PHARM111 Lecture Notes - Lecture 15: Oncotic Pressure, Plasma Osmolality, Extracellular Fluid

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greentrout73

23 Dec 2016

School

University of Waterloo

Department

Pharmacy

Course

PHARM111

Professor

Jamie Joseph

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Document Summary

Total body water content in adults is about 40l. Infants are 73% or more water (low body fat, low bone mass) Adult females: 50% water (higher fat, lower skeletal muscle) In old age water content decreases to about 45% Electrolytes: inorganic salts, acids and bases and proteins. Meq/l = mmoles/l x number of electrical charges in one ion. For single charged ions (na+) 1 meq = 1 mosm. For bivalent ions 2 meq = 1 mosm. All electrolytes dissociate into ions in water. Ions have greater osmotic power than nonelectrolytes: nacl -> na+ + cl, mgcl2 -> mg2+ + cl, glucose -> glucose (nonelectrolyte) Na and k concentrations are opposite due to activity of na/k atpase. Proteins, phospholipids, cholesterol and fats account for: 90% of mass in plasma, 60% of mass in interstitial fluid, 97% of intracellular solute mass. Increasing plasma osmolality (decrease water -> osmolality = mass solute / kg solvent) releases adh and increases thirst.

Related Questions

31. Which of the followingstatements regarding decubitus ulcers is true?

	cells start dying if blood flow is reduced for an hour
	ulcers heal quickly if they are treated appropriately
	the legs are the most susceptible body part
	pressure and immobility are the main causes

32. What is the mostcommon type of arthritis in adults?

	Rheumatoid arthritis
	Psoriatic arthritis
	Osteoarthritis
	Gout

33. Which of the followingincreases the risk of age-related macular degeneration?

	Hypotension
	Diabetes
	Cataracts
	Atherosclerosis

34. Which of the followingstatements is true if one maintains a high level of physicalactivity throughout life?

	Slower decline in reaction time and recovery time in the musclesystem
	Slower increase in processing impulses by the CNS
	Slower increase in fat and fibers in the muscle system
	Slower increase in bone minerals in the skeletal system

35. Which type of musclefiber is considered to be 'fast contracting and resistant tofatigue'?

	Type I
	Type IIA
	Type IIB
	Type IIC

36. Which of the followingis not an age related change associated with the lens?

	Decline in transparency to all colors of light
	Formation of new capillaries in the lens
	Reduction in the ability to refract light
	Decrease in the elasticity of the lens

37. Which statementregarding crush fractures is true?

	they only occur when lifting or carrying a heavy object
	the patient tends to lean backwards to take the pressure off thefracture
	pulmonary and circulatory systems are not effected by thefracture
	nerve function may be compromised by pinching of the bonepieces

38. What is the definitionof tidal volume?

	the volume of air inspired equals the volume expired at rest
	the most air a person can inspire when taking a deep breath
	the amount of air left in the lungs following fullexpiration
	the total amount of air that can be in lungs at any one time

39. Tremors, musclestiffness, inability to complete a motion after it was initiated,loss of balance, weakness, and a stooped posture are all signs ofwhich disease?

	Stroke
	Alzheimers
	Parkinson's
	Multi-infarct dementia

40. A pannus is adestructive type of tissue associated with which condition?

	Emphysema
	Colitis
	Rheumatoid arthritis
	Osteoporosis

6. The site for countercurrent multiplier and exchange in the nephron is ________.
a. proximal tubule b. nephron loop and vasa recta c. distal tubule & collecting duct

7. The function of the kidneys is evaluated by measuring the
a. tubular reabsorption b. tubular secretion c. glomerular filtration rate

8. Abnormal amount of leukocytes in urine is termed _____.
a. ketonuria b. hematuria c. pyuria d. glycosuria e. nitrituria

9. In diabetes mellitus the clinical term for the abnormal urinalysis is called ________.
a. ketonuria b. hematuria c. pyuria d. glycosuria e. proteinuria

