general surgery Ulas

Question 1

does young and muscular people have more fluid in their body of fat and old ones?

Answer 1

young and muscular
muscle tissue 75%
fat tissue 10%
young >old

Question 2

where NA-containing fluids distributed mainly?

Answer 2

in the ESS
1/4 in the plasma
3/4 in the interstitial fluid

Question 3

a healthy person consumes an average ………… mL of fluid per day.

Answer 3

2000 mL

Question 4

where do our daily water loss happened

Answer 4

800-1200 ml with urine
250 ml with stool
600 ml with the insensible loss(skin>lungs)

Question 5

how much at least do the kidneys need to excrete per day?

Answer 5

500-800 for the clearance of metabolic products

Question 6

what is the most common fluid disorder in surgical patients ?

Answer 6

acute or chronic ESS loss (extracellular loss)

Question 7

sudden loss of fluid cause what kind of disease ?

Answer 7

acute -> cardio and CNS abs

Question 8

skin turgor and sunken eyes happened in which type of fluid disease ?

Answer 8

chronic losses

Question 9

what are the laboratory findings of fluid disorders? (ask)

Answer 9

hemoconcentration,high BUN , higher urine osmolality than serum osmolality , and low urine sodium <20 mEq/L

Question 10

what is the most common cause of volume depletion in surgical patients?

Answer 10

the loss of gastrointestinal fluids due to nasogastric aspiration,vomiting,diarrhea, or enter-cutaneous fistula

Question 11

what else can causes massive volume losses ?

Answer 11

soft tissue injuries , burns , peritonitis , and intestinal obstruction or prolonged surgery

Question 12

the most fluid excretion organ

Answer 12

Kidney

Question 13

the most acidic excretion

Answer 13

from stomach

Question 14

the most basic excretion

Answer 14

pancreas

Question 15

fluid volume changes are sensed by where?

Answer 15

by osmoreceptors & baroreceptors

Question 16

where osmoreceptor located

Answer 16

supraoptic nucleus in hypothalamus

Question 17

what will happens if plasma osmolality rises?

Answer 17

thirst
vasopressin (ADH,AVP) secretion

Question 18

what are the function of vasopressors

Answer 18

Vasopressors help you raise your blood pressure when it’s so low that you can’t get enough blood to your organs.

Question 19

What are the 5 vasopressors?

Answer 19

Norepinephrine, phenylephrine, dopamine, epinephrine, and vasopressin

Question 20

where do baroreceptors located?

Answer 20

in the aortic arch and carotid sinuses

Question 21

how does osmoreceptors trigger?

Answer 21

change in osmolarity

Question 22

how does baroreceptors work?

Answer 22

with sympathetic and parasympathetic ways :
neural
hormonal

Question 23

what is renin-angiotensin-aldosterone mechanism

Answer 23

The renin-angiotensin-aldosterone system (RAAS) is a critical regulator of blood volume, electrolyte balance, and systemic vascular resistance. While the baroreceptor reflex responds short term to decreased arterial pressure, the RAAS is responsible for acute and chronic alterations.

Question 24

what is the most important cation of ESS?

Answer 24

sodium

Question 25

what is the normal concentration of NA?

Answer 25

135-145

Question 26

how much is the daily requirement of NA in babies and adults?

Answer 26

2-3 mEq /kg in babies
1.5 mEq/kg in adults

Question 27

what are the causes of hypervolemic in hyponatremia ?

Answer 27

increased uptake
postoperative ADH secretion
drugs

Question 28

what are the causes of normovolemic in hayponatremia ?

Answer 28

hyperglycemia
plasma lipids/proteins
SIADH
water intoxication
diuretics

Question 29

SIADH

Answer 29

Syndrome of inappropriate antidiuretic hormone ADH release (SIADH) is a condition defined by the unsuppressed release of antidiuretic hormone (ADH) from the pituitary gland or nonpituitary sources or its continued action on vasopressin receptors.

Question 30

what are the causes of hypovolemic in hyponatremia?

Answer 30

decreased NA uptake
GIS loss
renal loss
diuretics
primary renal loss

Question 31

what are the causes of hypervolemic in hypernatremia ?

Answer 31

Iatrogenic sodium administration
excess mineralocorticoids
aldostronism
Cushing’s disease
congenital adrenal hyperplasia

Question 32

What is iatrogenic hypernatremia?

Answer 32

Hypernatremia can also be iatrogenic, resulting from inappropriate fluid therapy or excessive administration of sodium bicarbonate during cardiopulmonary resuscitation.

Question 33

what is mineralocorticoids?

Answer 33

Mineralocorticoids are a class of steroid hormones that regulate salt and water balances. Aldosterone is the primary mineralocorticoid.

Question 34

what is aldosteronism

Answer 34

Primary aldosteronism, also called Conn’s syndrome, is a disorder in which your adrenal glands make too much of a hormone called aldosterone.

Question 35

what are the causes of normovolemic hypernatremia

Answer 35

extra renal water loss(skin,GIS)
renal water loss
renal disease
diuretics
Diabetes inspitus

Question 36

what are the causes of hypovolemic of hypernatremia?

Answer 36

extra renal water loss (skin,GIS)
renal water loss
renal(tubular disease )
osmotic diuretics
diabetes inspitus
adrenal failure

Question 37

hyponatremia is the decreased of serum NA concentration below ………..

Answer 37

135 mEq/L

Question 39

When does hyponatremia is Asymptomatic?

Answer 39

Until <120 mEq/L if kidneys are normal

Question 40

When does hyponatremia symptomatic?

Question 41

what is the most cation of intreacellular fluid ?

Answer 41

potassium

Question 42

what is the normal concentration of potassium ?

Answer 42

3.5-5 mEq/L

Question 43

the intracellular and extracellular distribution of pottasium is affected by what?

Answer 43

surgical stress , injury , acidosis , and tissue catabolism

Question 44

how we can increase the entry of potassium into the cell ?

Answer 44

insulin and B2 adrenergic agonists (such as albuterol ) increase the entry of potassium into the cell by acting on the sodium potassium ATPase enzyme.