Fluids and electrolytes

Question 1

dominant cation in ECF

Answer 1

Sodium

Question 2

most devastating consequence of hypernatremia

Answer 2

Brain hemorrhage

Question 3

what is the goal in decreasing the serum sodium?

Answer 3

<12mEqs/L every 24 hours

Question 4

hyponatremia is defined as

Answer 4

serum sodium less than 135 meq/L

Question 5

responsible for most symptoms of hyponatremia

Answer 5

Brain cell swelling

Question 6

rapid correction of hyponatremia may cause

Answer 6

Central Pontine myelinosis (CPM)

Question 7

major intracellular cation

Answer 7

Potassium

Question 8

principal hormone regulating potassium secretion

Answer 8

Aldosterone

Question 9

ECG findings in hyperkalemia

Answer 9

peaking of T waves, followed by ST segment depression, increased PR interval, flattening of P wave, widening of QRS complex

Question 10

seen in patients with leukemia and very elevated WBC counts

Answer 10

spurious hypokalemia

Question 11

ECG changes in hypokalemia

Answer 11

flattened T wave, depressed ST segment, appearance of U wave

Question 12

what are the effects of severe hypermagnesemia (>15mg/dL)

Answer 12

complete heart block and cardiac arrest

Question 13

most common etiology of Metabolic acidosis

Answer 13

diarrhea

Question 14

most commonly secondary to emesis or diuretic use

Answer 14

Metabolic alkalosis

• low urinary chloride level
• elevated urinary chloride

Question 15

Most devastating consequence of untreated hypernatremia

Answer 15

Brain hemorrhage

Question 16

Associated with overly rapid correction of hyponatremia

Answer 16

Central pontine myelinolysis

Question 17

Most common cause of hypovolemic hyponatremia in children

Answer 17

Diarrhea

Question 18

Management for hyperkalemia

Answer 18

Ca gluc
Insulin + Dextrose
Salbutamol
Bicarb for acidosis
Loop diuretics, HD

Question 19

Metabolic acidosis in children is most commonly secondary to

Answer 19

Vomiting

Question 20

Nasogastric suctioning may cause

Answer 20

Metabolic alkalosis

Question 21

Goals of maintenance fluids

Answer 21

Prevent dehydration
Prevent electrolyte disoders
Prevent ketoacidosis
Prevent protein degradation

Question 22

Sources of water loss

Answer 22

Urine: 60%
Insensible loss: 35%
Stool: 5%

Question 23

Normal anion gap

Answer 23

12-16

Question 24

Central diabetes insipidus will have laboratory result of

Answer 24

Serum Na increased

Urine Na decreased