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Both collagen and elastin tend to degenerate in the aged. Elastin is digested by elastases released by bacteria and by inflammatory cells. Collagenases released by inflammatory cells disrupt the triple helix, rendering the fragments susceptible to proteases present in inflamed tissue. Deficient collagen formation leads to impaired wound healing and capillary fragility (eg, in vitamin C deficiency Chapter 10: Nutritional Diseases). Synthesis of new collagen is an integral part of the repair process (fibrosis Chapter 6: Healing & Repair) and is also seen as a response to chronic inflammation ( Chapter 5: Chronic Inflammation). Sodium depletion (hyponatremia) will occur if fluid loss is replaced with water only.Ĭonn's syndrome is primary aldosterone excess Cushing's syndrome is cortisol excess. Sweat is hypotonic although salt is lost, water is lost more quickly. Convulsions, raised intracranial pressure Tetany, carpopedal spasm, laryngeal stridor, increased irritability of nervesĢ. Respiratory hyperventilation (decreased ionized calcium)ġ. Metastatic calcification (nephrocalcinosis)Ĥ. Parathyroid hormone–like secretions by neoplasmsģ. Renal tubular dysfunction (impaired concentrating ability)ħ. Into cells (familial–type periodic paralysis, alkalosis, insulin)ģ. Adrenal mineralocorticoid excess (Conn's and Cushing's syndromes Loss (diuretics, osmotic diuresis, renal tubular disease)ģ. Intestinal fluid loss (vomiting, diarrhea) Decreased ECF osmolality, causing intracellular fluid increaseĮxcretion (acute and chronic renal failure, adrenal insufficiency, diuretics )įrom cells (tissue necrosis, acidosis, hyperkalemic periodic paralysis)Ībnormal electrical activity in contractile cellsġ.
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Inappropriate secretion of antidiuretic hormone (SIADH)Ģ. Adrenal insufficiency (Addison's disease)ģ. Hyponatremia (water gain or relative loss of NaĢ. Increased ECF osmolality, causing intracellular fluid loss Adrenal mineralocorticoid excess (Conn's and Cushing's syndromesģ. Renal water loss (diabetes insipidus, diuretics, osmotic diuresis)Ĥ. Hypernatremia (water loss or relative gain of Naģ. Electrolyte Abnormalities in Extracellular Fluid.