FEN/GI/Renal Flashcards
Formula for anion gap?
Anion gap = [Na+] — ([Cl-] + [HCO3-])
Acute renal failure —
AGMA or NAGMA?
Anion gap metabolic acidosis (AGMA)
CAH — AGMA or NAGMA?
Non-anion gap metabolic acidosis (NAGMA)
Congenital hypothyroidism — AGMA or NAGMA?
Non-anion gap metabolic acidosis (NAGMA)
High protein formula — AGMA or NAGMA?
Non-anion gap metabolic acidosis (NAGMA)
MUDPILES — AGMA or NAGMA?
List
Anion gap metabolic acidosis Methanol Uremia — Acute renal failure* DKA Paraldehyde Iron, isoniazid, inborn errors of metabolism*, galactosemia* Lactic acidosis, organic academias* Ethanol, toxins* Salicylates
VACTERL
Vertebral anomalies Anal atresia Cardiac anomalies Tracheoseophageal atresia Esophageal atresia Renal anomalies Limb anomalies
Causes of respiratory alkalosis (7)
CNS-Lung-Metabolic-Meds:
Hypoxia
Parenchymal lung disease
Hyperventilation syndrome
Mechanical ventilation
CNS disorders
Metabolic disorders
Medications (salicylates, xanthines, catecholamines)
If respiratory alkalosis persists, how long before renal compensation?
What are the compensatory mechanisms? (2)
2-6 hours
Decrease H+ secretion (increases pH)
Increase HCO3 excretion (decrease bicarb)
By how much does plasma HCO3- decrease with the decrease in pCO2?
A 10 mmHg decrease in pCO2 causes a decrease of plasma HCO3- by 4 mEq/L
How much kcal/g in carbohydrates?
3.4 kcal/g
How much kcal/g in protein?
4 kcal/g
How much kcal/g in lipids?
9 kcal/g
Which immunoglobulins are preserved in donor milk?
IgA
IgG
Which immunoglobulins are destroyed by pasteurization of donor milk?
IgM
Neonatal ascites - type of fluid in hydrops infant with cardiac arrhythmia or CHF?
Transudative
Neonatal ascites - type of fluid in hydrops infant with hepatosplenic trauma?
Peritoneal blood
Neonatal ascites - type of fluid in hydrops infant with meconium peritonitis?
Exudative
Neonatal ascites - type of fluid in hydrops infant with posterior urethral valve or bladder perforation?
Urine
RTA - NAGMA or AGMA?
Non-anion gap metabolic acidosis (NAGMA)
Type I RTA pathophys
Urine pH high/low?
Diminished H+ secretion in distal tubule -> high urine pH
Which RTA type?
RTA I and II - high or low serum K+? Why?
Low serum K+
K+ lost in urine as cation replacement for H+
Which RTA type?
Which RTA type causes hypercalciuria? Why?
Type I RTA
Increased Ca release from bone as buffer
Downregulation of Ca transport proteins in kidney
High distal Na delivery -> Ca excretion
Type I RTA treatment?
Bicarb