10. The possible cause of increase ____________ in urine is liver pathology o gallstones.
a. bile b. erythrocytes c. nitrites d. glucose e. protein

11. Proteinuria is caused by increase glomerular permeability due to kidney trauma, heavy mental, toxins, exertion, hypertension or glomerular nephritis.
a. True b. False

12. The normal pH of urine ranges from _____ to _____.
a. 2.2, 4.5 b. 10.3, 13.5 c. 8.0, 10.2 d. 4.5, 8.0 e. 6.0, 7.0

13. The average specific gravity of urine is slightly higher than 1.000 because the solutes it contains.
a. True b. False

14. __________ is the term for the normal smell of fresh urine.
a. Asparagus b. Nitrites c. Urinoid d. Ammonia

15. The concentration of this pigment in urine change the color of it.
a. Urinoid b. Nitrites c. Urobilin d. Calcium

16. The failure of a kidney to develop is termed _________________.
a. renal agenesis b. horseshoe kidney
c. supernumerary kidney d. pelvic kidney

17 Renal ptosis refers to the ___________ movement of the kidney within the abdominal cavity.
a. anterior b. posterior c. superior d. inferior

18. Renal failure refers to the diminish o absent renal function caused by the destruction of about ___ of the kidney.
a. 20% b. 40% c. 60% d. 90%

19. Renal calculus may occur from crystallized glucose after high levels in blood.
a. True b. False

20. An untreated UTI that spread to the kidneys is termed ____________.
a. urethritis b. cystitis c. pyelonephritis d. dysuria

21. Pain is an associated symptom of an UTI, and this is termed as __________.
a. urethritis b. cystitis c. pyelonephritis d. dysuria

22. Incontinence refers to ___________ whereas retention refers to____________
a. inability to involuntary control urination, failure to eliminate urine normally.
b. failure to eliminate urine normally, inability to voluntary control urination
c. inability to voluntary control urination, failure to eliminate urine normally
d. failure to eliminate urine normally, inability to involuntary control urination

23. All of the following are physical characteristics of urine except:
a. Color and transparency b. Odor c. pH d. specific gravity e. taste

24. Preformed water includes the water absorbed from food and drink whereas metabolic water includes the water from cellular respiration and dehydration.
a. True b. False

25. Sensible water los is not measured. In contrast insensible water loss is measured and includes sweat and transpiration.
a. True b, False

26. ____________ water loss is dependent upon the degree of hydration and is hormonally regulated in the tubules and collecting ducts of the kidney.
a. Sensible b. Insensible c. Obligatory d. Facultative
27. ___________ water loss is a loss of water that always occur regales of the state of hydration of the body.
a. Sensible b. Insensible c. Obligatory d. Facultative

28. Fluid is lost from the body through the following normal mechanism except:
a. breathing b. sweating c. defecation d. urination e. vomiting

29. Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬The stimuli that activates the thirst center include all of the following except:
a. decreased salivary secretions b. distention of the stomach
c. increased blood osmolality d. decreased blood pressure

30. Stimuli for inhibiting the thirst center are produced when fluid intake is greater than fluid output.
a. True b. False

31. Fluid balance is regulated by monitoring blood volume, blood pressure, and blood plasma osmolarity.
a. True b. False

32. This electrolyte imbalance can lead to confusion, coma, paralysis of breathing muscles, and death.
a. hypenatremia b. hyperkalemia c. hypercalcemia d. hypocalcemia

33. _____________ may cause muscle weakness and irregular heart beat that can lead to cardiac arrest.
a. Hyponatremia b. Hyperkalemia c. Hypercalcemia d. Hypokalemia

34. Numbness, tingling, increase heat rate, and muscle spasm that can lead to tetany is caused by _____.
a. hypenatremia b. hyperkalemia c. hypercalcemia d. hypocalcemia

35. If a patient needs IV fluids like 0.9% saline solution it means the solution contains 0.9 gr of _______ to every 100 ml of sterile water.
a. glucose chloride b. calcium chloride c. potassium chloride d. sodium chloride

