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1. Surgery FIRST PART > Fluid And Electrolyte > Flashcards

Fluid And Electrolyte Flashcards

1
Q

Metabolic acidosis with a normal anion gap (AG) occurs with

A. Diabetic acidosis
B. Renal failure
C. Severe diarrhea
D. Starvation

A

C. Severe diarrhea

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2
Q
  1. All are possible causes of postoperative hyponatremia EXCEPT

A. Excess infusion of normal saline intraooperatively
B. Administration of antipsychotic medication
. Transient decrease in ADH secretion
D. Excess oral water intake

A

C. Transient decrease in ADH secretion

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3
Q

Which of the following is an early sign of hyperkalemia

A. Peaked T waves
B. Peaked P waves
C. Peaked (shortened) QRS complex
D. Peaked U waves

A

A. Pealed. T waves

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4
Q

Hypocalcemia may cause which of the following

A. Congestive heart failure
B. Atrial fibrillation
C. Pancreatitis
D. Hypoparathyroidism

A

A. Congestive heart failure

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5
Q 
The next most appropriate test to order in a patient with a: 
pH of 7.1
Pco2 of 40
Na 132
K 4.2
Cl 105

A. Serum bicarbonate
B. Serum magnesium
C. Serum ethanol
D. Serum salicylate

A

A. Serum bicarbonate

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6
Q

Which of the following is FALSE regarding hypertonic saline

A. Is an arteriolar vasodilator and may increase bleeding
B. Should be avoided in closed head injury
C. Should not be used for initial resuscitation
D. Increase cerebral perfusion

A

B. Should be avoided in closed head injury

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7
Q

Normal saline is

A. 134 mEq NaCl/L
B. 145 mEq NaCl/L
C. 148 mEq NaCl/L
D. 154 mEq NaCl/L

A

D. 154 mEq NaCl/L

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8
Q

Fluid resuscitation using albumin

A. Is associated with coagulopathy
B. Is available as 1% or 5% solutions
C. Can lead to pulmonary edema
D. Decreased factor XIII

A

C. Can lead to pulmonary edema

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9
Q

Water constitutes what percentage of total body weight

A. 30-40%
B. 40-50%
C. 50-60%
D. 60-70%

A

C. 50-60%

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10
Q 
If a patient’s serum glucose increases by 180 mg/dL, what is the increase in serum osmolality, assuming all other laboratory values remain constant? 
A. Does not change 
B. 8 
C. 10 
D. 12
A

C. 10

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11
Q

What is the actual potassium of a patient with pH of 7.8 and serum potassium of 2.2

A. 2.2
B. 2.8
C. 3.2
D. 3.4

A

D. 3.4

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12
Q

The free water deficit of a 70kg man with serum sodium of 154 is

A. 0.1 L
B. 0.7 L
C. 1 L
D. 7 L

A

D. 7 L

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13
Q

A patient with serum calcium of 6.8 and albumin of 1.2 has a corrected calcium of

A. 7.7
B. 8.0
C. 8.6
D. 9.2

A

D. 9.2

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14
Q

All of the following treatments for hyperkalemia reduce serum potassium EXCEPT

A. Bicarbonate
B. Kayexalate
C. Glucose infusion with insulin
D. Calcium

A

D. Calcium

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15
Q

An alcoholic patient with serum albumin of 3.9, K of 3.1, Mg of 2.4, Ca of 7.8, and PO4 of 3.2 receives three boluses of IV potassium and has serum potassium of 3.3. You should

A. Continue to bolus potassium until serum level is >3.6
B. Give MgSO4 IV
C. Check the ionized calcium
D. Check the BUN and creatinine

A

B. Give MgSO4 IV

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16
Q

Calculate the daily maintenance fluids needed for a 60-kg female

A. 2060
B. 2100
C. 2160
D. 2400

A

B. 2100

17
Q

A patient who has spasms in the had when a blood pressure cuff is blown up most likely has

A. Hypercalcemia
B. Hypocalcemia
C. Hypermagnesemia
D. Hypomagnesemia

A

B. Hypocalcemia

18
Q

The actual AG of a chronic alcoholic with Na 133, K 4, Cl 101, HCO3 22, albumin 2.5 mg/dL is

A. 6
B. 10
C. 14
D. 15

A

D. 15

19
Q

The effective osmotic pressure between the plasma and interstitial fluid compartments is primarily controlled by

