Isotonic Fluid Loss

Mr. K. B’s kidneys should be compensating for his fluid losses and electrolytes by excreting more acids and

4. Why does potassium concentration rise in patients with acidosis? What is this called? What effects does it have?

Irrespective of the potential metabolic acidosis, Initial management of both DKA and HHS is focused on rehydration. The aim is to replace fluids in the both the intravascular and extra vascular spaces, while simultaneously diluting glucose levels (and thus lower osmolality) and counter-regulatory hormones (Raghavan, 2014) The Monash Health HHS & DKA

If, these signs and symptoms go undetected, for a long period of time, they will result in chronic dehydration and cause several other medical issues. (Vasey, 2002) One of the results of chronic dehydration is fatigue or energy loss which resembles depression. (Vasey, 2002) Constipation is another result chronic dehydration, by removing too much excess liquid from stool making it hard to expel. (Vasey, 2002) Chronic dehydration also contributes to digestive disorders such as: poor digestion, gas, bloating, pain, nausea, ingestion, and loss of appetite. (Vasey, 2002) The average body produces 7 liters of digestive juices daily; but a dehydrated individual will secrete less, thereby causing improper digestion. (Vasey, 2002) Chronic dehydration causes high blood pressure due to low blood volume and the vessels sharply contracting. (Vasey, 2002) It can also cause low blood pressure in individuals, with weak vasoconstriction, who again, have a low blood volume. (Vasey, 2002) Chronic dehydration is also the culprit of gastritis and

The thick mucus also builds up in the pancreas causing the digestive enzymes not to do their jobs effectively. Nutrition is not broken down properly and so the body can’t absorb it right. That causes the weight loss and diarrhea.

After passing through the esophagus, which absorbs much of the salt ions in the swallowed saltwater, and the gut the luminal fluid is isosmotic with the plasma. The intestines continue to absorb salt (sodium through chloride co-transport proteins and the chloride through the sodium co transport proteins and anion exchange protinis) which is followed by an uptake of water. More chloride is absorbed than sodium which creates an electrogradient in the cell (the cell being more positive and the plasma more negative). The anion exchanger intakes chloride all while excreting HCO3- into the intestinal lumen. The intestinal fluid is highly alkaline, high in HcO3- and high in calcium (from the environment), this allows for CaCo3 to be precipitated in the

The kidney is the organ involved in the filtration of blood and excretion of toxins. An increased ingestion of solutes creates a concentration gradient in the kidneys that causes an increase in the production of ADH by the hypothalamus. This causes an increase in the permeability of the distal and collecting tubes in their kidneys and an increased uptake of water (Reese et al 2011). The purpose of this lab is to examine the effect of sodium chloride on the production of ADH by observing the volume and density (measured as specific gravity) over a total period of 120 minutes. Based on the given information, it can be predicted that the subjects

Although the mucosa itself does not appear to be damaged by CT, the net flow of Na+ into tissue is decreased and the net flow of Cl- and water out of tissue is increased so as a result, there is more Na+, Cl-, and water in the lumen than there should be. This leads to massive diarrhea and great electrolyte imbalance. A patient with severe cholera can lose up to 20L of water a day (Salyers A., Abigail, 141). At times, diarrhea becomes so dilute it is almost clear, containing flecks of mucus that it is called rice water stool because of its watery consistency (Salyers A., Abigail, 142). This rapid rate of water loss and dehydration is tremendously fatal. At its most extreme, symptoms emerge in 3-4 hours, previously healthy patients can die within 6-8 hours of infection, and more commonly go into shock 6-12 hours after infection and die within 18 hours (Weekly Epidemiological Record, 6). Cholera’s level of severity is very life threatening and remains a big problem even in our world today.

Diarrhea being expelled from the body is not normal. This indicates that there is an issue within the gastrointestinal tract. Normally the small intestine absorbs most of the water in chyme. Approximately 95% of water is absorbed in the small intestine by osmosis (Marieb, 2014). The remaining water is usually absorbed in the large intestine, and some is even used to help soften the stool that is supposed to be pushed out. Peristalsis and segmentation in the small intestine helps mucosal cells absorb the water within the chyme. According to Marieb (2014), water moves freely in both directions of the intestinal mucosa, and active transport of solutes into the mucosal cells creates net osmosis because of the concentration gradient established. Therefore, water uptake is paired to solute uptake, and then affects the absorption of substances that

However, “although V. cholerae is the source of the cholera infection, the deadly effects of the disease are the result of a potent toxin, called CTX, that the bacteria produce in the small intestine. CTX binds to the intestinal walls, where it interferes with the normal flow of sodium and chloride. This causes the body to secrete enormous amounts of water, leading to diarrhea and a rapid loss of fluids and salts (electrolytes)” (Cholera: Causes)

The large intestines plays a major role in storing waste before its eradication, it also reabsorbs water and maintains the fluid balance of the body, process certain undigested molecules and vitamins. The ENS is lining the wall of the digestive tract; myenteric is located deep amid the external muscle layers from the esophagus to the anus. Its role is to increase smooth muscle tone in the gut, create rhythmic contractions at variable speeds, increase or decrease contractions of peristaltic waves as well as inhibiting sections of smooth muscle that is stopping the flow of contents. The submucosal ganglia are located in the submucosa which is right under the mucosal membrane in the large intestines, this ganglia helps in absorption, contraction of the submucosal muscle and intestinal secretion

Vomiting and diarrhea cause a number of changes to the body. With the loss of stomach contents, we also see a loss of Hydrochloric Acid (HCl), which in turn contributes to the loss of potassium, or hypokalemia, and loss of sodium, or hyponatremia. The kidneys begin to retain any sodium that is in the collecting ducts by sacrificing hydrogen ions. This helps to prevent loss of potassium by halting the sodium/potassium pump and leads to Metabolic Alkalosis. The loss

If metabolic acidosis persists for many hours and if the kidneys are functional, the kidneys can also help compensate for metabolic acidosis. They begin to secrete hydrogen ions at a greater rate and increase the rate of bicarbonate ion reabsorption. Symptoms of metabolic acidosis appear if the respiratory and renal systems are not able to maintain the pH

The human body contains blood and fluid compounds and elements like chloride, phosphate, potassium, calcium, sodium, and magnesium known as electrolytes that occur naturally to control important physiologic functions. When the body levels of electrolytes are low (hypo) or high (hyper) it results in electrolyte disorder. Depending on the affected electrolyte(s), when body electrolytes are hyper (high) or hypo(low) it leads to electrolyte disorder, which in turn disrupts blood ionized salts balance ( Buttaro, et al., 2017). For instance, disruption of chloride leads to either hyperchloremia or hypochloremia, calcium (hypercalcemia or hypocalcemia ), Potassium (hyperkalemia or hypokalemia), Magnesium disruption

Chloride depletion also results from loss of GI secretions caused by severe vomiting (case study) or diarrhea. Chloride and bicarbonate are the two main anions in the plasma, and their concentrations vary inversely. When the plasma chloride falls, plasma bicarbonate rises to keep the total concentration of anions in the extracellular fluids in check.