Electrolytes and Fluid Balance Quiz
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Questions and Answers

What is the main function of electrolytes in the body?

  • To regulate fluid balance and provide minerals for essential functions (correct)
  • To transport oxygen and carbon dioxide throughout the body
  • To produce hormones and enzymes
  • To provide energy for cellular processes

    • Which of the following is NOT a function of electrolytes in the body?

  • Contracting muscles
  • Producing blood cells in the bone marrow (correct)
  • Maintaining osmotic pressure
  • Regulating nerve impulse transmission

    • Why are electrolytes considered to have greater osmotic power than nonelectrolytes?

  • They are larger molecules and therefore exert more pressure on cell membranes
  • They are directly involved in the transport of water across cell membranes
  • They dissociate into ions in water, increasing the number of particles and osmotic pressure (correct)
  • They are more easily absorbed into the bloodstream than nonelectrolytes

    • What is the primary reason why electrolyte balance is typically referred to as salt balance?

    <p>Salts play a crucial role in controlling fluid movements and mineral availability. (A)</p> Signup and view all the answers

    Which of the following is NOT an example of an electrolyte?

    <p>Glucose (C6H12O6) (D)</p> Signup and view all the answers

    What is the primary cause of dehydration?

    <p>Excessive body fluid loss (D)</p> Signup and view all the answers

    Which of the following is NOT a symptom of hypovolemia?

    <p>Increased BP (C)</p> Signup and view all the answers

    Which of these is a cause of hypervolemia?

    <p>Heart failure (C)</p> Signup and view all the answers

    Which of the following is a primary clinical sign of dehydration?

    <p>Loss of skin elasticity (C)</p> Signup and view all the answers

    Which of the following is NOT a characteristic symptom of fluid excess?

    <p>Increased Heart Rate (A)</p> Signup and view all the answers

    What is the primary characteristic of hypotonic hydration?

    <p>Cellular overhydration (A)</p> Signup and view all the answers

    Which of the following disorders of water balance involves a reduction in fluid intake?

    <p>Hypovolemia (B)</p> Signup and view all the answers

    Which of the following best describes the primary function of potassium-sparing diuretics?

    <p>Inhibit the function of aldosterone, preventing potassium loss (C)</p> Signup and view all the answers

    What percentage of body fluid is accounted for by plasma?

    <p>5% (D)</p> Signup and view all the answers

    Which compartment experiences a net water flow when ECF osmolality increases?

    <p>Intracellular Fluid (B)</p> Signup and view all the answers

    What triggers the release of ADH when plasma osmolality rises?

    <p>Increase in thirst (C)</p> Signup and view all the answers

    Which type of diuretic primarily targets the thick ascending loop of the nephron?

    <p>Loop diuretics (D)</p> Signup and view all the answers

    How is the movement of ions across cell membranes described?

    <p>Two-way for water, unidirectional for nutrients and wastes (A)</p> Signup and view all the answers

    Which of the following fluids is considered transcellular fluid?

    <p>Lymph (A)</p> Signup and view all the answers

    What is the osmolality range that body fluids are maintained at?

    <p>280 – 300 mOsm (C)</p> Signup and view all the answers

    What is a general mechanism by which fluid excretion is promoted?

    <p>Diuretics (B)</p> Signup and view all the answers

    What condition occurs when there is more water retained than sodium?

    <p>Water intoxication (C)</p> Signup and view all the answers

    What is a potential severe result of water intoxication?

    <p>Cerebral edema (D)</p> Signup and view all the answers

    Which of the following is a cause of edema due to increased fluid out of blood?

    <p>Increased capillary permeability (A)</p> Signup and view all the answers

    What condition results from a hypoproteinemic state?

    <p>Ascites (A)</p> Signup and view all the answers

    Which symptom is associated with edema in the brain?

    <p>Cognitive dysfunction (C)</p> Signup and view all the answers

    Which of the following conditions can directly cause increased capillary hydrostatic pressure?

    <p>Congestive heart failure (D)</p> Signup and view all the answers

    What describes a non-pitting edema?

    <p>Swelling does not retain an indentation after pressure (A)</p> Signup and view all the answers

    Which factor can lead to decreased fluid intake in the blood?

    <p>Hypoproteinemia (D)</p> Signup and view all the answers

    What serum sodium level indicates hyponatremia?

    <p>Below 135 mEq/L (D)</p> Signup and view all the answers

    Which of the following is a symptom of hypernatremia?

    <p>Intracellular dehydration (B)</p> Signup and view all the answers

    What is a common cause of hypokalemia?

    <p>Increased loss through diuretics (D)</p> Signup and view all the answers

    What serum potassium level indicates hyperkalemia?

