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absite review > ABSITE Review - Fluids & Lytes > Flashcards

ABSITE Review - Fluids & Lytes Flashcards

1
Q

What is the relation of total body water between men, woman and infants?

A

infants > men > women

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2
Q

How is the total body water divided?

A

2/3 intracellular + 1/3 extracellular (2/3 interstitial + 1/3 plasma)

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3
Q

What determines the plasma/interstitial osmotic pressure?

A

Proteins

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4
Q

What determines the intracellular/extracellular osmotic pressure?

A

Sodium

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5
Q

What is the MCC of volume overload?

A

Iatrogenic

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6
Q

What are the lytes components of NS?

A

Na 154 and Cl 154

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7
Q

What are the lytes components of LR?

A

Na 130, K 4, Ca 2.7, Cl 109, bicarb 28

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8
Q

What is the plasma osmolarity formula?

A

Posm = (2 x Na) + (glucose/18) + (BUN/2.8)

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9
Q

How is volume replaced depending on weight?

A

4cc/kg/h for 1st 10kg, 2cc/kg/h for 2nd 10kg, 1cc/kg/h for each additional kg

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10
Q

What is the best indicator of adequate volume replacement?

A

Urine Output

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11
Q

What is the usual water fluid loss during open abdominal surgery?

A

0.5/1.0 L/hr

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12
Q

What IVFs should be used postop?

A

Use LR for 1st 24hrs. After 24hrs, switch to D5W1/2NS w 20mEq K because it stimulates insulin release, resulting in AA uptake and protein synthesis

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13
Q

What is the daily GI fluid volume secretion of the stomach, bile, pancreas and duodenum?

A

Stomach 1-2L/day
Bile 500-1000mL/day
Pancreas 500-1000mL/day
Duodenum 500-1000mL/day

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14
Q

What is the electrolyte composition of sweat, saliva, stomach, pancreas, bile, small intestine and colon secretions? What should be used for replacement?

A 
Sweat - hypotonic
Saliva - K (highest [] in the body)
Stomach - H and Cl - D5W1/2NS w 20 K
Pancreas - HCO3 - LR w HCO3
Bile - HCO3 - LR w HCO3
Small intestine - HCO3, K - LR w HCO3
Colon - K - LR w K
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15
Q

What EKG changes are seen in hyperK? What is the treatment?

A

Peaked T waves

Tx - Ca gluconate, Na bicarb, 10U insulin, 1amp 50% glucose, kayexalate, dialysis

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16
Q

What electrolyte can help hypokalemia?

A

Mg

17
Q

What is the formula of Total free water deficit?

A

T FW def = 0.6 x kg x [(Na/140) - 1]

18
Q

What is the formula of water requirement?

A

Water req = (desired change in Na over 1 day x TBW)/desired Na after giving the water requirement

19
Q

What is the maximum Na change over 1 day for hyperNa?

A

No more than 0.7 mEq/h (16mEq/day)

20
Q

What can cause rapid correction of hypoNa?

A

Central pontine myelinosis (no more than 1 mEq/h)

21
Q

What is the formula to correct Na with hyperglycemia?

A

Add 2 points to Na for each 100 increment of glucose

22
Q

Which diuretic is contraindicated in hypercalcemia?

A

Thiazides

23
Q

What are the two physical exam signs present in hypocalcemia?

A

Chvostek’s (tapping on face produces twitching) and Trousseau (carpopedal spasm) sign

24
Q

What is the correction for hypocalcemia and albumin?

A

Add 0.8 to Ca for every 1g decrease in albumin

25
Q

What MUDPILES stands for in anion gap acidosis?

A

Methanol, Uremia, DKA, Paraldehydes, INH, Lactic acidosis, Ethylene glycol, Salicylates

26
Q

What acid-base disorder is present after vomiting or NGT suctioning?

A

HypoCl hypoK metabolic alkalosis and paradoxical aciduria

27
Q

What is the FeNa formula?

A

FeNa = (urine Na/Cr)/(plasma Na/Cr)

28
Q

What abnormalities are found in prerenal failure?

A

FeNa < 1%, urine Na < 20, BUN/Cr ratio > 20, urine osm > 500mOsm

29
Q

What electrolytes abnormalities are seen during tumor lysis syndrome?

A

increase PO4, uric acid, BUN, Cr
decrease Ca
Tx - hydration, allopurinol, diuretics, alkalinization of urine

30
Q

What is transferrin?

A

transporter of iron

31
Q

What is ferritin?

A

storage form of iron

32
Q

What is vitamin D activation pathway?

A

Vitamin D is made in the skin then goes to liver for (25-OH) then kidney for (1-OH)

absite review (32 decks)

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