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Fluids,Acid Base and Electrolytes > 14.7.2013 > Flashcards

14.7.2013 Flashcards

0
Q

Why infants lose more fluid than adults?

A
  • larger body surface area relative to body weight
  • higher metabolic rate
  • immature kidney function
  • larger percentage of Extracellular body fluid
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1
Q

Insensible fluid loss

A

Loss from lungs and skin

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2
Q

Split up of daily fluid intake

A

Water- 1.5L
Food- 800ml
Water of oxidation-300ml

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3
Q

Split up of daily fluid loss

A

Skin- 600ml
Lungs- 400ml
Urine -1.5L
Stools-100ml

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4
Q

Intracellular fluid constitutes _______ % of TBW

A

40%

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5
Q

Extracellular fluid constitutes ________ % of TBW

A

20%

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6
Q

Interstitial fluid accounts for _____ % of Extracellular fluid

A

75

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7
Q

Transcellular fluid

A 
CSF
pleural
Eye
Joint
Lymphatics
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8
Q

Interstitial fluid is ______ % of TBW

A

15%

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9
Q

_______ % of full term neonates body weight is water

A

80%

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10
Q

________ % of a 60 yr old man body weight is water

A

45%

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11
Q

Why amount of water content in body decreases with old age?

A

In old age,
Skeletal muscle(contains water) mass decreases
Fat mass increases

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12
Q

Difference btw osmosis and diffusion

A

Fluids move in osmosis

Solutes move in diffusion

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13
Q

Urine concentrating ability appears after age of

A

3 months

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14
Q

Kidneys must excrete ______ ml of fluid per hour to excrete solute load

A

20

Atleast 500ml per day

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15
Q

Conversion of angiotensin 1 to angiotensin 2 takes place in

A

Lungs

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16
Q

Angiotensin 1 formation takes place in

A

Liver

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17
Q

Signs of dehydration in elderly

A

Confusion
Subnormal temperature
Tachycardia
Pinched facial expression

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18
Q

Insensible water loss depends on

A

Humidity
BSA
respiratory rate and depth

19
Q

Normal serum sodium

A

135-145mEq/L

20
Q

Normal serum K+

A

3.5-5 mEq/L

21
Q

Total serum calcium

A

8.9-10.1mg/dl

22
Q

Ionised calcium level

A

4.4-5.3 mg/dl

23
Q

Normal serum phosphates

A

2.5-4.5 mg/dl
Or
1.8-2.6 mEq/L

24
Q

Normal serum magnesium

A

1.5 -2.5 mEq/L

25
Q

Normal serum chloride level

A

98-108 mEq/L

26
Q

Concentrations of various NaCl containing electrolyte solutions

A

5%. 855mEq/L
3% 513mEq/L
0.9% 154mEq/L
0.45% 77mEq/L

27
Q

Composition of ringer lactate

A 
Na - 130mEq/L
K - 4mEq/L
Cl - 109mEq/L
Ca - 3mEq/L
Lactate - 28mEq/L
28
Q

Normal urine protein:creatinine ratio

A

Less than 0.2

29
Q

Indications for renal replacement therapy in CKD

A

Without diabetes- GFR less than 10ml/min

With diabetes- GFR less than 15ml/min

30
Q

Stages of CKD

A 
1- greater than 90ml/min
2- 60-89ml/min
3- 30-59ml/min
4- 15-29ml/min
5- less than 15ml/min
31
Q

Immunoglobulin deposited in IgA nephropathy

A

Polymeric IgA1

32
Q

Causes of secondary IgA nephropathy

A

Cystic fibrosis
Celiac disease
IBD

33
Q

Rx of IgA nephropathy

A

ACE inhibitors

Immunosuppression

34
Q

Bicarbonate is responsible for buffering

A

Blood

Interstitial fluid

35
Q

The kidneys of older adults can’t handle excess acids because

A

Ammonia production decreases with age

36
Q

Causes of increased anion gap

A

Hypermagnesimia

Increase in paraproteins

37
Q

Blood pressure cuff,dimensions

A

Length 80%

Width 40% of upper arm circumference

38
Q

Positioning of blood pressure cuff

A

Medially
Adults- 2.5 cm above antecubital fossa
Children- just above antecubital fossa

39
Q

Normal CVP

A

2-8 mm Hg

40
Q

Normal PAWP

A

4-12 mm of Hg

41
Q

Lab findings in dehydration

A

Elevated Hct
Na greater than 145mEq/L
Serum osmolality greater than 300mosm/Kg
Urine specific gravity above 1.030

42
Q

Signs of hypervolemia

A

S3

Veins remain distended for more than 5s when elevated above heart level

43
Q

Rx of pts who cannot tolerate hemodialysis

A

Continuous renal replacement therapy(CRRT)

44
Q

Effect of heparin on Na level

A

Hyponatremia

45
Q

Drugs causing hypernatremia

A

Antacids containing soda.bicarb
Sodium polystyrene Sulfonate
Ticarcillin disodium clavulinate potassium
IV NaCl

46
Q

Presentation of hypernatremia

A

Skin flushed
Agitated
Low grade fever
Thirst

SALT

Fluids,Acid Base and Electrolytes (8 decks)

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