IVF and Diuretics

Question 1

how many mg/meq?

Answer 1

23

Question 2

What is the equation for serum osms? What is a normal value?

Answer 2

2*Na+BUN/2.8+glucose/18. 285-295

Question 3

what is D5W? What happens upon infusion? how much makes it to plasma?

Answer 3

5% dextrose. Osm of 278. Sugar metabolized, leaves only water. Less than 10% ends up in plasma

Question 4

What is normal saline? How much ends up in plasma?

Answer 4

.9% Nacl. Osm of 308. 25% in plasma.

Question 5

what is HNS? How much ends up in plasma?

Answer 5

.45% NaCl. ~167 cc in plasma

Question 6

Lactated Ringers

Answer 6

contains Na, Cl, K, Ca, lactate. Roughly same distribution as NS

Question 7

What are the usually daily water needs?

Answer 7

100cc/kg for first 10 kg, 50 for next 10 kg, 20 for every kg over 20. 70 Kg=2500

Question 8

who would you give NS to?

Answer 8

volume deplete

Question 9

acetazolamide

Answer 9

PT diuretic. Inhibits Carbonic anhydrase so less Na absorption and H+ secretion. good for met alkalosis

Question 10

Loop diuretics

Answer 10

Furosemide torsemide, bumetanide. Inhibit Na/K/Cl symporter in TAL. Also cause Ca and K loss

Question 11

Thiazides

Answer 11

HCTZ, chlorthalidone. Inhibit Na/Cl symporter in DCT. Less intracell Na leads to more favorable Na/Ca exchange and hyper calcemia

Question 12

Why do thiazides and others cause hypokalemia?

Answer 12

^ Na to distal tubule where it is exchanged for K+

Question 13

K sparing diuretics

Answer 13

Spironolactone, amiloride. Spironolactone blocks aldosterone which means fewer Na channels. Amiloride blocks Na channels directly. Can cause hyperkalemia