Fiser Chapter 9 FLUIDS & ELECTROLYTES

Question 1

Total body water

Answer 1

2/3 of body weight in men
2/3 of TBW is intracellular
1/3 of TBW is extracellular
2/3 of ECW is interstitial
1/3 of ECW is in plasma

Question 2

Treatment of hyperkalemia

Answer 2

Calcium gluconate
Sodium bicarbonate
10 U inline and 1 ampule 50% dextrose
Kayexalate
Dialysis

Question 3

Treatment of hypernatremia

Answer 3

D5 water slowly

Question 4

Treatment of hyponatremia

Answer 4

Water restriction –> diuresis

Correct by up to 1 mEq/h

Question 5

Hypercalcemia treatment

Answer 5

(from breast cancer or hyperparathyroid)
NS 200-300cc/h and Lasix
For malignant disease: mithramycin, calcitonin, alendronic acid, dialysis
NO LR or thiazides

Question 6

Hypocalcemia treatment

Answer 6

Mag first

Question 7

Hypermagnesium tx

Answer 7

Calcium

Question 8

Hypomagnesium causes

Answer 8

(d/t massive diuresis, chronic TPN without minerals, EtOH abuse)

Question 9

Anion gap equation

Answer 9

Na - (HCO3 + CL)

Normal

Question 10

High anion gap acidosis causes

Answer 10

MUDPILE
Methanol
Uremia
DKA
Paraldehydes
Isoniazid
Lactic acidosis
Ethylene glycol
Salicylates

Question 11

Normal anion gap acidosis

Answer 11

Usually loss of Na/HCO3 (ileostomies, small bowel fistulas)

Question 12

Metabolic alkalosis causes

Answer 12

Usually contraction alkalosis
NG suction -> hypochloremic, hypokalemic, metabolic alkalosis and paradoxical aciduria
Tx: HS to correct CL deficit

Question 13

FeNa equation

Answer 13

Urine Na/Cr / Plasma Na/Cr

Fena

Question 14

Tumor lysis syndrome mechanism and tx

Answer 14

Release of purines and pyrimidines -> increased PO4 and uric acid, decreased Ca
Renal damage and EKG changes
Tx: Hydration, rasburicase, allopurinol, diuretics, alkalinize urine

Question 15

Sweat electrolyte losses

Answer 15

Hypotonic (Na concentration 35-65)

Replace with NS

Question 16

Saliva electrolyte losses

Answer 16

K+ (highest concentration of K in body)

Question 17

Stomach electrolyte losses

Answer 17

H+ and Cl-

Replace gastric losses with D5 1/2 NS with 20mg K+

Question 18

Pancreas electrolyte losses

Answer 18

HCO3-

Replace with LR and HCO3-

Question 19

Bile electrolyte losses

Answer 19

HCO3-

Replace with LR and HCO3-

Question 20

Small bowel fistula electrolyte losses

Answer 20

HCO3- and K+

Replace with LR and HCO3-

Question 21

Large intestine electrolyte losses (diarrhea)

Answer 21

K+

Replace with LR and K+

Question 22

GI losses replacement amount

Answer 22

cc/cc

Question 23

Dehydration (marathon runner) replacement

Answer 23

NS