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IMF-018-01-0001-en	Which variable does body sodium content mainly determine, and which does water relative to body solute mainly determine?	Sodium content is the major determinant of extracellular fluid volume, while water relative to body solute largely determines plasma sodium concentration and osmolality.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0002-en	Why can plasma potassium change dangerously without an equivalent change in total body potassium?	Potassium is mostly intracellular, so redistribution between compartments alters the plasma concentration by itself.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0003-en	Cell membranes are highly water-permeable, so what determines the distribution of water between intracellular and extracellular space?	Effective osmoles: water moves until effective osmotic pressure equilibrates, so a change in extracellular tonicity alters cell volume.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0004-en	Which solutes dominate extracellular and intracellular osmolality, and what maintains the gradients?	Sodium with its accompanying anions extracellularly and potassium salts intracellularly, with the sodium-potassium pump maintaining the gradients.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0005-en	Why does urea contribute to measured osmolality but little to sustained tonicity?	Urea crosses many membranes, so it is not an effective osmole that holds water outside cells.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0006-en	By what mechanism does hyperglycaemia lower the measured plasma sodium?	It raises extracellular tonicity, drawing water out of cells and lowering sodium through dilution.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0007-en	What does antidiuretic hormone do in the collecting duct, and what is the result?	It increases collecting-duct water permeability, producing concentrated urine.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0008-en	Why can antidiuretic hormone remain active when plasma tonicity is low?	Reduced effective circulating volume stimulates it through baroreceptor pathways, so volume defence can override osmotic regulation.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0009-en	What must be in place for the kidney to produce dilute urine?	Suppression of antidiuretic hormone, adequate filtration, intact diluting segments, and sufficient distal delivery.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0010-en	Why can very low solute intake impair the excretion of free water?	Water excretion is limited by the amount of solute available for excretion.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0011-en	What does hyponatraemia usually indicate about water and the exchangeable body cations?	Excess water relative to exchangeable sodium and potassium.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0012-en	Which two situations give a low plasma sodium that is not hypotonic?	Hyperglycaemia, which causes hypertonic hyponatraemia, and laboratory pseudohyponatraemia from severe lipid or protein effects with selected methods.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0013-en	Which patterns produce euvolaemic hypotonic hyponatraemia?	Inappropriate antidiuretic hormone effect, glucocorticoid deficiency, hypothyroidism, low solute intake, and excess water.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0014-en	Why does acute severe hyponatraemia cause headache, confusion, seizures and coma?	Water enters brain cells and produces cerebral oedema.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0015-en	What does brain adaptation in chronic hyponatraemia achieve, and what risk does it create?	Osmolyte adaptation reduces swelling, but it creates vulnerability to osmotic demyelination if sodium is corrected too rapidly.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0016-en	Which mechanisms produce hypernatraemia?	Inadequate access or thirst, impaired urinary concentration, gastrointestinal or skin water loss, osmotic diuresis, or rarely excessive sodium gain.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0017-en	What are the two mechanisms of diabetes insipidus?	Deficient antidiuretic hormone production, or renal resistance to the hormone.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0018-en	Why do heart failure and cirrhosis drive further sodium and water retention despite oedema?	The kidneys sense arterial underfilling and activate sympathetic tone, renin-angiotensin-aldosterone, antidiuretic hormone and thirst, which worsens oedema and dilutional hyponatraemia.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0019-en	What increases distal potassium secretion?	Aldosterone, a raised plasma potassium, distal sodium delivery, tubular flow, and a negative luminal voltage.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0020-en	Which electrocardiographic changes can accompany hypokalaemia?	Flattened T waves, S T depression, U waves, and prolonged repolarisation.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0021-en	What does each of maintenance, replacement and resuscitation fluid address?	Maintenance replaces expected water and electrolyte needs, replacement matches abnormal ongoing losses, and resuscitation addresses impaired perfusion.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0022-en	Why does an unremarkable electrocardiogram fail to exclude severe hyperkalaemia?	Severe hyperkalaemia can occur without the classic changes.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0023-en	What are the three aims of immediate hyperkalaemia therapy?	Stabilise cardiac membranes with intravenous calcium when indicated, shift potassium into cells with insulin and glucose, and remove potassium through the kidneys, gastrointestinal binders, or dialysis.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending
IMF-018-01-0024-en	Why can alkalosis cause paraesthesia or tetany when the total calcium has changed little?	Alkalosis increases protein binding and lowers the ionised calcium, which is the biologically active fraction.	Integrated Medical Foundations; chapter 18, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2c64fd063237bb4cb850701dfcf0439ad08d9dbfe86ebbbe89546802513e7136; editorial review pending	imf lang::en chapter::018 module::018-01 review::pending