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QUESTION NOTES > FEK AB > Flashcards

FEK AB Flashcards

1
Q

Transfusion amount for pediatrics

A

10cc/kg

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2
Q

Components of LR

A 
Na 130
Cl 109
K 4 **
Ca 3 **
Lactate 28
pH 6.5
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3
Q

pH NS

A

6

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4
Q

How much Na do pts need mEq/kg/day? K?

A

Na - 1-2 mEq/kg/day (~1L 1/2NS)

K - 0.5-1 (~20mEq added to fluids)

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5
Q

Replace high NGT output with…?

A

NS

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6
Q

Replace high volume bile leak with…?

A

LR (bc lose bicarb)

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7
Q

Replace severe diarrhea with…?

A

LR (need potassium)

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8
Q

Largest GI loss of potassium is where?

A

colon

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9
Q

Equation: serum osms

A

2NA + glucose/18 + BUN/2.8

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10
Q

Max rate of hyponatremic correction

A

max. 1 mEq/hr

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11
Q

Mgmt SIADH

A
  1. fluid restrict
  2. hypertonic saline
  3. demeclocycline, vaptan (V2-R antag)
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12
Q

Urine osm vs. Serum osm: dilutional hypoNa

A

urine osm low

serum osm low

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13
Q

Urine osm vs. Serum osm: SIADH

A

urine osm high

serum osm low

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14
Q

What is pseudohypoNa?

A

2/2 hyperglycemia, hyperproteinemia, hyperTG

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15
Q

Equation: Na deficit

A

(desired Na - actual Na) x TBW = mEq Na needed

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16
Q

Equation: free water deficit

A

(actual Na - desired Na) / (desired Na) * TBW

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17
Q

Urine osm vs. Serum osm: diabetes insipidus

A

urine osm low

serum osm high

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18
Q

Urine osm vs. Serum osm: iatrogenic hyperNa

A

urine osm high

serum osm high

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19
Q

Mgmt: central diabetes insipidus

A

DDAVP

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20
Q

Correcting Ca in hypoalbuminemia pt

A

for every point <4 (nl albumin), add 0.8 to calcium

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21
Q

Non-gap metabolic acidosis

A 
[HARDASS]
hyperalimentation
addison's disease
renal tubular acidosis
diarrhea (or high stomal output)
acetazolamide
spironolactone
saline infusion
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22
Q

MCC metabolic alkalosis (2)

A
  • NG suction

- contraction alkalosis (CHF pt that is over-diuresed) - need to give them back Cl

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23
Q

Change of ? in pH for every ? change of CO2

A

0.1 change in pH for every 12 of CO2

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24
Q

Sepsis resuscitation bolus amount

A

30cc/kg bolus

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25
Q

Resuscitation bolus for peds? How about for blood?

A

bolus 20 cc/kg.

transfuse 10 cc/kg.

26
Q

Urine abnormality in pyloric stenosis baby s/p emesis

A

paradoxical aciduria + hypoCl hypoK met alkalosis

27
Q

Hyperhomocystinemia associated with…? (vascular)

A

increased risk arterial and venous thrombi

28
Q

Persistent elevation of K always associated with…?

A

impaired urinary excretion of K

29
Q

Primary reasons of decreased urinary K excretion are…?

A
  • hypovolemia
  • hypoaldo
  • renal failure
  • drugs (spironolactone, NSAIDs)
30
Q

EKG changes: hyperK

A
  • quick repolarization -> peaked T-waves and short QT interval
  • delayed depolarization -> loss of P-wave and widened QRS interval
31
Q

Cytokines stimulate release of what chemicals during sepsis?

A

cortisol + glucagon + catecholeamines

32
Q

Lab tests to eval short-term nutrition status vs. long-term

A

short: prealbumin (1/2 life 2d) + retinol-binding protein (1/2 life 12hrs)
long: albumin (10d) + transferrin (20d)

33
Q

Why excess carbs -> RQ>1?

A

bc excess carbs -> lipogenesis -> large amts CO2 produced

34
Q

Equation: FENa%

A

100 x PcrUna/PnaUcr

35
Q

Sxs hypoP (<0.07)

A

muscle weakness (affects diaphragm most) -> resp failure

36
Q

K+ secretion highest in…?

A

colon>salivary>gastric>bile,panc,duo,ileum

37
Q

What kind of feeding for burn pts?

A

Enteral feeding (decreases gastroparesis)

38
Q

What kind of feeding for major head or torso trauma pts?

A

Postpyloric enteral feeding

39
Q

Min amount exogenous glucose needed per day to decrease protein breakdown

A

100g glucose

40
Q

In metabolic acidosis, renal regulation of serum pH dependent on what transporter?

A

Na+/H+ antiporter in proximal tubules

41
Q

Why not give bicarb for lactic acidosis?

A

bicarb + protein -> carbonic acid + CO2 -> conversion metabolic to respiratory acidosis, which has greater neg inotropic effects

42
Q

What is ceruloplasmin?

A

storage and transport cuproprotein

43
Q

Zn deficiency sxs

A

eczematoid rash, papular perioral, and perianal eruptions, taste atrophy, diarrhea

44
Q

Cu deficiency sxs

A

microcytic anemia, neuro (ataxia, spasticity, muscle weakness)

45
Q

Selenium deficiency sxs

A

cardiomyopathy

46
Q

Essential fatty acid deficiency sxs

A

dry, scaly dermatitis, loss of brittle nails, easy bruising, diarrhea

47
Q

Essential amino acid deficiency sxs

A

decreased immune function

48
Q

Energy source during fasting/starvation?

A

Primary fuel: glucose
Next option: glycogen (avail for 6hrs)
Next option: FFA (avail 5 days)
Starvation phase: glucose taken from breakdown of muscle of protein into AA, which are then converted to glucose by liver

49
Q

Majority of ingested proteins are absorbed in intestines as…?

A

dipeptide vs. tripeptides via peptide transporter 1 (PEPT1)

50
Q

MCC endogenous hypercortisolism (Cushing syndrome)

A

ACTH-dependent 2/2 pituitary adenoma (Cushing disease)

51
Q

How many gram protein in 1g nitrogen?

A

6.25g protein

52
Q

Equation: non-protein caloric requirement for burn pts

A

25 kcal/kg/d*kg + (30 kcal/day * %TBSA)

53
Q

Equation: protein gram req for burn pts

A

1 g/kg/d*kg + (3 g/day * %TBSA)

54
Q

Definition of respiratory quotient (RQ)

A

ratio CO2 produced to O2 consumed

55
Q

Starvation vs. hypermetabolism

A

Starvation: goal to preserve lean body mass and reduce protein wasting (fat is primary fuel source - RQ 0.7)
Hypermetabolism: will have rapid loss of lean body mass; mobilization of proteins + increase gluconeogenesis -> mixed RQ 0.8-0.95

56
Q

Why use D1/4NS+20K in children <2 as opposed to D1/2NS?

A

children <2 have ineffective concentrating ability of distal nephrons so have difficulty with Na excretion

57
Q

Prerenal BUN/Cr ratio

A

> 20

58
Q

Prerenal FEna

A

<1%

59
Q

Prerenal spot urine Na

A

<10

60
Q

How to calculate ideal body weight (used for TPN req calculations)

A

IBW (male) = 50kg + 2.3kg x height(in)-60in

IBW (female) = 45.5kg + “”

QUESTION NOTES (28 decks)

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