Fluids and Electrolytes

Question 1

In a 70kg male, water constitutes _____% of total body weight, which equates to ___L

Answer 1

60% of TBW, or 42L

Question 2

ICV accounts for what percentage of TBW?

Answer 2

40% or 28L

Question 3

ECV accounts for what percentage of TBW?

Answer 3

20% or 14L

Question 4

ECV consists of:

Answer 4

Plasma: 15% of TBW
Interstitial: 5% of TBW

Question 5

Which population has the highest TBW?

Answer 5

Neonates

Question 6

Which population has the lowest TBW?

Answer 6

Females
Obese
Elderly

Question 7

What are starling forces?

Answer 7

Hydrostatic and oncotic forces that determine movement of plasma between the capillaries and the interstitial space

Question 8

What is the glycocalyx?

Answer 8

The protective layer on the inside of blood vessel walls that controls what can and cannot pass through pores in the vessel. Disruptions in the glycocalyx=capillary leak

Question 9

What is hematocrit?

Answer 9

The percentage of the blood volume that’s occupied by erythrocytes

Question 10

Where is the interstitial space?

Answer 10

It’s the space between cells, filled with a gel

Question 11

The lymphatic system is the ______ of the body

Answer 11

scavenger system

Question 12

Answer 12

Question 13

What is osmolarity?

Answer 13

Number of moles per LITER of solution

Question 14

What is osmolality?

Answer 14

Number of moles per KG of solution

“L is not for Liter”

Question 15

How does albumin impact inflammation?

Answer 15

It actually has anti-inflammatory properties

Question 16

Which colloid has the highest risk for anaphylaxis?

Answer 16

Dextran

Question 17

How does albumin impact Ca?

Answer 17

It binds calcium, so it can cause a reduction in ionized calcium

Question 18

Crystalloids expand ______ whereas colloids expand _______

Answer 18

Crystalloids expand the ECF
BUT colloids ONLY expand plasma volume

Question 19

Excessive NS can lead to what metabolic derangement?

Answer 19

Hyperchloremic metabolic acidosis

Question 20

What is the black box warning for colloids?

Answer 20

Renal injury

Question 21

HYPERkalemia ________ cell membranes

Answer 21

depolarizes

In order for cellular excitation to occur, potassium efflex has to DECREASE. When extracellular K is high, less K leaves the membranes

Question 22

HYPOkalemia _______ cell membranes

Answer 22

hyperpolarizes

In order for cellular inhibitio to occur, K efflux must INCREASE. Hypokalemia causes more K to shift out of the cell

Question 23

How does potassium derangement impact EKG?

Answer 23

Question 24

Which electrolyte derangement is the most common in clinical practice

Answer 24

Hypokalemia

Question 25

How quickly should serum sodium derangement be corrected?

Answer 25

Slowly. No more than 1-2 mEq/L/hr

Question 26

Treating hyponatremia too quickly causes:

Answer 26

central pontine myelinolysis

Question 27

Treating hypernatremia too quickly causes:

Answer 27

cerebral edema

Question 28

Surgery should be cancelled if serum Na is less than:

Answer 28

130

Question 29

What is the most abundant electrolyte in the body?

Answer 29

Calcium

Question 30

Nearly all of calcium is stored:

Answer 30

in bone

Question 31

Calcium is responsible for which phase of the cardiac cycle?

Answer 31

Phase 2

Question 32

Ca is factor ____ in the coagulation cascade

Answer 32

4

Question 33

An increase in calcium leads to the release of:

Answer 33

Calcitonin from the thyroid, which inhibits bone break down and decreases Ca reabsorption in the kidney

Question 34

A decrease in calcium leads to the release of:

Answer 34

Parathyroid Hormone (PTH), which stimulates osteoclasts to break down bone and increases reabsorption of Ca from the kidney

Question 35

Chvostek's Sign is:

Answer 35

Question 36

Trousseau's Sign is:

Answer 36

Question 37

Chvostek and Trousseau are signs of ______calcemia

Answer 37

HYPOcalcemia

Question 38

Magnesium antagonizes the effects of which electrolyte?

Answer 38

Calcium at the NMJ, in the bronchioles etc.

Question 39

What can cause an Anion Gap metabolic acidosis?

Answer 39

Question 40

What can cause a non-anion gap metabolic acidosis?

Answer 40

Question 41

How does acidosis impact ICP?

Answer 41

Acidosis increases ICP and CBF Alkalosis decreases ICP and CBF

Question 42

Massive transfusion can cause:

Answer 42

metabolic alkalosis BECAUSE the liver changes all of that citrate into bicarbonate!

Question 43

What does acetazolamide do?

Answer 43

Inhibits carbonic anhydrase, which increases renal excretion of bicarb

Question 44

What is the adult shortcut for the 4-2-1 rule?

Answer 44

Weight + 40 ml