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pearljam59
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03/20/06 - 07:46 AM             #1

Which of the following is the rationale for advising a decrease in dietary intake of sodium chloride in patients with hepatic disease who develop edema?

A. Edema fluid has a high concentration of Cl-
B. Glomerular filtration rate is increased
C. Injured hepatocytes are more permeable to Na+
D. Secondary hyperaldosteronism is present
E. Serum globulin concentration is increased


robin082006
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03/20/06 - 08:04 AM             #2

D?

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sosikan
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03/20/06 - 09:43 AM             #3

D ? could you explaın the answer


doc179
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03/20/06 - 11:20 AM             #4

edeme fluid will have a high concentration of Na which attracts fluid towards it and hence dietary Na should be restricted...I do not know whether Cl- is also increased if it is so then I am choosing A as the ans. Robin could you pls explain the ans? Thank you.

fleuve
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03/20/06 - 04:47 PM             #5

it's D

heptic disease cause decreased deactivation of aldosterone.

too much aldostern lead to na and water retaintion which will worsen edema


skyhigh
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03/20/06 - 05:05 PM             #6

A makes sense to me, but D sounds better.

Maybe D.



Edited by skyhigh on 03/20/06 - 05:27 PM

robin082006
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03/21/06 - 12:10 AM             #7

good explanation fleuve

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Addicudo
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05/21/07 - 01:34 AM             #8

Aint getting this one ... !! How about C ?? Excluded all except C and D ... BUT D .. Am not able to corelate .. ! ? ..

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doc179
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05/21/07 - 02:06 AM             #9

Addicudo the answer should be D for this. I think I have 2 reasons for the same.
1) aldosterone metabolism is decreased in hepatic disease and hence high aldosterone reabsorbs more sodium and water and hence more edema.
2) since the circulatory blood volume decreases in edema states, less renal perfusion, RAA system activated and hence again more reabsorption of sodium and water.
Thats the reason why you restrict salt in pts of hepatic disease who develop edema.

Addicudo
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05/21/07 - 04:25 AM             #10

Ok.. Thankz .. !!!! C) Cannot be .. !!!! Was thinkin in a diff frame of mind then .... !!! D) it is now .. !!! smiling face nod

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ssrpk
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05/21/07 - 04:32 AM             #11

just like restricting water in patients with SIADH grin

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lq2006
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05/21/07 - 06:03 PM             #12

D







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