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Apex > Fluids and Electrolytes > Flashcards

Fluids and Electrolytes Flashcards

1
Q

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

A

60% of TBW, or 42L

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2
Q

ICV accounts for what percentage of TBW?

A

40% or 28L

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3
Q

ECV accounts for what percentage of TBW?

A

20% or 14L

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4
Q

ECV consists of:

A

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

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5
Q

Which population has the highest TBW?

A

Neonates

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6
Q

Which population has the lowest TBW?

A

Females
Obese
Elderly

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7
Q

What are starling forces?

A

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

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8
Q

What is the glycocalyx?

A

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

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9
Q

What is hematocrit?

A

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

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10
Q

Where is the interstitial space?

A

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

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11
Q

The lymphatic system is the ______ of the body

A

scavenger system

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12
Q
A
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13
Q

What is osmolarity?

A

Number of moles per LITER of solution

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14
Q

What is osmolality?

A

Number of moles per KG of solution

“L is not for Liter”

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15
Q

How does albumin impact inflammation?

A

It actually has anti-inflammatory properties

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16
Q

Which colloid has the highest risk for anaphylaxis?

A

Dextran

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17
Q

How does albumin impact Ca?

A

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

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18
Q

Crystalloids expand ______ whereas colloids expand _______

A

Crystalloids expand the ECF
BUT colloids ONLY expand plasma volume

19
Q

Excessive NS can lead to what metabolic derangement?

A

Hyperchloremic metabolic acidosis

20
Q

What is the black box warning for colloids?

A

Renal injury

21
Q

HYPERkalemia ________ cell membranes

A

depolarizes

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

22
Q

HYPOkalemia _______ cell membranes

A

hyperpolarizes

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

23
Q

How does potassium derangement impact EKG?

A
24
Q

Which electrolyte derangement is the most common in clinical practice

A

Hypokalemia

25
Q

How quickly should serum sodium derangement be corrected?

A

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

26
Q

Treating hyponatremia too quickly causes:

A

central pontine myelinolysis

27
Q

Treating hypernatremia too quickly causes:

A

cerebral edema

28
Q

Surgery should be cancelled if serum Na is less than:

A

130

29
Q

What is the most abundant electrolyte in the body?

A

Calcium

30
Q

Nearly all of calcium is stored:

A

in bone

31
Q

Calcium is responsible for which phase of the cardiac cycle?

A

Phase 2

32
Q

Ca is factor ____ in the coagulation cascade

A

4

33
Q

An increase in calcium leads to the release of:

A

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

34
Q

A decrease in calcium leads to the release of:

A

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

35
Q

Chvostek’s Sign is:

A
36
Q

Trousseau’s Sign is:

A
37
Q

Chvostek and Trousseau are signs of ______calcemia

A

HYPOcalcemia

38
Q

Magnesium antagonizes the effects of which electrolyte?

A

Calcium

at the NMJ, in the bronchioles etc.

39
Q

What can cause an Anion Gap metabolic acidosis?

A
40
Q

What can cause a non-anion gap metabolic acidosis?

A
41
Q

How does acidosis impact ICP?

A

Acidosis increases ICP and CBF
Alkalosis decreases ICP and CBF

42
Q

Massive transfusion can cause:

A

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

43
Q

What does acetazolamide do?

A

Inhibits carbonic anhydrase, which increases renal excretion of bicarb

44
Q

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

A

Weight + 40 ml

Apex (46 decks)

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