fluid and electrolytes

Question 1

What is the total body water percentage of male

Answer 1

60%

Question 2

What is the total body water percentage of female

Answer 2

50%

Question 3

What is the total body water percentage of newborn

Answer 3

80%

Question 4

Breakdown of daily water loss

Answer 4

1. 800 - 1200 ml in urine
2. 250 ml in stool
3. 600 ml insensible loss - 75% skin and 25% lungs

Question 5

What is the most common fluid disorder in surgical patients

Answer 5

Extra cellular volume deficit

Question 6

composition of lactated ringers solution

Answer 6

Na - 130
Cl - 109
K - 4
Ca - 27
Lactate - 28
mOsm - 280

Question 7

Composition of ECF

Answer 7

Na - 142
Cl - 103
K - 4
Ca - 28
mIOsm - 280

Question 8

Composition of PNSS

Answer 8

Na - 154
Cl - 154
mOsm - 308

Question 9

This is used as maintenance fluid therapy in postoperative period

Answer 9

D5 0.45% NaCl

-for patients unable to tolerate enteral nutrition and started 24 to 48 hours post operative

Question 10

This is used in patietns with closed head injuries

Answer 10

D5 7% NaCl

Question 11

Ways of preventing refeeding syndrome

Answer 11

1. underlying electrolyte or volume deficit should be corrected
2. thiamine should be administered before feeding
3. caloric repletion at 20/kcal/kg/day

Question 12

consequence of rapid correction of hypernatremia

Answer 12

cerebral edema and herniation

Question 13

consequence of rapid correction of hyponatremia

Answer 13

central pontine myelinosis

Question 14

Drugs that are aldosterone antagonist

Answer 14

1. spironolactone

2. eplerenone

Question 15

Drugs that are Na channel blockers

Answer 15

1. amiloride

2. triamterene

Question 16

ECG changes in hyperkalemia

Answer 16

1. Peak T waves
2. prolong PR interval
3. flattened p waave
4. widened QRS complex
5. sine wave formation
6. ventricular fibrillation

Question 17

What happens to deep tendon reflex in hypokalemia

Answer 17

decrease

Question 18

What happens to deep tendon reflex in hypocalcemia, and hypomagnesemia

Answer 18

increase

Question 19

ECG changes in hypercalcemia

Answer 19

1. shortened QT interval
2. prolonged PR interval
3. increase QRS voltage
4. T wave flattening and widening
5. AV block

Question 20

What is the critical level of serum calcium

Answer 20

5 meq/l

Question 21

ECG changes in hypocalcemia

Answer 21

1. prolonged QT interval
2. T wave inversion
3. heaert block
4. ventricular fibrillation

Question 22

what is a concomitant electrolyte imbalance in metabolic alkalosis

Answer 22

hypokalemia

Question 23

Potassium repletion is difficult in the presence of hypomagnesemia

Answer 23

true

Question 24

hypocalceia will be refractory to treatment if coexisting hypomagneseia is not corrected first

Answer 24

true

Question 25

Tumor lysis syndrome electrolyte imbalance

Answer 25

1. hyperkalemia
2. hyperphosphatemia
3. hyperurecemie
4. hypocalcemia

Question 26

what are the electrolyte imbalance in rhabdomyolosis

Answer 26

hyperkalemia

hyperphosphatemia

Question 27

causes of acute hypophosphatemia

Answer 27

1. respiratory alkalosis
2. insulin therapy
3. refeeding syndrome
   . hungry bone syndrome

Question 28

composition of saliva

Answer 28

volume - 1000
Na - 10
K - 26
Cl - 10
HC03 - 30

Question 29

composition of stomach

Answer 29

volume - 1000 - 2000
Na - 60 - 90
K - 10
Cl - 130
HC03 - 0

Question 30

composition of duodenum

Answer 30

volume - 1500
Na - 120 - 140
K - 5 - 10
Cl - 90 - 120
HC03 - 0

Question 31

composition of ileum

Answer 31

volume - 3000
Na - 140
K - 5
Cl - 104
HC03 - 30

Question 32

composition of colon

Answer 32

volume - 750
Na - 60
K - 30
Cl - 40
HC03 - 0

Question 33

composition of pancreas

Answer 33

volume - 600 - 800
Na - 135 - 145
K - 5- 10
Cl - 70 - 90
HC03 - 115

Question 34

composition of bile

Answer 34

volume - 300 - 800
Na - 135 - 145
K - 5 - 10
Cl - 90 - 110
HC03 - 30 - 40