Electrolyte/Acid-Base Flashcards
Rate of Na change should not exceed what mEq/day?
12 mEq/L per day
acid-base parameters that could necessitate Na bicarb administration
pH less than 7.2 or HCO3 < 12 mEq/L - ensure patient is not dehydrated
Water requirements for dogs can increase during exercise or hot days. T/F?
True - JVIM 2018
Tetrastarch causes dilutional coagulopathy at similar volumes to LRS with similar severity. T/F?
False - tetrastarch causes similar dilutional coagulopathy as LRS but at lower volumes JVIM 2018
Components of refeeding syndrome in cats?
Hypophosphatemia (8/11), HYPOKALEMIA (all cats), hypomagnesemia, altered glucose homeostasis (can be hi or lo); neurologic deficits (8/11) (JFMS 2021)
Acidosis or alkalosis was more common in dogs with hypoadrenocorticism? What % of dogs had acid-base abnormalities as determined by semi-quantitative approach.
Acidosis (metabolic); 100% of dogs had acid-base abnormalities by semi-quantitative approach (more so than the traditional approach)- JVECC 2021. Acidosis due to free water deficit was present in all dogs.
The semiquantitative approach evaluates which ions in determining acid base status?
Serum free water (marked by serum sodium concentration), chloride, albumin, phosphate, and plasma lactate concentrations
Hypoalbuminemia, hypochloridemia - alkalinizing
Hyperphosphatemia, hyponatremia, hyperlactemia - acidifying (JVECC 2021)
Using traditional acid-base approach, which acid-base abnormality was most common in dogs with parvoviral enteritis?
Metabolic acidosis with compensatory respiratory alkalosis (JVIM 2020)
What was specificity of TP > 3 in pleural fluid and abdominal fluid to determine exudate vs nonexudate?
100% (pleural), 94% (abdominal) - JAVMA 2016
sensitivity of refractometry was 77% for pleural fluid and 80% for abdominal fluid
Hemodiluted samples are likely to have a falsely increased/decreased glucose on glucometer, and the opposite was true in hemoconcentrated samples in cats.
increased - JAVMA 2019
Can you do an overnight fast for kittens > 8w without worrying about hypoglycemia?
Yes - JFMS 2018
Did transmucosal oral corn syrup increase glucose in kittens?
No - JFMS 2018
What were incidences of coagulopathy and peritoneal effusion in severe anaphylaxis?
85.2% and 65.5% - not indicative of survival (JAVMA 2020)
A dilutional hyponatremia may still occur in a hypovolemic animal. T/F? Why / why not?
True - through secretion of ADH and angiotensin II (JVECC 2019 review) [in this case the fractional excretion of Na in urine would be very low]
Urine [Na] of euvolemic patients is expected to be over how much?
> 30 mmol/L (JVECC 2019 review)
Mechanisms of hyponatremia in hypoadrenocorticism:
Cortisol deficiency leading to uninhibited release of ADH NOT aldosterone deficiency alone (or maybe even at all)- JVECCS 2019 review (also gives some good sources to back up)
Ddx for hypervolemic hyponatremia?
CHF, kidney disease, hepatic cirrhosis
Can fractional excretion of Na be used in patients with intrinsic renal disease?
No
Timeline for osmotic demyelination?
Initial neurologic improvement, followed by progressive/irreversible deficits 1-several days later
How to calculate sodium deficit?
Sodium deficit = TBW * (Normal [Na] - Patient [Na]), TBW = 0.6 * lean body weight in kg
K supplementation with Na supplementation will do what to Na levels?
Increase them (faster?, unsure) - because administration of K will result in intracellular intake of K with EXTRAcellular output of Na. Thus this needs to be considered when you are correcting Na and also administering K. (there is an equation for this but I feel like we shouldn’t need to know it…?)
Norm-R and Plasmalyte will generally do what changes to plasma pH?
Increase (but likely not significant unless large volumes) - JVIM 2017
The ability of sodium bicarbonate solution administration to produce CNS and intracellular acidosis is dose and rate related. T/F?
True - JVIM 2017
Rough equation to calculate strong ion difference?
Na-Cl. Should be about 20 meq/L normally. High = metabolic alkalosis, low = metabolic acidosis
Reduction of plasma bicarbonate is consistent with proximal or distal RTA?
Proximal RTA
Alkali therapy worsens hypokalemia with which RTA?
Proximal RTA
Why is sodium bicarb not recommended for respiratory acidosis?
Exacerbates hypercapnia by donating substrate for the carbonic acid equation
Main differentials for hyperchloremic metabolic acidosis?
RTA, severe diarrhea, loss of intestinal bicarb, admin of alkali-free chloride containing IV solution
Equation for bicarb admin
mEq = 0.3 x BW in kgs x base deficit OR 0.6 x BW (kg) x (desired bicarb - measured bicarb))
Main differentials for metabolic alkalosis
Loss of extracellular fluid (upper GI fluid loss or sequestration); thiazide diuretic; hyperaldosteronism; NaBicarb admin (excessive)
Hypertonic saline should not be administered faster than 1 ml/kg/min to avoid what consequence?
Vagally mediated bradycardia (and potential cardiopulmonary arrest)
Is vitamin B complex enough for an animal with documented thiamine or cobalamin deficiency?
No
Magnesium is not compatible with solutions containing
Sodium bicarb or calcium
