Disorders of Water and Ions Metabolism

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Disorders of Water and Ions Metabolism General Pathology – Seminar Disorders of Water and Ions Metabolism Jaroslava Dušková Inst. Pathol. ,1st Med. Faculty, Charles Univ., Prague http://www1.lf1.cuni.cz/~jdusk/

Body Fluids intracellular extracellular intravascular extravascular TBW …total body water intravascular extravascular

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

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

Starling´s 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

Edema Def.: accumulation of fluid in the intersticial spaces

Causes & Types of Edema Extent: generalized, localized increased hydrostatic pressure - cardiac decreased oncotic pressure –hypalbuminotic blocked lymphatics – lymphostatic neuromediators - allergic Extent: generalized, localized

Thrombosis intravital intravascular blood clotting Def.: Range: parietal obturative

Types of Thrombi red stagnation white fluxe mixed hyaline

thrombosis rheumatis scurvy cholelithiasis appendicitis RES Beiträge zur pathologischen Anatomie und zur allgemeinen Pathologie Beiträge zur Thrombosenfrage Karl Albert Ludwig Aschoff 1866-1942, German