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This seminar discusses the disorders of water and ions metabolism, including edema and dehydration. It also covers the causes and types of edema, as well as filarial diseases such as Bancroftian Filariasis.
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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 TBW …total body water intravascular extravascular
Daily Intake Drinking 1600 Food 850 Oxidation 350 Total 2800 Normal Water Gains & Losses[~ ml] Daily Otput Urine 1600 Stool 100 Skin 300 Lungs 800 Total 2800
+ Edema - Dehydration Water Balance Disorders
Edema Def.: accumulation of fluid • intracellular • extracellular (interstitial)
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 - extracellular Def.: accumulation of fluid in the intersticial spaces
Causes & Types of Edema • increased hydrostatic pressure - cardiac • decreased oncotic pressure –hypalbuminotic • blocked lymphatics – lymphostatic • neuromediators - allergic Extent: generalized, localized
Filarial diseases • helminthoses (Filaroidea) • conveyed by Culex fatigans – common domestic mosquito • rural forms – Anopheles, Aedes • lymphatic, subcutaneous • tropic and subtropic regions
Wuchereria Bancrofti (man the only definitive host) and Brugia malayi (monkeys, cats, dogs in addition) Clinic incubation 8-12 mth. lymphangitis eosinophilia lymphedema sef eradication of the disease when aaway from the endemic area – calcification of worms Bancroftian Filariasis