Fluid, Electrolyte, Acid Base

Question 1

Serum sodium level indicative of hypernatremia

Answer 1

> 145

Question 2

Serum sodium level of 200 requires

Answer 2

dialysis

Question 3

Rapid correction of hypernatremia can cause

Answer 3

pulmonary or cerebral edema - esp in patients w DM

Question 4

Serum sodium level indicative of hyponatremia

Answer 4

< 135

**signs and symptoms may not be present until 125

Question 5

Most common electrolyte disorder seen in general hospital population secondary to fluid administration

Answer 5

Hyponatremia

Question 6

Hyponatremia w HYPERvolemia

Answer 6

occurs in setting of

CHF
nephrotic syndrome
renal failure
hepatic cirrhosis

Question 7

Hyponatremia and EUvolemia occurs with

Answer 7

hypothyroidism
glucocorticoid excess
SIADH

Question 8

Hypotonic hyponatremia, Urine Osmo > 100, absence go extracellular fluid volume deficit

Answer 8

SIADH

Question 9

Plasma osmo 280-295

Answer 9

Isotonic hyponatremia (paraproteinemia, hypertriglyceridemia)

Question 10

Plasma osmo > 295

Answer 10

Hypertonic hyponatremia (hyperglycemia)

Question 11

Plasma osmo < 280

Answer 11

Hypotonic hyponatremia, measure urine osmo

Question 12

URINE osmo < 100

Answer 12

Excessive water intake (primary polydipsia)

Question 13

URINE osmo > 100

Answer 13

impaired renal diluting ability (SIADH, diuretics)

Question 14

Neurologic symptoms of hyperkalemia

Answer 14

numbness, tingling, weakness, flaccid paralysis

Question 15

IV administration for hyperkalemia

Answer 15

Sodium bicarbonate

Glucose

Insulin (10 units)

Question 16

Med used to remove potassium from the body when levels are extremely high

Answer 16

Sodium polystyrene sulfonate (Kayexalate)

Question 17

Hypokalemia defined as

Answer 17

Serum potassium < 3.5

Question 18

Hyperkalemia defined as

Answer 18

Serum potassium > 5.0

Question 19

Most common causes of hypokalemia

Answer 19

Diuretics

Renal tubular acidosis

GI loss

Question 20

Cardiovascular manifestations of hypokalemia

Answer 20

Ventricular arrhythmias

Hypotension

Cardiac arrest

Question 21

Neuromuscular manifestations of hypokalemia

Answer 21

Malaise
Skeletal muscle weakness
Cramps
Smooth muscle involvement

Question 22

Tx for hypercalcemia

Answer 22

Isotonic saline

Loop diuretics (if hypervolemic after iv fluids)

Bisphosphonates

Question 23

Tx for hypermagnesemia

Answer 23

IV calcium gluconate

Diuresis

Dialysis if severe

Question 24

Tx hypomagnesemia

Answer 24

oral magnesium oxide

if severe, IV magnesium sulfate

Question 25

Primary CO2 changes bring

Answer 25

Secondary HCO3 changes

Question 26

Primary HCO3 changes bring

Answer 26

Secondary HCO3 changes

Question 27

Anion gap

Answer 27

(Na - (Cl + HCO3))

Tells us how many unmeasured anions are present in blood

(accumulating acids in ECF)

For differentiating cause of metabolic academia

• HCO3 loss has normal anion gap
• acid production or accumulation has wide anion gap