    <p>Above 5.0 mEq/L (A)</p> Signup and view all the answers

    Which condition is likely associated with hypocalcemia?

    <p>Severe burns (D)</p> Signup and view all the answers

    What is a typical manifestation of hypercalcemia?

    <p>Constipation (C)</p> Signup and view all the answers

    Hypochloremia is often associated with which condition?

    <p>Metabolic alkalosis (C)</p> Signup and view all the answers

    What is a common cause of hyperchloremia?

    <p>Kidney failure (C)</p> Signup and view all the answers

    What level indicates hypomagnesemia?

    <p>Below 1.5 mEq/L (C)</p> Signup and view all the answers

    What is a noticeable symptom of hypermagnesemia?

    <p>Diminished reflexes (B)</p> Signup and view all the answers

    What is hypophosphatemia defined as?

    <p>Below 1.6 mEq/L (A)</p> Signup and view all the answers

    Which condition is often associated with hyperphosphatemia?

    <p>Hypocalcemia (D)</p> Signup and view all the answers

    How much of the total body water is extracellular fluid (ECF)?

    <p>20% (D)</p> Signup and view all the answers

    What percentage of total body water is intracellular fluid (ICF)?

    <p>40% (B)</p> Signup and view all the answers

    Flashcards

    Body Fluids

    The liquids containing water and dissolved substances in the body.

    Electrolytes

    Dissolved particles that dissociate into ions and conduct electricity in body fluids.

    Nonelectrolytes

    Substances that do not dissociate into ions in water and cannot conduct electricity.

    Osmotic Power

    The ability of a substance to cause fluid shifts across membranes.

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    Electrolyte Balance

    The equilibrium of electrolytes that controls fluid movements and functions in the body.

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    Potassium sparing diuretics

    Medications that prevent potassium loss while promoting fluid elimination.

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    Fluid imbalance

    Abnormality in total volume, concentration, or distribution of body fluids.

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    Hypovolemia

    A deficit in body fluid volume often leading to dehydration.

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    Dehydration

    A state where water loss exceeds sodium loss, causing negative fluid balance.

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    Fluid excess

    Condition where there is an expansion of extracellular fluid volume.

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    Hypervolemia

    An increase in extracellular fluid, possibly due to heart or kidney issues.

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    Oliguria

    Low urine output, often a sign of dehydration or fluid deficiency.

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    Pulmonary edema

    Fluid accumulation in the lungs, often a manifestation of hypervolemia.

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    Plasma

    The liquid component of blood, ~5% of body fluids.

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    Interstitial Fluid (IF)

    Fluid found in spaces between cells, ~14% of body fluids.

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    Transcellular Fluid

    Special fluids like lymph and cerebrospinal fluid, ~1% of body fluids.

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    Osmotic Pressure

    Pressure needed to stop water movement across a membrane.

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    ADH

    Antidiuretic hormone that regulates water retention.

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    Diuretics

    Medications that increase urine production and fluid excretion.

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    Loop Diuretics

    Diuretics that reduce sodium reabsorption in the kidney's loop.

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    Water Intoxication

    Condition caused by excess water retention or rapid excess ingestion, resulting in hyponatremia and cellular swelling.

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    Hyponatremia

    A condition characterized by low sodium concentration in the blood, often leading to cellular swelling.

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    Fluid Deficiency

    A state where there is reduced total body water or dehydration, affecting the body's functions.

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    Edema

    An atypical accumulation of fluid in the interstitial space, causing tissue swelling.

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    Increased Capillary Hydrostatic Pressure

    Higher pressure in capillaries leading to greater filtration and possible edema.

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    Colloid Osmotic Pressure

    The pressure exerted by proteins in the blood that helps draw fluid into the circulatory system.

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    Clinical Manifestations of Edema

    Symptoms of edema depend on the site, causing pain and impaired function in affected areas.

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    Hypocalcemia

    Condition where calcium level < 4.5 mEq/L causes muscle spasms.

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    Hypercalcemia

    Calcium level > 5.2 mEq/L causing confusion and muscle weakness.

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    Hypochloremia

    Chloride level < 98 mEq/L often with sodium or potassium imbalances.

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    Hyperchloremia

    Chloride level > 108 mEq/L leading to acid-base disorders.

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    Hypomagnesemia

    Magnesium level < 1.5 mEq/L with symptoms like muscle cramps.

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    Hypermagnesemia

    Magnesium level > 2.5 mEq/L causes muscle weakness.

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    Hypophosphatemia

    Phosphate level < 1.6 mEq/L linked to bone and muscle issues.

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    Hyperphosphatemia

    Phosphate level > 2.9 mEq/L usually without symptoms.

