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

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

3. 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

4. Water Balance Disorders + Edema- Dehydration

5. Edema Def.: accumulation of fluid  intracellular  extracellular (interstitial)

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

7. 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

8. Edema - extracellular Def.: accumulation of fluid in the intersticial spaces

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

10. Filarial diseases u helminthoses (Filaroidea) u conveyed by Culex fatigans – common domestic mosquito u rural forms – Anopheles, Aedes u lymphatic, subcutaneous u tropic and subtropic regions

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