Electrolytes

Hyponatremia etio

sodium loss

restricted intake

excess water gain

Hyponatremia CM

hypoosmolality, altered cellular depol/repol, might see lethargy or confusion

Hypernatremia etio

acute sodium gain (water would move from ICF —> ECF; ICF dehydration)

Water loss (without Na loss; both ICF and ECF dehydration)

Hypernatremia CM

Hyperosmolarity

Intracellular dehydration

Hypervolemia (if etio #1)

Hypokalemia Etio

Dec intake, increased losses (diarrhea, vomiting, renal diuretics, dialysis),

shift from ECF —> ICF (K goes into cells as H+ goes out- alkalosis)

Hypokalemia CM

r/t decreased neuromuscular excitability

• loss of smooth muscle tone

• cardiac rhythm problems

Hyperkalemia etio

increased intake (supp), renal failure (cannot excrete excess),

shift from ICF to ECF (acidosis, so K moves out of cells as acidic H+ moves in to correct it)

Hyperkalemia CM

r/t cells being more excitable

• restlessness, intestinal cramping/diarrhea, muscle weakness, cardiac rhythm problems

Hypocalcemia etio

inadequate intestinal absorption and nutritional deficits of Ca++ or vit D, excess PO4-, malabsorption of fat, hypoparathyroidism

Hypocalcemia CM

r/t increased neuromuscular excitability

• confusion

• Facing twitching

• Muscle spasms/convulsions

• diarrhea/cramping

• cardiac rhythm changes

Hypercalcemia etio

hyperparathyroidism, excess vit. D, cancers with bony metastases (Ca++ resoprtion loss from bone, Ca moves out of bone)

Hypercalcemia CM

r/t cells being less excitable

• fatigue, weakness, lethargy

• Anorexia, constipation

• Kidney stones

• ECG changes

Major intracellular cation

Major Extracellular cation

Intra- potassium

Extra- sodium

Three things that contribute to formation of edema

Favoring forces: increased interstitial oncotic pressure and capillary hydrostatic pressure

Dec capillary oncotic pressure

Capillary hydrostatic pressure

FAVORS filtration (out of cap)

pressure/flow caused by fluid inside capillary. Inc- filtration favored

Interstitial hydrostatic pressure

OPPOSE filtration (into cap)

pressure/force caused by flow of fluids in interstitial space (inc- filtration opposed)

Capillary oncotic pressure

OPPOSE filtration (into cap)

osmotic pull generated by large molecules in capillary- increase if increase proteins in capillary

ex: IV infusion of protein would lead to increase in this (as protein would be in capillary, and lead to fluid moving into cap)

Interstitial oncotic pressure

Favor filtration (out of cap)

osmotic pull generated by large molecules in interstitial space

Caused by burns- proteins leaking out

F- IO- CH

Favoring filtration

Increased Osmotic

Capillary hydrostatic

Endometriosis etio, patho, CM

Etio: unknown, occurs in 6-10% all women

Patho: disorder of uterus, growth of endometrial tissue outside uterus

CM: pelvic pain common and early (during/after menstrual cycle, during sex), and difficulty getting pregnant or being infertile

HPV- etio, patho, CM

most prevalent VIRUS

Etio- HPV

patho; viral infection of cells of anogenital tract (more common in women)

CM: most women asymptomatic, genital warts in 1%

Chlamydia etio, patho, CM

Most prevalent BACTERIA

Etio: chlamydia trachomatous (usually occurs with gonorrhea)

Patho: sexual contact, mother to infant (can lead to conjunctivitis or pneumonia in infant)

CM: commonly asymptomatic. Inflammation in anogenital tract. Dysuria, yellow urethral drainage. Scrotal swelling and pain in men. Vaginal drainage or bleeding in women.

Gonorrhea etio, patho, CM

Bacteria

Etio: neisseria gonorrhoeae

Patho: sexual contact, can be spread through eyes and pharynx. attach to sperm or walls of vagina, PYOGENIC

CM: commonly asymptomatic until later stages. Dysuria. Purulent vaginal or penile discharge (PUS)

Syphilis etio, patho, CM

Etio: spirochete treponema pallidum; m/f both affected

patho- sexual contact, chancres (open lesions- contact)

CM:

• Primary: chancre (open lesions) resolve around 3 months

• Secondary: alopecia, rash on palms and soles of feet, lymphadenopathy, fever, arthralgia (joint discomfort)

• Latent: primary and secondary resolved, still infectious

• Tertiary: aortic aneurysm and meningitis