Regulation of Fluid and Electrolyte Balance

by Carlo Raj, MD

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    Continuing our discussion of sodium and water pathophys. Well, we are going to take this information, stuff that we have seen and really put onto clinical setting. That at this point I would say this is more of an advanced type of application of what we have seen earlier. But trust me it's not too bad. So two carefully regulated parameters. Regulated. We have effective circulating volume. What does that mean to you? The plasma. In other words, that is your intravascular volume, isn't it? And you have tonicity. Tonicity, of course, representing the osmolarity. Effective circulating volume is found in the extracellular fluid. The tonicity is then determined by, here you go again, serum sodium concentration. The serum sodium concentration as we discussed in previous lectures, was the fact that it is your total body sodium over your total body water. And we went through all of your isotonic, hypotonic, hypertonic disorders. Effective circulating volume, the operative term here portion of the intravascular volume that then, of course, perfuses your organs. Hence, there has to be constant regulation. These two bullet points as simple as it may seem have profound meaning. Listen. Normally body fluid volume, how do you control this? Let me bring in the hormone aldosterone. With aldosterone, when it kicks in, it wants to do what? Reabsorb the sodium. As soon as you reabsorb the sodium, does it affect osmolarity or does it affect more of the volume? Interesting. For example, if you talk about aldosterone and increasing blood pressure and you are reabsorbing your sodium, does that increase more of your systolic or diastolic blood pressure? Mean to say that sodium fluid comes in. It puts more fluid or volume into the heart. You increase your stretch thus you increase your systolic blood pressure. So...

    About the Lecture

    The lecture Regulation of Fluid and Electrolyte Balance by Carlo Raj, MD is from the course Fluid and Electrolyte Balance. It contains the following chapters:

    • Regulation of Water and Sodium Balance
    • Key Points
    • Regulation Wheels

    Included Quiz Questions

    1. Aldosterone and ADH
    2. Renin and Aldosterone
    3. Renin and ADH
    4. Renin and Angiotensin II
    5. Aldosterone and Angiotensin II
    1. ADH increases urine osmolarity
    2. Aldosterone increases plasma osmolarity
    3. None are correct
    4. ADH increases effective circulating volume
    5. Aldosterone decreases effective circulating volume
    1. Under most conditions osmolarity is more tightly regulated than volume.
    2. Volume is mainly regulated by antidiuretic hormone.
    3. None of the statements are correct.
    4. All of the statements are correct.
    5. Osmolarity is mainly regulated by aldosterone.
    1. Suppresion of ADH release
    2. Renin release
    3. None are correct
    4. Angiotensin II activation
    5. Aldosterone activation
    1. Angiotensin II
    2. Renin
    3. None are correct
    4. ADH
    5. Aldosterone
    1. If greater than 10% of effective circulating volume is lost.
    2. Volume regulation is always more tightly regulated than osmolarity.
    3. Only when plasma osmolarity is in the normal range.
    4. When systolic blood pressure has fallen by at least 10 mmHg.
    5. Only when antidiuretic hormone is released.
    1. Systolic blood pressure
    2. Diastolic blood pressure
    3. Sodium excretion
    4. Renin release
    5. Plasma osmolarity

    Author of lecture Regulation of Fluid and Electrolyte Balance

     Carlo Raj, MD

    Carlo Raj, MD

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