Fluids and Electrolytes Acid Base

Question 0

What is the most significant complication of hypernatremia

a. seizures
b. brain hemorrhage

Answer 0

b. brain hemorrhage

* Nelson’s 18th: Brain hemorrhage is the most devastating consequence of hypernatremia.

Question 1

A patient with mild metabolic acidosis…no treatment but if with severe metabolic acidosis what will be your management?

Answer 1

IV bicarbonate

Question 2

A patient with metabolic acidosis, who had normal electrolytes but with calcium almost below normal, was given sodium bicarbonate to correct acidosis and then developed seizures. What caused the seizures?

a. Hypernatremia
b. Hyponatremia
c. Hypocalcemia
d. Hypokalemia

Answer 2

No answer given

Question 3

Which of the following fluids should not be included in the replacement of fluid losses in GI losses (patient with vomiting yata ang case, can’t remember exactly).

a. NSS
b. PLR
c. 45 Saline
d. Maintenance fluids

Answer 3

d. Maintenance fluids

Question 4

In a patient with nephrotic syndrome, what is the mechanism behind his hypervolemic hyponatremia?

a. Excess in water retained exceed sodium retention
b. Sodium deficiency
c. Water excess

Answer 4

a. Excess in water retained exceed sodium retention

Question 5

Associated with hypocalcemia
​a. hypomagnesemia
​b. hyponatremia
​c. hyperkalemia
​d. hypernatremia

Answer 5

A. hypomagnesemia

NTP, Magnesium Chapter: Hypomagnesemia causes secondary hypocalcemia by impairing the release of PTH by the parathyroid gland and through blunting the tissue response to PTH. Thus, hypomagnesemia is part of the differential diagnosis of hypocalcemia (see Chapter 572 ). This usually occurs only at magnesium levels <0.7 mg/dL. The dominant manifestations of hypomagnesemia are due to hypocalcemia: tetany, positive Chvostek and Trousseau signs, and seizures.