Disorders of Sodium and Potassium Metabolism | Physiology PPT | Download

December 17, 2012 | By | Reply More

Disorders of Sodium and Potassium Metabolism | Physiology PPT | Download

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Disorders of Sodium and Potassium Metabolism




Review of sodium and potassium metabolism

Paradigm for analyzing pathophysiology

Abnormalities of potassium balance

Abnormalities of sodium and water balance

Example cases


Major Mediators of Sodium and Water Balance


Angiotensin II


Antidiuretic hormone (ADH)


Renin-Angiotensin-Aldosterone Axis


Role of ADH (antidiuretic hormone)

Synthesized in the hypothalamus and stored in the posterior pituitary

Released in response to plasma hyperosmolality and decreased effective circulating volume

Actions of ADH à

1. Increases the water permeability of                 the collecting tubule

2. Mildly increases vascular resistance


Overview of Biochemical Homeostasis


Overview of Potassium Balance


Etiologies of Hyperkalemia


Etiologies of Hypokalemia


Overview of Sodium Balance


Etiologies of Hyponatremia


Etiologies of Hypernatremia


Case 1

Mrs. L is a 62 y/o woman with a past medical history significant only for hypertension.  She has a 45 pack year smoking history.  She comes to the urgent care clinic today complaining of a cough and shortness of breath for the past week.  Her physical exam is notable for both mild wheezing and rhonchi, more pronounced on the right side than the left.

Labs include the following:

Na 126  Cl 95        BUN 12    Glucose 102

K 4.4          HCO3 25  Cr 1.4

Her CBC shows mild normocytic anemia.


Case 2

Mr. R is an 85 y/o man with advanced dementia who was sent to the ER from his skilled nursing facility for non-responsiveness since the morning nursing shift started about 8 hours ago.  The remainder of his past medical history is unknown.  Aside from his mental status, his physical exam is remarkable for a HR of 110 and BP of 100/50.

Labs include the following:

Na 164  Cl 126      BUN 50    Glucose 98

K 4.8          HCO3 28  Cr 2.6


Case 3

Miss K is a 28 y/o woman who presents for her first routine clinic visit.  She has no complaints, and her medical history is unremarkable.  On physical exam you note that her BP is 162/94.

You send her for some routine labs which find the following:

Na 147  Cl 105      BUN 12    Glucose 102

K 2.8          HCO3 32 Cr 0.7

UA unremarkable.

Case 4

Mr. W is a 65 y/o man with a past history significant for CHF secondary from an MI 4 years ago.  He comes to general medicine clinic today for a routine appointment.  He states that he was complaining of some mild dyspnea on exertion at his cardiology appointment 2 weeks ago.  In response, his cardiologist told him to double one of his medications, which the patient did, but at the moment he can’t remember which medication this was.  He does report that his shortness of breath is now better.

Routine fasting labs reveal the following:

Today            Na 128       Cl 89          BUN 32         Glucose 135

K 3.1       HCO3 32    Cr 1.4

2 months ago Na 132       Cl 97          BUN 24         Glucose 128

K 3.8       HCO3 27    Cr 1.2


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