36. Which of the following individual will be more vulnerable to dehydration?
a. Young adults b. Middle-aged adults c. Elderly d. Infants e. c & d

37. Diabetes insipidus refers to:
a. hypersecretion of insulin b. hyposecretion of antidiuretic hormone
c. hyposecretion of insulin d. hypersecretion of antidiuretic hormone
e. none of the above

38. During vomiting the major loss is ___________ whereas in diarrhea there is an extensive loss of ________.
a. hydrochloric acid (HCl), bicarbonate (HCO3) b. bicarbonate (HCO3), hydrochloric acid (HCl)
c. bicarbonate (HCO3), glucose d. hydrochloric acid (HCl), sodium

39. Lactic acidosis results from:
a. prolongs intense exercise b. congestive heart failure
c. insufficient insulin production d. a & b e. a, b & c

40. Ketoacidosis results from:
a. prolongs intense exercise b. congestive heart failure
c. insufficient insulin production d. a & b e. a, b & c

41. In respiratory alkalosis, respiratory rate increases and blood __________ _____________.
a. CO2 increases b. CO2 decreases
c. O2 increases d. O2 decreases e. none of the above

42. Metabolic acidosis compensate with _____________ ______________.
a. respiratory acidosis b. respiratory alkalosis
c. metabolic acidosis e. metabolic alkalosis e. none of the above

43. The step in the digestive process that deals with a series of catabolic steps in which complex food molecules are broken down into their chemical building blocks by enzymes secreted into the lumen of the alimentary tract is called
a. Propulsion b. Ingestion c. Chemical digestion d. Defecation e. Absorption

44. ________________ is the passage of digestive end products from the lumen of the GI tract by active or passive transport into the blood or lymph.
a. Propulsion b. Ingestion c. Chemical digestion d. Defecation e. Absorption

45. In which part of the digestive tract is chemical digestion essentially completed?
a. stomach b. pancreas c. liver d. small intestine e. large intestine

46. The organ that carries most metabolic function in the body is the
a. stomach b. liver c. small intestine d. pancreas

47. The main function of these organs is propulsion: peristaltic waves move food bolus to stomach accomplishing the phase of deglutition
a. Mouth and associated accessory organs b. Pharynx and esophagus
c. Stomach d. Small intestine e. Large intestine

48. Which hormone will be secreted especially if the bolus contains proteins?
a. gastrin b. cholecystokinin c. secretin

49. The following target organs are stimulated by secretin except:
a. stomach b. pancreas c. liver d. gallbladder

50. The stimulus of chime containing amino acids and fatty acids entering the small intestine releases ____________.
a. gastrin b. cholecystokinin c. secretin

51. The cells that produce intrinsic factor, important in the absorption of B12, is the ______ cells.
a. surface mucous b. mucous neck c. parietal d. chief e. G-cells

52. The most numerous of the secretory cells within the gastric glands, which produce zymogen are:
a. surface mucous b. mucous neck c. parietal d. chief e. G-cells

53. The following are functions of hydrochloric acid except:
a. activates pepsinogen b. kills microorganism
c. prevents ulceration of the stomach d. denatures proteins

54. Barrett esophagus refers to an advance case of GERD in which the epithelium changes from columnar secretory to stratified squamous.
a. True b. False

55. Gastric and duodenal ulcer are both peptic ulcers; the difference is that one occurs in the stomach and the other in the first part of the duodenum respectively.
a. True b. False

56. The following are common complication of advanced liver cirrhosis except:
a. jaundice b. edema c. ascites d. gastritis e. intense itching

57. Most cases of appendicitis occurs because fecal matter obstructs the appendix. As the inflammation worsens the parietal peritoneum becomes inflamed as well.
A. True b. False

58. The majority of colorectal cancer appears in the following areas except:
a. descending colon b. sigmoid colon c. rectum d. proximal ileum

