Lecture

• ECFV overload occurs due to these conditions: hyperaldosteronism, IV overload, renal failure and Cushing's syndrome. It can lead to heart failure, cirrhosis of the liver and nephrotic syndrome(too much protein in piss)
• S/S of ECFV overload: weight gain, edema, bounding pulse, JVD, orthopnea and gravity dependent crackles
• ECFV depletion occurs due to vomiting/diarrhea, adrenal insufficiency, use of diuretics, hemorrhage and sweating
• S/S of ECFV depletion: tachycardia at rest, orthostatic hypotension, signs of dehydration(Poor skin turgor/dry mucous membranes) and weight loss
• Na+ is the main ECF cation. Lack of Na+ causes H2O to leave the blood and cause edema.
• FRIEDD acronym for S/S of Hypernatremia: fever/flushed, restless, increased fluid retention, edema, decreased urine output and dry mucous/skin
• SALTSSS acronym for hyponatremia: Seizures/Stupor, abdo cramps, lethargy, trouble concentrating, loss of urine/appetite and shallow respirations
• K+ is the main ICF cation and it functions to maintain ICF osmolality, action potential, muscle contraction and acid-base balance
• Acidosis is often associated with hyperkalemia
• Alkalosis if often associated with hypokalemia(How it affects pH)
• Addison's causes hyperkalemia due to reduced aldosterone secretions
• Hyperkalemia almost always causes cardiac effects
• Cl- is the main ECF anion
• S/S of different levels of chlorines: Hyperchloremia causes weakness/lethargy and Kussmaul respirations while hypochloremia causes muscle excitability, bradypnea and hypotension.
• Chvostek's(weird cheek one) and Trousseau's(Hand one)signs are both indicators of hypocalcemia
• Magnesium has a role in nerve/muscle fxn, immunity, bone density, BGL and protein/energy production
• Hypomagnesemia occurs due to alcoholism, diarrhea, bad nutrition and pancreatitis
• Hypermagnesemia occurs due to: hyperparathyroidism, excess laxative/antacid ingestion and renal failure
• Hypocalcemia is relatively rare
• Hypomagnesemia increases Ach release while Hypermagnesemia decreases it
• Phosphate is found in teeth/bones and it used to repair them. It also helps in nerve/muscle function and is regulated by the kidneys
• Kidneys are the slowest mechanism for acid-base balancing but they're the only mechanism for eliminating acids besides carbonic acid
• Blood buffers are the quickest at acid-base balancing and they work by temporarily binding H+ ions
• Respiration allows the exhalation of CO2 which rids the body of carbonic acid. It's effective in minutes(not fast but not slow either0
• In respiratory acidosis, CO2 is retained due to decreased alveolar ventilation
• Metabolic acidosis causes a decreased peripheral response to catecholamines
• Anions and Cations should be equal
• Metabolic acidosis can develop in 2 ways: 1 is where there's a direct loss of HCO3- and no anions left over(no increase in anion gap) which is called non-anion gap acidosis. The other is when HCO3- combines with H+ so that the conjugated base is separated and a negative charge remains. This causes an increase in unmeasured anions and is called anion gap metabolic acidosis
• Respiratory alkalosis is caused by hyperventilation which excretes CO2
• Metabolic alkalosis is considered rare and it results in decreased O2 delivery to the cells