Transcript Hyponatremia

Hyponatremia
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– Diarrhea
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– Drinking
• Effects:
– Movement of water into cells, swelling
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Hypernatremia
• Causes:
– High fever
– Diabetes insipidus
• Effects:
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Hypokalemia
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• Causes:
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– Diuretic drugs
– Prolonged vomiting, diarrhea
• Effects:
– Muscular weakness, paralysis, _
Hyperkalemia
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• Causes:
– Renal disease, drugs,
__________________________________
(Addison’s Disease)
• Effects
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Acid Base Balance
• Acids:
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• Bases:
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• Balance: regulation of the _
Sources of H+
• As _
• 1.
– Carbon dioxide reacts with water to form carbonic
acid which ionizes to release hydrogen ions and
bicarbonate ions
• CO2 + H20  H2C03  H+ + HCO3-
Sources of H+
• 2.
– Glucose in anaerobic respiration produces
_______________________ which adds H+
• 3. Incomplete oxidation of _
– Produces ____________________________
which increase H+ concentration
• 4. Oxidation of a.a. containing _
– Produces H2SO4  which releases H+ ions
Sources of H +
• 5. ______________________ of
phosphoproteins and nucleic acids
– These substances contain phosphorus which lends
itself to _________________________ which can
release H +
Regulation
• Acid/base regulation is essential because a
shift towards more acid or more base can
threaten the internal environment
– Which is why we have
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Acid Base buffer systems
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Bicarbonate buffer system
Present in both IC fluids and EC fluids
Involves _
Involves carbonic acid _
– If there is ___________________ in system:
• H + will add to bicarbonate ion
• H + + HCO3-  H2CO3
Bicarbonate Buffer system
• If there is not enough H + in system
– Carbonic acid _
H2CO3  H + + HCO3-
Phosphate buffer system
• Present in IC and EC fluids
• More important in _
• Contains
H2PO4-
• And
HPO42-
Phosphate Buffer system
• If _
– Monohydrogen phosphate acts as weak base and
_______________________________ to form
dihydrogen phosphate
• H + HPO4 –2  H2PO4 –
• If conditions are too basic:
– Dihydrogen phosphate will _
• H2PO4-  H + HPO4 -2
Protein Buffer system
• Uses _
• Review Ch 2 for protein structure and
chemistry
• Some proteins have a carboxyl group –COOH
that _________________________ when too
alkaline
• Or, if conditions are too acidic, the COO- can _
Protein Buffer system
• Amino acids also have amino groups: --NH2
– If conditions become too acidic:
• The ________________________ will accept a H+
• --NH2 + H+  --NH3+
– If conditions become too basic:
• NH3 can give up a H+ if there is an OH- group to accept it
Respiratory Excretion of CO2
• Previous buffer systems good for
______________________________ …but
presence of excess acid or base needs to be
more completely remedied.
• ______________________________ will
affect more permanent changes
Respiratory Excretion of CO2
• Respiratory center in brain stem
– Controls _
• During exercise:
– If body cells __________________________
production
– Increases ________________________H2CO3
– Carbonic acid dissociates and _
– the pH starts to drop
Respiratory Excretion of CO2
• Increase in H+ and increase in CO2 _
• Response:
– increase ___________________ of breathing
– Increase ___________________ of breathing
• Result: _
Respiratory Excretion of CO2
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During rest:
Concentrations of CO2 and H+ _
Breathing rate and depth falls
Decreased respirations allows _
Returns pH to normal
Respiratory Excretion of CO2
• Increased H+ More acidic
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• Decreased H+ More basic
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Renal excretion of H+ ions
• Nephrons __________________________
into the urine
• Kidney also regulates concentration of _
Renal excretion of H+ ions
• Metabolism can result in acid formation
– Amino acids when metabolized can result in
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• Kidneys will secrete _
Renal excretion of H+
• So, why if the body secretes H+ into the renal
tubules doesn’t the urine have a low pH?
– Some of the same buffering systems _
• Phosphate buffer system
• Ammonia: NH3 + H+  NH4+
– Prevents urine from becoming acidic
Rates of regulation
• Acid base buffers:
– Can convert strong acids and bases to _
– Considered
_____________________________________ for
pH shifts
• Respiratory systems __________________
and renal __________________ and function
more slowly
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Effects of pH changes
• Acidosis:
– Increased _
• Depressed neuron activity
• Decrease in consciousness
• Alkalosis
– Increased _
• Neurons become excitable
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Acidosis
• Results from an ______________________ or
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• Respiratory acidosis
– Accumulation of _
– Decreased ventilation
• Injury to _
• Obstruction in air passages
• Pneumonia, emphysema
Respiratory acidosis
• As the H+ increases in the acidosis, the
breathing rate will _
• As the body returns to normal, the acidosis is
_
Respiratory acidosis
• Symptoms
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– Stupor
– Labored breathing
– If it remains uncompensated: _
Metabolic acidosis
• Due to ___________________________ (not
related to respiration) or _
• Contributing conditions:
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– Prolonged vomiting (including contents of small
intestine)
– Prolonged _
– Diabetes mellitus (fatty acids converted into
ketone bodies)
Respiratory alkalosis
• Hyperventilation: blows off _
– Anxiety
– Fever
– Salicylate poisoning (aspirin)
Respiratory alkalosis
• Body’s response:
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– Kidneys _
– Kidneys increase _
• Symptoms
– Light-headedness
– Agitation
– Dizziness
– Muscle tetany if severe
Metabolic alkalosis
• Results from
• a_
• Increase in bases
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– Prolonged vomiting _
– Diuretic drugs
– Too much _
Metabolic alkalosis
• Will result in a _
– Allows CO2 and H+ to recuperate