A. Bicarbonate
B. Chloride ion
C. Potassium ion
D. Protein

A

D. Protein

20
Q

The metabolic derangement most commonly seen in patients with profuse vomiting

A. Hypochloremic, hypokalemic metabolic alkalosis
B. Hypochloremic, hypokalemic metabolic acidosis
C. Hypochloremic, hyperkalemic metabolic alkalosis
D. Hypochloremic, hyperkalemic metabolic acidosis

A

B. Hypochloremic, hypokalemic metabolic acidosis

21
Q

Symptoms and signs of extracellular fluid volume deficit include all of the following EXCEPT

A. Anorexia
B. Apathy
C. Decreased body temperature
D. High pulse pressure

A

D. High pulse pressure

22
Q

A low urinary [NH4+] with a hyperchloremic acidosis indicates what cause?

A. Excessive vomiting
B. Enterocutaneous fistula
C. Chronic diarrhea
D. Renal tubular acidosis

A

D. Renal tubular acidosis

23
Q

When lactic acidosis is produced in response to injury, the body minimizes pH change by

A. Decreasing production of sodium bicarbonate in tissues
B. Excreting carbon dioxide through the lungs
C. Excreting lactic acid through the kidneys
D. Metabolizing the lactic acid in the liver

A

B. Excreting carbon dioxide through the lungs

24
Q

What is the best determinant of whether a patient has a metabolic acidosis versus alkalosis?

A. Arterial pH
B. Serum bicarbonate
C. Pco2
D. Serum CO2 level

A

A. Arterial pH

25
Q

If a patient’s arterial Pco2 is found to be 25 mm Hg, the arterial pH will be approximately

A. 7.52
B. 7.40
C. 7.32
D. 7.28

A

D. 7.28

26
Q 
Which of the following are NOT characteristic findings of acute renal failure? 
A. BUN >100 mg/dL 
B. Hypokalemia 
C. Severe acidosis 
D. Uremic pericarditis 
E. Uremic encephalopathy
A

A. BUN >100 mg/dL

27
Q

An elderly diabetic patient who has acute cholecystitis is found to have a serum sodium level of 122 mEq/L and a blood glucose of 600 mg/dL. After correcting the glucose concentration to 100 mg/dL with insulin, the serum sodium concentration would

A. Decrease significantly unless the patient also received 3% saline
B. Decrease transiently but return to approximately 122 mEq/L without specific therapy
C. Remain essentially unchanged
D. Increase to the normal range without specific therapy

A

D. Increase to the normal range without specific therapy

28
Q

Excessive administration of normal saline for fluid resuscitation can lead to what metabolic derangement?

A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Respiratory acidosis

A

B. Metabolic acidosis

29
Q

The first step in the management of acute hypercalcemia

A. Correction of deficit of extracellular fluid volume
B. Hemodialysis
C. Administration of furosemide
D. Administration of mithramycin

A

A. Correction of deficit of extracellular fluid volume

30
Q

A victim of a motor vehicle accident arrives in hemorrhagic shock. His arterial blood gases are pH, 7.25; Po2, 95 mm Hg; Pco2, 25 mm Hg; HCO3–, 15 mEq/L. The patient’s metabolic acidosis would be treated best with

A. Ampule of sodium bicarbonate
B. Sodium bicarbonate infusion
C. Lactated Ringer solution
D. Hyperventilation

A

C. Lactated Ringer solution

31
Q

Three days afer surgery for gastric carcinoma, a 50-year-old alcoholic male exhibits delirium, muscle tremors, and hyperactive tendon reflexes. Magnesium deficiency is suspected. All the following statements regarding this situation are true EXCEPT

A. A decision to administer magnesium should be based on the serum magnesium level.
B. Adequate cellular replacement magnesium will require 1 to 3 weeks.
C. A concomitant calcium defciency should be suspected.
D. Calcium is a specific antagonist of the myocardial effects of magnesium

A

A. A decision to administer magnesium should be based on the serum magnesium level.

32
Q

Refeeding syndrome can be associated with all of the following EXCEPT

A. Respiratory failure
B. Hyperkalemia
C. Confusion
D. Cardiac arrhythmias

A

B. Hyperkalemia

1. Surgery FIRST PART (7 decks)

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