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DR. RAJENDRAN’S INSTITUTE OF MEDICAL EDUCATION
Phone 0470 – 2604199, 09388852220.
FLUID AND ELECTROLYTE DISTURBANCES
MANIFESTATIONS OF DISORDERED WATER, ELECTROLYTE AND ACID-BASE STATUSPrimary disturbanceAltered physiologyClinical effect
SodiumECF volumeCirculatory changesWaterECF osmolalityCerebral changesPotassiumAction potentialNeuromuscular weakness,cardiac effectsHydrogen ionAcid-base Balance (pH)Altered tissue function, respiratorycompensationMagnesiumCell membrane StabilityNeuromuscular, vascular and cardiaceffects
Phosphate
Cellular energeticWidespread tissue effects
1)
What percentage of body weight in men is water?a.15b.30
c.
60T [ About 50% of body weight in women and60% in men is water. Body fat content influences the proportion of body weight that iswater. As body fat increases, water declines as a proportion of body weight. As musclemass increases, water increases as a proportion of body weight. Intracellular fluid (ICF)is the largest compartment and is 60% of total body weight. Extracellular fluid (ECF) is40% of TBW. The solutes in the ICF and ECF compartments are different. See figurebelow. In ICF the main cation is potassium and the anions are phosphates andbicarbonate. In ECF the main cation is sodium, and chloride and bicarbonate are theanions.]d.90
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2)
What percentage of total body water is intracellular fluid?a.30b.40
c.
60T [ 55 to 75% of total body water isintracellular and 25 to 45% is extracellular. The total body water is approximately 40liters. About 25 liters is inside cells (ICF compartment). Some 15 liters is in theextracellular fluid (ECF) compartment. The ECF is further subdivided into intravascular and extravascular spaces in a ratio of 1:3. Of the ECF, the plasma is only 3 liters. 12liters is interstitial fluid outside the cells. See figure below.]
d.
80
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3)Plasma volume is ------------- L
a.
3T [ 25% of the ECF is intravascular subcompartment. This corresponds to 3 - 3.5 L of plasma. The remaining 75% of ECFvolume is in the interstitial spaces. This corresponds to 10 – 12 L.]b.6c.9
d.
12
4)
If 1 L of solute-free water is lost from the body, how much fluid is lost by the ICF compartment?a.333 mL
b.
667 mL T [ Water is distributed between the ICF andthe ECF in a 2:1 ratio. Therefore, a given amount of solute-free water loss will result in atwofold greater reduction in the ICF compartment than the ECF compartment. If 1 L of water is lost, the ICF volume will decrease by 667 mL, whereas the ECF volume will fallby only 333 mL. If the 1L of fluid lost is isoosmotic, ECF compartment will decrease by 1L because Na+ is largely restricted to the ECF.]c.1 Ld.None
5)
Extracellular osmolality in a healthy adult
a.
More than intracellular osmolality
b.
Less than intracellular osmolality
c.
Same as intracellular osmolality[ Osmolality is a measure of the total number of solutes per mass of water. Osmolality is the solute or particle concentration of a fluid.It is expressed as milliosmoles per kilogram of water (mosmol/kg H
2
O). The normalplasma osmolality is 275 to 290 mosmol/kg. The extracellular and intracellular solutes (or osmoles) are markedly different, but water crosses cell membranes to achieve osmoticequilibrium. Water moves across cell membranes and distributes between ICF and ECF
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MCQs in Fluid and Electrolyte balance with Answers
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Very informative. Thanks for such a lucid and in depth discussion on fluid and electrolyte imbalance.