Acid–Base Physiology
. Thus, pH is defined as the negative logarithm of the [H+]. An inverse relationship exists between pH and [H+]. In other words, as the pH increases, the [H+] decreases…
Body Fluid Compartments
Electrolyte Mol wt Valence Eq wt Concentrations Intracellular concentration mg/dL mEq/dL mmol/L mEq/L Cations Na+ 23 1 23 326 142 142 14 K+ 39 1 39 16 4 4 140 Ca2 + a 40…
Metabolic Alkalosis
Chloride-responsive alkalosis Chloride-resistant alkalosis Gastrointestinal (GI)and renal-associated Hypertension-associated Vomiting Primary aldosteronism Nasogastric suction 11β-hydroxysteroid dehydrogenase type 2 deficiency Congenital chloride diarrhea Licorice, chewing tobacco, carbenoxolone Villous adenoma Fludrocortisone administration Posthypercapnia…
Disorders of Water Balance: Hypernatremia
where Nae + and Ke + are total exchangeable quantities of these cations, and TBW is total body water. Therefore, hypernatremia can develop by a deficit in total body water…
Mixed Acid–Base Disorders
Acid–base disorder Clinical setting pH pCO2 a Na+ K+ Cl− HCO3 −a AG Double acid–base disorders Metabolic acidosis and metabolic alkalosis Renal failure (CKD 4 and 5), diabetic ketoacidosis, lactic…
Disorders of Potassium: Physiology
Fig. 14.1 Handling of K+ by various segments of the nephron; 60–80 % of K+ is reabsorbed by the proximal convoluted tubule (PCT) and about 25 % by the medullary thick ascending limb…
Interpretation of Urine Electrolytes and Osmolality
Electrolyte Use Na+ To assess volume status Differential diagnosis of hyponatremia Differential diagnosis of AKI To assess salt intake in patients with hypertension To evaluate calcium and uric acid excretion…
High Anion Gap Metabolic Acidosis
From the above reaction, excess lactate production can be expected by the following pathophysiologic processes: 1. Increased pyruvate production caused by intravenous (i.v.) glucose or epinephrine infusion, and metabolic or…
Disorders of Potassium: Hyperkalemia
Cause Mechanism 1. Exogenous intake Oral Excess oral intake High K+—containing foods (fruits, salt substitutes, KCl supplements, river bed clay, burnt match heads, raw coconut juice) Herbal medications (horsetail, noni…
Hyperchloremic Metabolic Acidosis: Nonrenal Causes
Intestinal Diarrhea Biliary fistula Pancreatic fistula Villous adenoma Gastrointestinal (GI)–ureteral connections Ureterosigmoidostomy Ureterojejunostomy Ureteroileostomy Drugs Laxatives Cholestyramine Before we discuss the pathophysiology of diarrhea, it is essential to understand water…
