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x Medicine 200 > Fluids, electrolytes, Acid-Base disorders > Flashcards

Fluids, electrolytes, Acid-Base disorders Flashcards

1
Q

Normal urine output in an adult

A

0.5 to 1 mL/kg/hr

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2
Q

Standard maintenance fluid

A

D51/2NS with 20 mEq of KCl/L of fluid

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3
Q

When do you not use LR solution

A

Hyperkalemia b/c it contains potassium

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4
Q

What does a Swan-ganz catheter do

A

Measure CVP and PCWP

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5
Q

How to measure maintenance fluids amount

A

100-50-20 rule for 24 hr total, or 4-2-1 rule for per hr

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6
Q

Most common cause of edema

A

Renal sodium retention

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7
Q

What to do with patients with head trauma and hyponatremia

A

Keep the sodium higher up so they don’t get cerebral edema

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8
Q

Hypotonic hyponatremia

A

Hypovolemic: Low urine sodium (20: diuretics, decreased Aldosterone (ACEIs), ATN)

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9
Q

Pseudohyponatremia

A

More plasma solids decreases Na concentration but the amount is the same. caused by anything that causes elevated protein or lipids.

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10
Q

Glucose and sodium relation in plasma

A

For ever 100 mg/dL increase in blood glucose above normal, serum sodium decreases 3 Meq/L. sodium content is the same though.

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11
Q

Most common cause of hypercalcemia in O/P

A

Hyperparathyroidism: 85% parathyroid adenoma 15% hyperplasia&raquo_space;» carcinoma

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12
Q

EKG findings for hyperCa

A

Short QT, T wave widening, first degree AV block

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13
Q

Bone disease and hyperCa

A

osteitis fibrosa cystica

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14
Q

PTHrP-SCC secreting cancers

A

SCC, renal cell cancer, breast, gyn cancers

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15
Q

Calcitriol secreting cancer

A

Lymphoma

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16
Q

Lithium and Ca effect

A

HyperCa

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17
Q

Do granulomatous diseases increase Ca

A

Yes, they increased 1,25 OH vit D (TB< sarcoid, histo, coccidio, lymphoma)

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18
Q

Familial Hypocalciuric Hypercalcemia (FHH)

A

AD inheritance, benign, hypocalciuria, mild-mod increase in Mg

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19
Q

What thyroid disorder causes hypercalcemia

A

Thyrotoxicosis

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20
Q

Other causes of HyperCa

A

Malignancies, medications, immobilization (increased bone resorption), Pagets disease

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21
Q

Osteolytic cancers

A

Breast, lung, renal

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22
Q

SPEP/UPEP disease

A

Multiple myeloma

23
Q

Polyclonal hypergammaglobulinemia and family of diseases

A

Rheumatologic (RA, SLE)

24
Q

How would you treat HyperCa

A
  1. Increase excretion: Add Na to diet and volume expand (NSS)
  2. Inhibit bone resoprtion: IV bisphosphonates, calctinonin
  3. Treat underlying dz
  4. Dialysis as last resort
25
Q

What is the formula for getting corrected Ca

A

Corrected Calcium = (0.8 * (Normal Albumin - Pt’s Albumin)) + Serum Ca

For every one below 4 for the patient’s albumin, add 0.8 to the calcium. This is because the Ca test only measures bound Ca?

26
Q

Causes of u/l LE edema

A

DVT, cellulitis, ruptured baker’s cyst, lymphatic obstruction, venous insufficiency

27
Q

Causes of b/l LE edema

A

Nephrotic syndrome, liver failure, malnutrition, malabsorption, burns, angioedema, sepsis, venous obstruction, icirrhosis, CHF, renal failure, pregnancy

28
Q

Nonpitting edemas

A

Myxedema, lymphedema

29
Q

What cardiac drug class causes edema

30
Q

How to treat CCB edema?

A

ACEi, better than diuretics

31
Q

Is venous insufficiency a volume overload state?

A

Nope, so don’t use diuretics in the long term

32
Q

Most common cause of outpatient LE edema

A

Chronic venous insufficiency

33
Q

Top 5 causes of LE edema

A

CHF, venous insufficiency, NSAIDs, increased PAP 2nd to OSA, Idiopathic

34
Q

What happens when you are hyponatremic in normal urine

A

UNa<10 mEq/L

35
Q

SIADH diagnostic criteria

A
  1. SerumOsmSerumOsm
  2. UNa>20 mEq/L
  3. Absence of hypovolemia
  4. Normal renal, adrenal, and thyroid function
  5. No obvious traumatic stimulus known to activate neuroendocrine stress.
  6. Absence of other causes of HypoNa
36
Q

Does SIADH correct with NS infusion?

37
Q

Formula to calculate serum osmolarity

A

(2xNa)+(BUN/2.8)+(Glucose/18)

38
Q

Contraction alkalosis

39
Q

Treatment for hypokalemic, hypochloremic metabolic alkalosis

A

Hydration with sodium chloride and potassium replacement

40
Q

Correcting contraction alkalosis

A

Normal saline

41
Q

What causes contraction alkalosis

A

Aldosterone secretion in response to low BP leads to increased potassium secretion and bicarb reabsorption which causes the alkalosis and low K.

42
Q

Role of chloride in fixing metabolic alkalosis

A

Chloride allows bicarb to be excreted so once you replenish the chloride the kidneys should be able to fix the acid-base problem

43
Q

Chloride-sensitive metabolic alkalosis always has

A

ECF volume contraction

44
Q

Chloride-resistant alkalosis?

45
Q

What does Addison disease cause for acid-base disturbance

A

Non-anion gap, hyperK, hypoNa met. acidosis

46
Q

Does hypoalbuminemia affect ionized calcium?

47
Q

Na and K in diuretic use

A

Low in serum, high in urine

48
Q

Cause of refractory hypokalemia (electrolyte distrubance)

A

Hypomagnesemia

49
Q

Quickest way to lower potassium

A

Insulin/glucose

50
Q

Cushing’s syndrome causes what elec. abnormalities

A

HypoK and HypoNa

51
Q

Loop diuretic elec. effect

A

HypoK, met. alk., prerenal renal failure

52
Q

Winter’s formula

A

Respiratory compensation for met. acidosis. pCO2=1.5(HCO3)+8

53
Q

How to tell if it is Resp. acidosis and met. compensation or met. acidosis and resp. acidosis

x Medicine 200 (14 decks)

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