Water & Sodium Pathophysiology: Extracellular Fluid (ECF) and Intracellular Fluid (ICF)

by Carlo Raj, MD

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    Students have always asked me "Dr. Raj, I am having a hard time keeping straight and organized the feedback mechanisms for water and sodium pathophysiology." This is probably the most important section here. You go through as far as laying down the foundation of figuring out the two compartments of ECF and ICF. What kind of hormones would be involved and a little bit of a clinical tag that I will be putting in for you along with the physiology so that you clearly know how to move on to in the next lecture series of isotonic, hypotonic and hypertonic fluid disorders. Let us now begin. Basic definitions. Well, it comes down to the kidneys, doesn't it really? Really. In terms of being able to properly control and regulate your fluids. Electroneutrality of body fluid compartments become importance of back and basic physiology when you are dealing with action potentials and all. And you are dealing with electroneutrality whenever you have a positive ion such as sodium, of course, being the most infamous of them all and along with it must be a chloride so that you can have proper electroneutrality as an example. Composition between ICF and ECF is basically what this line is saying. For example, when we talked about total body water, you should know that majority of your total body water is where? Good. ICF. 2/3, isn't it? Simple things that you knew and you know that you keep repeating so that it becomes part of your unconscious reflex. ECF, would you tell me as to what is the most important component clinically for us to measure in your ECF. And you're telling me the vascular compartment, isn't it? The plasma compartment. The effective circulating volume compartment. All of this is the same name. They are...

    About the Lecture

    The lecture Water & Sodium Pathophysiology: Extracellular Fluid (ECF) and Intracellular Fluid (ICF) by Carlo Raj, MD is from the course Fluid and Electrolyte Balance. It contains the following chapters:

    • Water & Sodium Pathophysiology
    • Changes in ECF Volume
    • Plasma Osmolality (POsm)
    • Clinical Volume Dynamics

    Included Quiz Questions

    1. 1/12
    2. 3/4
    3. 2/3
    4. 1/3
    5. 1/4
    1. Interstitial fluid compartment
    2. Vascular compartment
    3. 1/12 of total body water
    4. ¼ of extracellular fluid volume
    5. Effective circulating volume
    1. Intracellular fluid compartment
    2. Extracellular fluid compartment
    3. Plasma fluid compartment
    4. Vascular fluid compartment
    5. Interstitial fluid compartment
    1. Decreased effective circulative volume.
    2. Decreased oncotic pressure in the plasma compartment.
    3. Ineffective circulation of blood due to heart dysfunction.
    4. Loss of isotonic fluid.
    5. Increased hydrostatic pressure in the plasma compartment.
    1. Lack of total caloric nutrition.
    2. Lack of protein nutrition.
    3. Too much fluid in the extracellular compartment.
    4. Urinary albumin loss.
    5. Inability to form albumin.
    1. Increased hydrostatic pressure in the plasma compartment.
    2. Increased oncotic pressure in the interstitium.
    3. Increased hydrostatic pressure in the interstitium.
    4. Decreased hydrostatic pressure in the plasma comparment.
    5. Decreased oncotic pressure in the plasma compartment.
    1. Inability to produce albumin.
    2. Dysfunctional liver metabolism.
    3. Excessive hydrostatic pressure.
    4. Protein wasting in the urine.
    5. Insufficient protein intake.
    1. In order to account for electroneutrality.
    2. Because it travels as a diatomic molecule.
    3. It is the proportion of Na compared to other solutes.
    4. It is related to the atomic weight of sodium.
    5. It is twice the size of the solvent molecule.
    1. All are correct.
    2. Thick ascending limb is impermeable to water.
    3. Urea diffuses freely between ECF and ICF.
    4. Capillary membrane is permeable to water and solute.
    5. Cell membrane is permeable to water.
    1. Because it diffuses freely between compartments.
    2. Because it is does not affect osmotic gradient.
    3. All answers are correct.
    4. Two answers are correct.
    5. Because it is too large for normal transport.
    1. Fluid moves according to the osmolality.
    2. Water moves along with sodium.
    3. It is impermeable to urea.
    4. It is permeable to glucose.
    5. It is permeable to sodium.
    1. Increased ICF osmolality
    2. Increased plasma volume
    3. Increased ICF volume
    4. Decreased ECF osmolality
    5. Increased ECF volume
    1. Capillary membrane is impermeant to sodium.
    2. Shifts between the ICF and ECF are controlled by solute concentration.
    3. Cell membrane is impermeant to sodium and glucose.
    4. Plasma compartment and interstitium are separated by the capillary membrane.
    5. ECF and ICF are separated by the cell membrane.
    1. Global vasodilation
    2. Protein wasting in the urine
    3. Water deprivation
    4. Inefficient cardiac pump
    5. Inability to produce albumin
    1. Loss of isotonic fluid
    2. Loss of free water
    3. Loss of hypertonic fluid
    4. Loss of salt
    5. Loss of protein
    1. Patient with sepsis
    2. Patient with cirrhosis
    3. Patient with Kwashiorkor
    4. Patient with nephrotic syndrome
    5. Patient with congestive heart failure
    1. Increase in intracellular fluid osmolality
    2. Increase in extracellular fluid volume
    3. None are correct
    4. Increase in intracellular fluid volume
    5. Decrease in extracellular fluid osmolality
    1. Patient infused with isotonic saline.
    2. Patient infused with D5W.
    3. Patient with Diarrhea.
    4. Patient with Addison’s disease.
    5. Patient with syndrome of inappropriate antidiuretic hormone
    1. Extracellular fluid osmolality
    2. Extracellular fluid volume
    3. Effective circulating volume
    4. Intracellular fluid volume
    5. Patient characteristics
    1. High salt intake
    2. Infusion of isotonic saline
    3. SIADH
    4. Adrenal insufficiency
    5. Water deprivation

    Author of lecture Water & Sodium Pathophysiology: Extracellular Fluid (ECF) and Intracellular Fluid (ICF)

     Carlo Raj, MD

    Carlo Raj, MD

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