fluids and electrolyte imbalances

Question 1

what is the daily water requirement?

Answer 1

25-30ml/kg

Question 2

what is the daily potassium requirement?

Answer 2

1mmol/kg

Question 3

what is the daily sodium requirement?

Answer 3

1mmol/kg

Question 4

wha tis the daily chloride requirement?

Answer 4

1mmol/kg

Question 5

what is the daily glucose requirement?

Answer 5

50-100g

Question 6

how fast can you replace potassium?

Answer 6

no faster than 10mmol/h - s0 a 0.3% bag of potassium chloride over 4 hours or a bag of 0.15% potassium chloride over 2 hours

Question 7

what fluids should you give in emergency rhesus?

Answer 7

500ml normal saline over 15 mins

Question 8

what should you give in an emergency hypoglycaemia?

Answer 8

20% glucose 100ml over 15 minutes

Question 9

how should you treat an emergency hypokalaemia?

Answer 9

sodium chloride 0.9%/potassium chloride 0.3% 1000ml over 4 hrs

Question 10

how can you treat emergency hypercalcaemia?

Answer 10

sodium chloride 0.9% 1000ml over 4 hrs

Question 11

how fast should you infuse maintenance fluids?

Answer 11

10-12 hrs 1000ml

Question 12

how fast should you infuse maintenance fluids with deficits or losses - e.g. if someone had diarrhoea?

Answer 12

4-6hrs 1000ml

Question 13

how many mol of sodium in a bag of normal saline?

Answer 13

150mmol

Question 14

how many mol go potassium in a bag od 0.3% potassium chloride?

Answer 14

40mmol

Question 15

how much glucosee in a bag of 5% glucose?

Answer 15

50mg

Question 16

how much fluids do you give for emergency rhesus of a child?

Answer 16

20ml/kg of normal saline

Question 17

what is the formula for fluid prescription for children?

Answer 17

100ml/kg for the first 10kg
50ml/kg for 10-20kg
20ml/kg for anything above 20kg

Question 18

how to know when to prescribe a patient a rhesus bolus?

Answer 18

when they are hypotensive and tachycardia

Question 19

what are the signs and symptoms of hypocalcaemia?

Answer 19

CATS go numb

• convulsions
• arrhythmias
• tetany
• numbness
• Trousseaus sign

Question 20

what is the treatment for hypocalcaemia?

Answer 20

10% calcium glutinate 10ml IV - to stabilise the cardiac membrane

Question 21

what is the management of hyperkalaemia?

Answer 21

10% calcium gluconate to stabilise the cardiac membrane

Question 22

what is a side effect of statins?

Answer 22

myalgia

Question 23

what level do transaminases need to get to before statins are discontinued?

Answer 23

3x upper limit of normal

Question 24

what electrolyte imbalance can be caused by carbamazepine?

Answer 24

hyponatraemia

Question 25

causes of hypokalaemia?

Answer 25

DIRE
drugs- loop and thiazide diuretics (furosemide/bendoflumathiazide)
inadequate intake/loss
renal tubular acidosis 
endocrine- Cushing/conns syndrome

Question 26

causes of hyperkalaemia?

Answer 26

DREAD
Drugs- potassium sparring diuretics (spironolactone) and ACEi

renal failure
endocrine- Addisons
arterfact- due to clotted sample
DKA

Question 27

which biochemical disturbance can you see in prerenal failure?

Answer 27

• the rise in urea is greater than the rise in creatinine

- this is usually caused by dehydration and insensible losses

Question 28

wha biochemical disturbance can you see in intrinsic renal failure?

Answer 28

the rise in creatinine is much greater than the rise in creatinine

this can be caused by ischaemia arising from prerenal AKI, glomerulonephritis or drugs like ACEi. NSAIDs and abs

Question 29

what are the biochemical disturbances for a post renal AKI?

Answer 29

creatinine will be raised much more than urea

may be caused by renal stone

Question 30

what is the adverse effect of carbamazepine?

Answer 30

hyponatraemia