Electrolytes/Biochemistry Flashcards
An elderly diabetic patient is found to have a serum sodium level of 122 and a blood glucose of 30.5. After correcting the glucose concentration with insulin, the serum sodium concentration should:
a) Decrease significantly unless the patient receives 3% saline.
b) Decrease transiently but return to 122 without specific treatment.
c) Remain essentially unchanged.
d) Increase to the normal range without specific therapy.
d) Increase to the normal range without specific therapy.
The oxyhemoglobin dissociation curve is shifted to the left by:
a) Decreased blood pH.
b) Increased erythrocyte 2, 3-diphospho – glycerate concentration.
c) Increased body temperature.
d) Methemoglobinemia.
Methemoglobinemia.
Harmful effects of significant alkalosis following trauma resuscitation or major surgery include all of the following, EXCEPT:
a) Decreased cerebral blood flow.
b) Hypercalcemia.
c) Hypokalemia.
d) Tissue hypoxia.
b) Hypercalcemia.
In the acute-phase response to injury or infection, levels of which of the following serum proteins is decreased?
a) C-reactive protein
b) fibrinogen
c) ceruloplasmin
d) albumin
d) albumin
Which of the following can cause spuriously elevated pulse oximeter readings?
a) methemoglobinemia
b) finger nail polish
c) hyperbilirubinemia
d) IV methylene blue
A
Stimuli of the neuroendocrine response (3)
- Hypoxia
- Hypotension
- Hypovolemia
Where are the baroreceptors located? (3)
- Atria
- Aortic arch
- Carotid bodies
What are the effects of cortisol? (2)
- Gluconeogenesis
- Lipolysis
What is the effect of RAS?
Increase in aldosterone, increases sodium and water
What is the effect of vasopressin?
Increases water resorption in the distal renal tubules
What is the effect of the neuroendocrine response on pancreas?
Decreased insulin leading to an increase hepatic gluconeogenesis
In SIRS, what is the organ most sensitive to injury?
Lungs, leading to ARDS
What is the most common cause of mortality in the ICU?
Multiorgan Dysfunction Syndrome
In hypovolemic shock, what happens to HR, CVP, PCWP, CO, and SVR?
HR variable
CVP decreases
PCWP decreases
CO decreases
SVR increases
In NEUROGENIC shock, what happens to HR, CVP, PCWP, CO, and SVR?
HR increases
CVP decreases
PCWP decreases
CO decreases
SVR decreases
In CARDIOGENIC shock, what happens to HR, CVP, PCWP, CO, and SVR?
HR variable
CVP increases
PCWP increases
CO decreases
SVR increases
What percent of blood loss is 750ml? What class of hemorrhagic shock is this?
<15%, Class I
What percent of blood loss is 750m-1500ml? What class of hemorrhagic shock is this?
15-30%, Class II
What percent of blood loss is 1500-2000ml? What class of hemorrhagic shock is this?
30-40%, Class III
What percent of blood loss is > 2000ml? What class of hemorrhagic shock is this?
> 40%, Class IV
At what class(es) of hemorrhagic shock where you see a BP drop?
Class III and Class IV
What are the causes of neurogenic shock?
Spinal cord injury, regional anesthetic, autonomicle blockade
How do you diagnose adrenal insufficiency?
- Cortisol <15mg/dl
- ACTH stimulation test
What is the treatment for adrenal insufficiency?
Steroid
What electrolytes are imbalanced after parathyroidectomy?
- Hypocalcemia
- Hypomagnasemia
- Hyperkalemia
- Hypophosphatemia
What is the most common cause of electrolyte disturbance leading to an ileus
Hypokalemia
What are the 3 signs and symptoms of central pontine myelinosis
Confusion
Spastic quadriplegia
Horizontal gaze paralysis
What is defined as anuria?
<50cc urine output in 24 hours
Oliguria
50 to 400cc urine output in 24 hours
What are the indications for acute dialysis?
AEIOU
Acidosis
Electrolyte abnormalities
Intoxication
Overload - volume
Uremic complication
