pH 7.45, 7.50, 7.55), normal pH is 7.3-7.4
? Diet
? Increase loss of K+
? Insulin Therapy
Hyperkalemia
? Found in pts with hyponatremia
? Loss of H2O > loss of K+
? IV unit of KCl
? Pt. w/ perotonial Dialysis
? Hemolytic Diseases
Hypochloremia
? Diet (Mal-nutrition/absorption)
? Prolonged vomiting
? Salt loosing diseases
Hypercholoremia
? Dehydration
• Loss of H2O > loss of Cl-
? Diarrhea
? Salicylation Intoxication
Hypercapnia
? Up tCO2
? Metabolic Alkalosis
? Repertory Acidosis
? Vomiting
? Hypocalemia Cases
? Excessive intake of Alkali reagents (Sodium Fluoride)
? Pts with hypokalemia
Hypocapnia
? Down CO2
? Metabolic Acidosis
? Repertory Alkalosis
? Renal Acidosis
? Hyperchloremia (opposite of vomiting)
? renal failure (no reabsorption)
Metabolic Acidosis
o Due to primary HCO3- defect
o Causes
? Production of organic acids
• Ketosis (D.M. or starvation)
• Lactic Acidosis (Extreme muscle metabolism)
• Product of Acetic acid [Alcohol intoxicity]
• Aceto acetates production > elimination
? Reduction in excretion of acids
• Renal failure
? Excessive loss of HCO3- “diarrhea”
? Renal Failure down renal reabsorption of HCO3-
• Renal tubular acidosis
? Net (HCO3-/pCO2) down
? pH < 7.35
Metabolic Alkalosis
o Primary HCO3- excess ( > 28 mmol/L)
o Causes
? Administration of excess alkali solution
? Excessive ingestion of Alkaline agents
? Less of HCl = vomiting
? K+ depletion (hyperaldosteronism)
• Up reabsorption of Na+
• Enhances reabsorption of HCO3-
? Renal retention of HCO3-
? Prolonged administration of Diuretics
? Net (HCO3-/pCO2) up
? pH > 7.35
? Compensated pCO2 > 47mmHg
o Solution
? Hypoventilation
? Decrease reabsorption of HCO3-
Respiratory Acidosis
o Primary pCO2 excess
o Cause
? Excessive ingestion of Alkaline agents
? Lower elimination of CO2 through lungs
? Net (HCO3-/pCO2) down
? pH < 7.35
o Solution
? Lungs: Hyperventilation
? Renal: Up Reabsorption of H2CO3; Up excretion of HCO3-
? Compensated respiratory acidosis
• pCO2 > 47mmHg
Respiratory Alkalosis
o Primary pCO2 Deficit
o Cause
? Excessive elimination of CO2 through lungs
? Net (HCO3-/pCO2) Up
? pH > 7.45
? CO2 low
? H2CO3 low
? HCO3- normal to high
o Solution
? Lungs: Hyperventilation
? Renal: Up Reabsorption of H2CO3; Up excretion of HCO3-
Hyperventilation
CO2 down pH up
Hypoventilation
CO2 up pH down
(Hypercapnia)

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