Quote:
Originally Posted by hunteradam07
I know what u mean interm of fluid shift and celebral edema. However, the dr. from Pass Program really makes a big deal about different electrolytes imbalance causing different depolarize or repolarize states and it links to clinical. I jz want to know if it's correct. So if anyone could tell me about that concepts, i would appeciate a lot. Thanks folks.
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I hope this might help... The Low Volume State....
Long term Control of BP- Stimulate JG apparatus- by low flow to the kidneys.
- Renin comes out
- Cuts Angiotensinogen (formed in liver) to Angiotensin I
- Angiotensin I is converted by ACE (in lungs) to Angiotensin II
- Angiotensin II
- Very potent vasoconstrictor
- TPR
- BP
- Ag II will also stimulates Aldosterone
- To decrease loss of volume
- Aldosterone goes to kidney and reabsorbs Na from DCT
- Excretes K in the process.
- Serum Na will be diluted and decreased. Because Na brings in 3x the Water!!!
- Serum Cl will also decrease due to dilution
- Serum K will decrease because of secretion
- Also excretes H+
LOW VOLUME STATE (after chronic period of time)
Will present with:- Hypertension
- TPR → Renin/Angio System
- ¯Na → Aldosterone
- ¯K → Aldosterone
- pH (metabolic alkalosis)
- Examples:
- CHF
- Pregnant woman with emesis
- Child with projectile vomiting
- Patient with renal artery stenosis
- Exercise
- ANY TIME ↓ Blood flow to the kidneys!!!
3 Exceptions: Low volume states that present with METABOLIC ACIDOSIS
1. Diarrhea → loss of HCO3-
2. DKA → ↑ ketones
3. RTA II – loss of HCO3-
Now, from what I have read...and remember..The different depolarization states for Na, K, Cl, Mg, Ca all play a large role in the more or less wanting to depolarize...too much K causes overshoot (I think) and if there is not enough Na the cell can't reset to go again... I hope this helps...