Disorders of Water and Ions Metabolism

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Disorders of Water and Ions Metabolism
General Pathology Seminar

• Jaroslava Dušková
• Inst. Pathol. ,1st Med. Faculty, Charles Univ.,
  Prague
• http//www1.lf1.cuni.cz/jdusk/

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Body Fluids

• intracellular
• extracellular

TBW total body water
intravascular
extravascular
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Normal Water Gains Losses
ml

• Daily Intake
• Drinking 1600
• Food 850
• Oxidation 350
• Total 2800

Daily Otput Urine 1600 Stool
100 Skin 300 Lungs
800 Total 2800
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Water Balance Disorders

• Edema

• - Dehydration

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Edema

• Def.
• accumulation of fluid
• intracellular
• extracellular (interstitial)

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Intracellular Edema

• energy (ATP) deficiency statuses hydropic
  degeneration vacuolar dystrophy
• Na/K dysbalances (hyperaldosteronism)
• hypokalaemia in severe diarrhoea
• hyperhydration - water intoxication (infusions!)

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Starlings Hypothesis

• Net filtration
• Forces favoring filtration
• Forces opposing filtration
• Forces favoring filtration capillary hydrostatic
  preassure intersticial oncotic
  pressure
• Forces opposing filtration plasma oncotic
  pressure tissue hydrostatic pressure

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Edema - extracellular

• Def.
• accumulation of fluid in the intersticial spaces

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Causes Types of Edema

• increased hydrostatic pressure - cardiac
• decreased oncotic pressure hypalbuminotic
• blocked lymphatics lymphostatic
• neuromediators - allergic

Extent generalized, localized
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Filarial diseases

• helminthoses (Filaroidea)
• conveyed by Culex fatigans common domestic
  mosquito
• rural forms Anopheles, Aedes
• lymphatic, subcutaneous
• tropic and subtropic regions

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Bancroftian Filariasis

• Wuchereria Bancrofti (man the only definitive
  host) and Brugia malayi (monkeys, cats, dogs in
  addition)
• Clinic
• incubation 8-12 mth.
• lymphangitis
• eosinophilia
• lymphedema
• sef eradication of the disease when aaway from
  the endemic area calcification of worms