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    Intracellular Fluid (ICF)

    Fluid within cells, making up 40% of total body water.

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    Extracellular Fluid (ECF)

    Fluid outside cells, accounting for 20% of total body water.

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    Total Body Water

    60% of body weight in a 70kg adult male.

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    Study Notes

    Fluid and Electrolyte Balance

    • Electrolytes are salts, acids, bases, and some proteins
    • Electrolyte balance often refers only to salt balance
    • Salts control fluid movement, provide minerals for excitability, and are related to secretory activity and membrane permeability
    • Salts enter the body through ingestion and metabolism
    • Salts are lost through perspiration, feces, urine, and vomit

    Composition of Body Fluids

    • Water is the universal solvent in body fluids
    • Solutes are classified as nonelectrolytes and electrolytes
    • Body fluids contain electrolytes, which dissociate into ions in water
    • Examples of electrolytes include inorganic salts, acids, bases, and some proteins
    • Ions conduct electrical current
    • Electrolytes have greater osmotic power than nonelectrolytes and cause fluid shifts

    Altered Sodium Balance: Hyponatremia

    • Serum sodium level < 135 mEq/L
    • Causes include vomiting, diarrhea, and sweating
    • Manifestations are related to plasma hypoosmolality and cellular swelling
    • Symptoms include muscle twitching, weakness, hypotension, tachycardia, oliguria, anuria, and altered neuronal function (nausea, vomiting, lethargy)

    Altered Sodium Balance: Hypernatremia

    • Serum sodium > 145 mEq/L
    • Causes include excessive dietary sodium intake and loss of body water
    • Manifestations include intracellular dehydration (water movement from ICF to ECF), agitation, restlessness, decreased level of consciousness, hypertension, tachycardia, edema, and weight gain

    Altered Potassium Balance: Hypokalemia

    • Potassium level < 3.5 mEq/L
    • Causes include reduced intake, increased loss due to diuretics, severe vomiting, and diarrhea
    • Manifestations include membrane hyperpolarization (decreased neuromuscular excitability), cardiac arrhythmias, dizziness, hypotension, skeletal muscle weakness, and smooth muscle atony (nausea, anorexia, abdominal distension)

    Altered Potassium Balance: Hyperkalemia

    • Potassium level > 5 mEq/L
    • Causes include iatrogenic (inappropriate drug use), shift of K+ from ICF to ECF, and decreased renal excretion
    • Manifestations include membrane depolarization (increased neuromuscular excitability), cardiac arrest, abdominal cramping, and flaccid paralysis (reduced muscle tone)

    Altered Calcium Balance: Hypocalcemia

    • Calcium level < 4.5 mEq/L
    • Causes include medications (heparin/glucagon), severe burns, kidney failure, thyroid disorder, vitamin D deficiency, and sepsis
    • Manifestations include anxiety, increased excitability and muscle tetany, muscle twitch, spasm, cardiac arrhythmia, and hypotension

    Altered Calcium Balance: Hypercalcemia

    • Calcium level > 5.2 mEq/L
    • Causes include excessive bone breakdown, thyroid disease, excessive calcium supplements intake, and excessive calcium-containing antacids
    • Manifestations include decreased neuromuscular irritability (inhibits neurons and muscle cells), confusion, headaches, irritability, constipation, nausea, vomiting, heart arrhythmias, and muscle weakness

    Altered Chlorine Balance: Hypochloremia

    • Chlorine level < 98 mEq/L
    • Often associated with hyponatremia, hypokalemia, and metabolic alkalosis
    • Causes include vomiting, diarrhea, and diuretics
    • Manifestations include excessive tone of muscle, tetany, weakness, twitching, shallow, depressed breathing, paralysis, and mental confusion

    Altered Chlorine Balance: Hyperchloremia

    • Chlorine level > 108 mEq/L
    • Causes include severe dehydration, kidney failure, hemodialysis, and traumatic brain injury
    • Manifestations include hyperchloremic metabolic acidosis, deep rapid breathing, headache, diminished cognitive ability, and cardiac arrest

    Altered Magnesium Balance: Hypomagnesemia

    • Magnesium level < 1.5mEq/L
    • Associated with hypokalemia and hypocalcemia
    • Causes include malnutrition, malabsorption, severe burns, alcoholism, and diuretic use
    • Manifestations include tetany, muscle cramps, seizures, altered neuromuscular transmission, cardiac arrhythmia, and hypotension

    Altered Magnesium Balance: Hypermagnesemia

    • Magnesium level > 2.5mEq/L
    • Less frequent than hypomagnesemia
    • Causes include excessive intake of magnesium supplements, magnesium antacids, and end-stage renal disease
    • Manifestations include reduced neuromuscular transmission and cell excitability, diminished reflexes, muscle weakness, and hypotension

