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2024 UTMB PATHO EXAM 2 WITH CORRECT ANSWERS
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2024 UTMB PATHO EXAM 2 WITH CORRECT ANSWERS
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2024 UTMB PATHO EXAM 2 WITHCORRECT ANSWERS
Drugs to decrease fluid volume: Diuretics - CORRECT ANSWERS-Examples:
1) Furosemide (Lasix) - a loop diuretic (works in the Loop of Henle in the
kidneys)
2) Hydrochorothiazide (HCTZ) - a thiazide diuretic
3) Spironlactone (aldactone)- an aldosterone receptor antagonist; potassium
sparing
*lasix is the most effective
Potential etiologies of edema - CORRECT ANSWERS-Increased hydrostatic
pressure
Increased capillary permeability
Lowered plasma oncotic pressure (due to decreased plasma proteins -
albumin)
Lymphatic channel obstruction; breast cancer
Consider what might cause each of these... (etiology)
*Pitting edema is almost always cardiac related
Intracellular Fluid - CORRECT ANSWERS-fluid within the cells. Contains about
two thirds of the water in healthy adults.
extracellular fluid - CORRECT ANSWERS-fluid outside of the cells including
those in the interstitial or tissue spaces and the plasma in the blood vessels.
Electrolytes - CORRECT ANSWERS-Substances that dissociate in a solution to
form a charged particle
Lasix (furesomide) - CORRECT ANSWERS-Mechanism of Action- acts in the
ascending loop of Henle to block sodium and chloride reabsorption, causing
profound diuresis
Given orally, IV and occasionally IM; action begins within 60 minutes when
given orally and five minutes when given IV
Given for pulmonary edema, CHF, cardiac and other edemas unresponsive to
less powerful diuretics
,May be combined with a thiazide diuretic
Ions - CORRECT ANSWERS-are the charged particles,
Example: NaCl
Nonelectrolytes - CORRECT ANSWERS-substances that do not dissociate into
charged particles, e.g. glucose,
Normal capillary- interstitial fluid exchange - CORRECT ANSWERS-The
transfer of water between the vascular and interstitial compartments occurs
at the capillary level. There are four main forces that control the movement
of water between the capillary and interstitial spaces:
1. capillary filtration pressure
2. capillary colloidal osmotic pressure
3. interstitial/tissue hydrostatic pressure
4. interstitial colloidal osmotic pressure
-normally the combination of these four forces is such as that only a small
excess of fluid remains in the interstitial compartment. This excess fluid is
removed from the interstitial by the lymphatic system and returned to the
systematic circulation.
Capillary filtration pressure - CORRECT ANSWERS-Capillary filtration refers to
the movement of water through capillary pores because of hydrostatic
pressure, rather than osmotic pressure. Capillary filtration pressure PUSHES
WATER OUT OF THE CAPILLARY INTO THE INTERSTITIAL SPACES. It reflects
the arterial pressure and venous pressure, the precapillary (arterioles) and
post capillary (venues) resistance, and the force of gravity.
Capillary filtration pressure mm Hg - CORRECT ANSWERS-30-40 at arterial
end
10-15 at venous end
25 in the middle
capillary colloidal osmotic pressure - CORRECT ANSWERS-Is the osmotic
pressure generated by the plasma proteins that are too large to pass
through the pore of the capillary wall. Because plasma proteins do not
normally penetrate the capillary pores and because their concentration is
greater in the plasma than in the interstitial fluid, it is capillary colloidal
osmotic pressure that PULLS FLUID/WATER BACK INTO THE CAPILLARY.
interstitial/tissue hydrostatic pressure - CORRECT ANSWERS-OPPOSES THE
MOVEMENT OF WATER OUT OF THE CAPILLARY .
,it is normally negative, contributes to the outward movement of water into
and out of the interstitial spaces
interstitial colloidal osmotic pressure - CORRECT ANSWERS-PULLS WATER
OUT OF THE CAPILLARY INTO THE INTERSTITIAL SPACES.
It reflects the small amount of plasma proteins that normally escape into the
interstitial spaces from the capillary, also pulls water out of the capillary into
the tissue spaces.
Hydrostatic pressure - - CORRECT ANSWERS-Pushing force exerted by a fluid.
Arterial capillary pressure is about 30 mm Hg and venous is 10. Interstitial
fluid may have a negative hydrostatic pressure of about (-3 mm), which
contributes to outward movement of fluid from the capillary.
Colloidal osmotic pressure - - CORRECT ANSWERS-Pulling force of plasma
proteins that cannot pass through the capillary membrane; assist the
movement of fluid back into the capillary
Intracellular fluid (ICF)- - CORRECT ANSWERS-contained in all body cells,
including the blood cells
Extracellular fluid (ECF) - CORRECT ANSWERS-contained in the vascular
system (blood plasma) and fluid contained in the interstitial spaces
Third-spacing - CORRECT ANSWERS-fluid trapped in one of several possible
transcellular spaces
Ex. pleural effusion, pericardial effusion, ascites.
This fluid is not available for ECF or ICF uses, since it is trapped or
"sequestered".
Pericardial effusion is the blood that is surrounding the heart and that
compresses the heart not allowing it to bead needs to be surgical to
decompress the heart
Third-space - CORRECT ANSWERS-Third spacing represents the loss or
movement and trapping of ECF in a transcompartmental space.
Osmosis - CORRECT ANSWERS-movement of water from an area of lower
concentration to an area of greater concentration of solutes (electrolytes)
Isotonic - CORRECT ANSWERS-has the same effective osmolality as the ICF,
neither shrink nor swell
, Ex. .9% sodium chloride
Hypotonic - CORRECT ANSWERS-has a lower osmolarity than the ICF, they
swell as water moves into the cell
Hypertonic - CORRECT ANSWERS-has a great osmolarity than the ICF, they
shrink as water is pulled out of the cell
Osmolarity of fluids - CORRECT ANSWERS--Osmolarity of body fluids has
many clinical implications, thus it is an important concept.
-Osmolarity of the blood plasma (serum) is determined largely by the
amount of Sodium (Na+) contained in the plasma. A patient with an elevated
serum Na+ will have serum hyperosmolarity. In this case, what fluid
movement would you expect to happen? (think of osmosis) The cell will
shrivel
Water gains - CORRECT ANSWERS-main source normally is oral intake;
Metabolism of nutrients supplies an additional small amount of H20.
Main source is through oral intake and metabolic process.
Water Losses - CORRECT ANSWERS-urine output, perspiration, lungs, NG
tube because its sucking out fluid, diahrrea,
The largest loss of water occurs through the kidneys, with lesser amounts
being lost through the skin, lungs, and GI tract
Normal homeostatic mechanisms - CORRECT ANSWERS-thirst, increased or
decreased secretion of ADH, increased or decreased urine output.
Water losses: normal and abnormal: kidneys - CORRECT ANSWERS-major
source of water loss (urine). Obligatory urine output: 300-500ml /24 hrs for
an adult (hourly urine output may need to be carefully assessed)
*shouldn't drop below 30ml per hours normal urine output is 50 ml per hour
Water losses: normal and abnormal: skin - CORRECT ANSWERS-normal
perspiration (may be "insensible"); abnormal - diaphoresis ("drenched in
sweat")
*water losses that occur through evaporation losses from skin and to
moisten air in the respiratory system are referred to as insensible water
losses
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