FLUIDS ELECTROLYTES ACID/BASE

Question 1

Why does ADH elevate after surgery?

Answer 1

loss of intravascular volume by sequestration in injured tissues or “third-spacing,” dehydration from prolonged fasting, and insensible losses during the operation

Question 2

Hyponatremia in CSW is due to

Answer 2

excessive urinary losses of sodium

Question 3

na and volume status in pt with CSW

Answer 3

HYPOvolemic and hyponatremic

Question 4

Treatment of CSW (initial)

Answer 4

NS
Remember they are hypovolemic

Question 5

In response to metabolic alkalosis a/w hypovolemia the urine chloride concentration will be

Answer 5

LOW, <20 mEq/L in response to rcorresponding hypochloremia and volume contraction

Question 6

3 primary mechanisms of hypercalcemia of malignancy

Answer 6

Tumor secretion of PTHrP
Osteolytic mets
Tumor production of 1,25-dihydroxyvitamin D

Question 7

How to correct for serum sodium in hyperglycemia

Answer 7

Add 2 mEq/L of Na for each 100 the blood glucose is above 100

Question 8

Calculation of anion gap

Answer 8

Na - Cl - HCO3

Question 9

Pregnancy causes what sort of shift in the oxyhemoglobin dissociation curve

Answer 9

Right shift

Question 10

succinylcholine is what type of muscle relaxant

Answer 10

depolarizing

Question 11

PO intake of fluids is about

Answer 11

2000 mL

Question 12

Saliva produces how much fluids

Answer 12

1500 mL

Question 13

Stomach produces how much fluid

Answer 13

1000-2000 mL

Question 14

Biliary system produces how much fluid

Answer 14

500 mL

Question 15

Pancreas produces how much fluid

Answer 15

1500 mL

Question 16

Small bowel produces how much fluid

Answer 16

1500 mL

Question 17

How much fluid is absorbed in small bowel

Answer 17

8500 mL

Question 18

How much fluid is absorbed in large bowel

Answer 18

400 mL

Question 19

Net loss of fluid with stool is about

Answer 19

100-200 mL/day

Question 20

What type of ARF
urine: plasma urea <3

Answer 20

intrinsic

Question 21

What type of ARF
urine creatinine: plasma creatininine ratio of <20

Answer 21

intrinsic

Question 22

FENa in pre renal

Answer 22

<1%

Question 23

excessive ileostomy output leads to what acid base

Answer 23

normal AG metabolic acidosis

Question 24

Electrolyte abnormalities with excessive ileostomy output

Answer 24

hypoNa
hypoK
hypoMg

Question 25

reducing ventilatory rate by 1/3 will do what to ABG PaCO2

Answer 25

increase by 1/3

Question 26

For an acute change in partial pressure of PaCO2 of 10, pH will change by

Answer 26

0.08

Question 27

Normal arterial PaCO2

Answer 27

40 +/- 4

Question 28

Normal venous PaCO2

Answer 28

46 +/- 4

Question 29

Normal arterial PaO2

Answer 29

75-100

Question 30

Normal venous PaO2

Answer 30

36-42

Question 31

Where is ADH synthesized

Answer 31

supraoptic nuclei of the hypothalamus

Question 32

Where is ADH stored

Answer 32

posterior pituitary

Question 33

Mechanism of ADH

Answer 33

acts at collecting ducts of the kidney
vasoconstriction and stimulation of release of vWf and factor VIIII from the endothelium

Question 34

Impact on phosphorus levels after hepatic resection

Answer 34

HYPO
Rapid phosphate utilization in regenerating hepatocytes

Question 35

hyperkalemia does what to aldosterone?

Answer 35

induces production

Question 36

most powerful stimulus for adrenal aldosterone secretion

Answer 36

angiotensin II

Question 37

Calcium and hyperventilation

Answer 37

Acid base dysfunction can affect binding of calcium to albumin so you can get sx of HYPOcalcemia a/w hyperventilation

Question 38

respiratory alkalosis causes what to the binding affinity of calcium for albumin

Answer 38

increases it leading to reduction in serum iCal

Question 39

Normal daily intake of calcium

Answer 39

500-1500 mg

Question 40

Constituents of 1 L LR

Answer 40

Na 130
K 4
Cl 109
Ca 2.7
Lactate 28

Question 41

EKG changes in hypercalcemia

Answer 41

shortened QT interval