    Altered Phosphate Balance: Hypophosphatemia

    • Phosphate level < 1.6 mEq/L
    • Often associated with hypomagnesemia and hypokalemia
    • Causes include severe burns, malnutrition, malabsorption, vitamin D deficiency, alcoholism, kidney disease, and prolonged diuretic use
    • Manifestations include osteomalacia (soft bones), bone deformities, muscle weakness, tremor, and paresthesia (tingling, burning)

    Altered Phosphate Balance: Hyperphosphatemia

    • Phosphate level > 2.9 mEq/L
    • Associated with hypocalcemia (reciprocal changes)
    • Causes include fractures, bone disease, hypoparathyroidism, acromegaly, systemic infection, intestinal obstruction, and major tissue trauma
    • Manifestations include no associated manifestations

    Fluid Compartments

    • Total body water is 60% of body weight (40 L in a 70 kg male)
    • Two main compartments are intracellular fluid (ICF) and extracellular fluid (ECF)
    • ICF comprises 40% of total body water, found inside cells
    • ECF comprises 20% of total body water, outside cells and includes plasma (~5%), interstitial fluid (~14%), and transcellular fluid (~1%)

    Fluid Movement Among Compartments

    • Fluid exchange and mixing are continuous
    • Movement is along osmotic gradients
    • All body fluid osmolality is almost always equal
    • Changes in solute concentration (any compartment) lead to net water flow

    Fluid Regulation Cycle

    • The cycle involves the hypothalamus, kidneys, and other organs
    • ADH (antidiuretic hormone) is produced in response to changes in blood volume or osmolarity. ADH leads to water retention or excretion as needed
    • In response to changes in blood pressure, the kidneys produce renin, regulating blood pressure and water balance. Hormones such as aldosterone, promote sodium retention or excretion

    Diuretics

    • Drugs that increase urine production to adjust fluid balance
    • Types of diuretics include loop diuretics, thiazide diuretics, and potassium-sparing diuretics
    • Each type targets a different segment of the nephron to promote fluid excretion

    Disorders of Water Balance

    • Categorized as total volume, concentration, or fluid distribution imbalances
    • Disorders include fluid deficiency (negative balance), fluid excess (positive balance), and fluid sequestration (edema formation)

    Hypovolemia (Fluid Deficiency)

    • Deficit of body fluid volume
    • Causes include excessive body fluid loss, reduction in fluid intake, loss of fluid due to a third space, or hemorrhage
    • Manifestations include thirst, dry mucous membranes, weight loss, flattened neck veins, diminished skin turgor, prolonged capillary refill, decreased urine output, increased heart rate, decreased blood pressure, and altered level of consciousness

    Dehydration (Fluid Deficiency)

    • Negative fluid balance; body eliminates significantly more water than sodium
    • ECF osmolality rises due to water loss through profuse sweating, water deprivation, diuretic abuse, endocrine disturbances (diabetes mellitus, ADH hyposecretion), or diabetes insipidus
    • Dehydration affects all water compartments
    • Clinical signs include skin turgor loss, sticky oral mucosa, thirst, dry flushed skin, and low urine output

    Hypervolemia (Fluid Excess)

    • Expansion of extracellular fluid, involving interstitial or vascular space
    • Causes include heart failure, cirrhosis, kidney failure, excessive fluid replacement, and administration of osmotically active fluids
    • Manifestations include increased blood pressure, increased sodium and water excretion, heart failure, and pulmonary edema

    Hypotonic Hydration (Fluid Excess)

    • Cellular overhydration (water intoxication)
    • More water than sodium is retained or rapid, excess water ingestion
    • Occurs after periods of strenuous activity, or excessive water intake without electrolyte replenishment which leads to a decrease in ECF osmolality and net osmosis of water into tissue cells
    • Manifestations include swelling of the cells, severe metabolic disturbances (nausea, vomiting, muscular cramping, cerebral edema), possible death

    Fluid Sequestration (Edema)

    • Atypical accumulation of fluid in interstitial space
    • Causes include increased fluid out of blood, decreased fluid into blood, (increased capillary hydrostatic pressure, decreased capillary oncotic pressure, increased capillary permeability, and lymphatic obstruction)
    • Edema can result in impaired function in joints, organs like brain and lungs, and extremities like arms and legs

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    Description

    Test your knowledge on the functions and importance of electrolytes in the body. This quiz covers topics such as dehydration, water balance disorders, and the role of electrolytes in maintaining osmotic power. Challenge yourself to see how well you understand electrolyte balance and its symptoms.

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