59. Polyps are outgrowths from the colon mucosa whereas diverticulosis are bulges in the intestinal lining.
a. True b. False

60. Celiac disease is an autoimmune disorder. The damage in the small intestine is the smooth muscle which interferes with absorption.
a. True b. False

olivedonkey40

Based on below tables just answer tWO PARTS OF question

Sample Case Study

Mrs. King is a 43-year-old married mother of four. Mrs. King is 5â 4â tall, weighs 160 pounds, and has a history of mild hypertension. Her blood pressure is controlled with a low-sodium diet, and although her doctor told her for years that she should exercise, she tried running but found it unpleasant and discontinued all forms of exercise. She is currently sedentary. Her grandmother died as a result of heart disease from years of diabetes and high cholesterol.

Gender	Female
Age	43 yrs
Height	5 ft. 4 in.
Weight	160 lbs.
Activity level	Sedentary
Pregnancy/Lactation status	Not Pregnant or Lactating

Begin New Calculation

Results:
Body Mass Index (BMI)ï	27.4
Estimated Daily Caloric Needs	1921 kcal/day

Macronutrients:
Macronutrient	Recommended Intake per day
Carbohydrate	216 - 312 gramsï
Total Fiber	25 grams
Protein	58 grams
Fat	43 - 75 gramsï
Saturated fatty acids	As low as possible while consuming a nutritionally adequate diet.
Trans fatty acids	As low as possible while consuming a nutritionally adequate diet.
Î±-Linolenic Acid	1.1 gramsï
Linoleic Acid	12 gramsï
Dietary Cholesterol	As low as possible while consuming a nutritionally adequate diet.
Total Water	2.7 Liters (about 11 cups)ï

Vitamins:
Vitamin	Recommended Intake per day	Tolerable UL Intake per day
Vitamin A	700 mcg	3,000 mcgï
Vitamin C	75 mg	2,000 mg
Vitamin D	15 mcg	100 mcg
Vitamin B6	1.3 mg	100 mg
Vitamin E	15 mg	1,000 mgï
Vitamin K	90 mcg	ND
Thiamin	1.1 mg	ND
Vitamin B12	2.4 mcg	ND
Riboflavin	1.1 mg	ND
Folate	400 mcg	1,000 mcgï
Niacin	14 mg	30 mgï
Choline	0.425 g	3.5 g
Pantothenic Acid	5 mg	ND
Biotin	30 mcg	ND
Carotenoids	NA	NDï

Minerals (Elements):
Mineral	Recommended Intake per day	Tolerable UL Intake per day
Essential
Calcium	1,000 mg	2,500 mg
Chloride	2.3 g	3.6 g
Chromium	25 mcg	ND
Copper	900 mcg	10,000 mcg
Fluoride	3 mg	10 mg
Iodine	150 mcg	1,100 mcg
Iron	18 mg	45 mg
Magnesium	320 mg	350 mgï
Manganese	1.8 mg	11 mg
Molybdenum	45 mcg	2,000 mcg
Phosphorus	0.7 g	4 g
Potassium	4.7 g	ND
Selenium	55 mcg	400 mcg
Sodium	1.5 g	2.3 g
Zinc	8 mg	40 mg
Non-Essential
Arsenic	NA	NDï
Boron	NA	20 mg
Nickel	NA	1 mg
Silicon	NA	NDï
Sulfate	NA	ND
Vanadium	NA	1.8 mgï

Questions: Please type your answer

A) Do you think Mrs King is currently meeting all her micro nutrient goals. Do you think this diet will provide her with all the vitamins and minerals she needs to be healthy why? AT LEAST 4 COMPLETE SENTENCES

B) Identify three changes to Mrs Kings day that would likely improve her long term health (do not restrict your answer to Diet alone)

( answer at least in 6 complete sentences)

PHARM111 Lecture Notes - Lecture 15: Oncotic Pressure, Plasma Osmolality, Extracellular Fluid

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