10 Questions
What is the primary determinant of serum osmolality and water transport?
Sodium concentration
Which hormone is released by the juxtaglomerular cells of the kidney in response to hypotension?
Renin
Where is angiotensin I converted to angiotensin II?
Kidneys
What is a primary function of angiotensin II?
Stimulate vasoconstriction
Which hormone increases renal tubular reabsorption of sodium and water?
Aldosterone
What triggers the release of ADH from the posterior pituitary?
Decrease in serum osmolality
Which structure plays an essential role in maintaining the normal fluid homeostasis of the body?
Endothelial glycocalyx
What can damage the endothelial glycocalyx layer?
All of the above
Which fluid solution is preferable for resuscitation related to dehydration conditions?
Lactated Ringers
What is the most isotonic of the balanced salt solutions?
Lactated Ringers
Study Notes
Fluids, Electrolytes, and Blood Therapy
Osmolality and Water Transport
- Serum osmolality is primarily determined by sodium concentration
- Sodium concentration regulates water transport
Renin-Angiotensin-Aldosterone System
- Juxtaglomerular cells of the kidney release renin in response to hypotension
- Angiotensin I is converted to angiotensin II in the lungs
- Angiotensin II stimulates vasoconstriction
- Aldosterone stimulates renal tubular reabsorption of sodium and water
- Angiotensin II increases heart rate
ADH and Fluid Homeostasis
- ADH (antidiuretic hormone) increases urine osmolality and regulates water balance
- ADH release is triggered by an increase in serum osmolality or a decrease in blood volume
- Endothelial glycocalyx plays an essential role in maintaining normal fluid homeostasis
Fluid Solutions
- Normal saline (0.9% sodium chloride) is a crystalloid solution
- Lactated Ringers is a crystalloid solution that contains calcium and is contraindicated with citrated infusion products
- Hydroxyethyl starches are colloids that can cause nephrotoxicity and are contraindicated in patients with pre-existing renal injury
- Albumin is a colloid that can be used as a volume expander
Electrolytes and Hormones
- Sodium is the primary cation in the extracellular fluid
- Potassium is the primary cation in the intracellular fluid
- Chloride is the primary anion in the extracellular fluid
- Aldosterone regulates sodium balance
- ANP (atrial natriuretic peptide) stimulates the removal of sodium and water from the body
- Cortisol stimulates protein catabolism, increases metabolic rate, and stimulates renal excretion of potassium
Fluid Therapy
- Crystalloids are used to manage dehydration and can cause hyperchloremic metabolic acidosis
- Colloids are used as volume expanders and can cause nephrotoxicity
- Normal saline can cause hyperchloremic metabolic acidosis due to its high concentration of chloride
- Lactated Ringers can cause hyponatremia and hypocalcemia
- Hydroxyethyl starches are contraindicated in patients with sepsis due to the risk of renal injury and increased mortality
Test your knowledge of fluids, electrolytes, and blood therapy in this multiple choice quiz. Questions cover serum osmolality, hormone regulation, and blood pressure management.
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