Question

1. Mrs. Bigda, a 60-year-old woman, was brought to the hospital by the police after falling to the pavement. She is found to have alcoholic hepatitis. She is put on a salt- and protein-restricted diet and diuretics are prescribed to manage her ascites (accumulated fluid in the peritoneal cavity). How will diuretics reduce this excess fluid? Name and describe the mechanisms of action of three types of diuretics. Why is her diet salt-restricted?

Answer 1

Answer:

Diuretics will remove water from the blood and eliminate it in the urine. Consequently, water will move from the peritoneal cavity into the bloodstream reducing her ascites.

•The mechanism of action of diuretics are

o Osmotic diuretics are substances that are not reabsorbed or that exceed the ability of the tubule to reabsorb it, which increases osmolarity of the urine, and causes water to be drawn into the urine from the ISF.

o Loop diuretics (Lasix) inhibit symporters in the loop of Henle by diminishing sodium chloride uptake. They reduce the normal hyperosmolality of the medullary interstitial fluid, reducing the effects of ADH, resulting in loss of NaCl and water.

o Thiazides act on the distal convoluted tubule to inhibit water reabsorption.

•Her diet is salt-restricted because if salt content in the blood is high, it will cause her to retain water rather than allowing her to eliminate it.

Explanation: