M1: Fluids & Electrolytes Flashcards
0
Q
TBW: 60%
A
Water
1
Q
Four compartments of Human body
A
Water, Protein, Fat & Bone ash
2
Q
Example of transcellular
A
CSF, Synovial & Ocular
3
Q
Total Body Water: of TBW
A
50-70%
4
Q
Total Body Water: young adult male
A
60%
5
Q
Total Body Water: young adult female
A
50%
6
Q
Total Body Water: decrease with
A
Aging
7
Q
Total Body Water: increase with
A
Newborn
8
Q
Total Body Water: three functional compartments
A
Plasma, Interstitial fluid & Intracellular volume
9
Q
ECF is composed
A
Plasma & Interstitial Fluid
10
Q
Major cation in the ECF
A
Na
11
Q
Major cation in the ICF
A
K
12
Q
Major anion in the ECF
A
Chloride
13
Q
Major anion in the ICF
A
Phosphate & Proteins
14
Q
Plasma volume 5%, interstitial 15%.
A
ECF
15
Q
Total number of osmotically active particles
A
Osmotic pressure
16
Q
Serum Osmolality by giving value of
A
Na, Glucose & Ures
17
Q
Normal exchange of F&E
A
Water exchange & Salt gain and losses
18
Q
Normal individual water consumed
A
2-2.5 L
19
Q
H20 Losses: stool
A
250cc
20
Q
H20 Losses: urine
A
800-1500cc
21
Q
H20 Losses: insensible
A
600cc
22
Q
Irreversible brain damage. Hypoxic Encephalopathy.
A
6minutes
23
Q
Classification of body fluid changes
A
Volume, Concentration & Composition
24
Classic for Volume Excess. Distenden neck veins, Increase CVP & Murmur.
CHF
25
Normal Atrial pressure
8-15mmHg
26
Increase in BUN & Crea
Azotemia
27
Daily salt intake
50-90 mEq
28
Salt gain & losses is maintained by
Kidney
29
Baroreceptors found in the
Carotid
30
Osmoreceptors found in the
Kidney
31
Most common fluid disorder in a surgical patient. Most common ECF loss GI fluids
Volume deficit
32
Iatrogenic, renal insufficiency, cirrhosis and CHF
Volume excess
33
Common CNS manifestation in Hyponatremia
Seizure & coma
34
For every 100mg/dL increment in plasma glucose above normal, the plasma sodium decreased by 1
Check glucose for hyponatremia
35
Common cause of hypernatremia
Iatrogenic sodium administration
36
Whether high or low sodium this manifestation will occur
Seizure
37
Electrolyte composition
Potassium, Calcium, Phosphorus & Magnesium
38
Excessive K intake. Increased release of K from cells. Impaired K excretion by kidneys. Seen in high voltage electrical burn.
Hyperkalemia
39
Needed for depolarization
Potassium
40
When severely dehydrated you become
Acidotic
41
Frequent drug offender that causes hypokalemia
Furosemide
42
Usual manifestation of Hypokalemia in NMS
Weakness & Paralysis
43
Contained in bone matrix. Protein bound 40%, completed to phosphate plus anion 10%.
Calcium
44
Normal calcium level
8.5-10.5 mEq/L
45
Bony mets, primary hyperparathyroidism & secretion of parathyroid hormone related protein.
Hypercalcemia
46
Looks like catatonia
Hypercalcemia
47
Below 8.5mEq/L. Etiology is pancreatitis, severe soft tissue infections, renal Failure & etc.
Hypocalcemia
48
Adjust total serum calcium down by _______ for every 1g/dL decrease in albumin.
0.8mg/dL
49
Decreased urinary excretion, increased intake and endogenous immobilization.
Hyperphosphatemia
50
Decreased intake. Intracellular shift. Increased excretion.
Hypophosphatemia
51
50% incorporated in bone. Excreted in feces & urine. Kidneys conserve this. Essential for proper functioning if enzyme system.
Magnesium
52
Severe renal insufficiency. Parallel changes in K excretion. Excess antacid intake.
Hypermagnesemia
53
Water constitutes how many percent of TBW
50-60%
54
TBW water for male
60%
55
TBW water for female
50%
56
TBW adjusted downward approximately 10-20% for
Obese individual
57
TBW adjusted upward by 10% for
Malnourished individuals
58
Is the largest fluid compartment in the body and makes up approximately 40% of TBW
Intracellular fluid
59
Extracellular fluid is composed of
Plasma & Interstitial fluid
60
Percentage of ECF
20%
61
Percentage of plasma
5%
62
Percentage of Interstitial fluid
15%
63
Most common cation present in ICF
Potassium
64
Most common cation present in ECF
Sodium
65
Virtually absent in intracellular fluid and is present only in small amounts in ECF.
Calcium
66
Principal determinants of osmolality
Sodium, Glucose & Urea
67
Formula & conversion for serum osmolality
SO= 2 sodium + (Glucose/18) + (Urea/2.8)
68
A patient develop a high output fistula following abdominal surgery, the fluid is sent for evaluation with the ff results Na 135, K 5 & Cl 70. What is the source of the fistula.
Pancreas
69
Diagnosis for a patient with normovolemic hyponatremia
SIADH
70
Can be seen with an excess of solute relative to free water, such as with untreated hyperglycemia or mannitol administration.
Hyponatremia
71
Exerts an osmotic force in the extracellular compartment, causing a shift of water from intra to extracellular compartments.
Glucose
72
For every 100mg/dL increment in plasma glucose above normal, the plasma sodium should decrease by
1.6 mEq/L
73
Results from either loss of free water or a gain of sodium in excess water
Hypernatremia
74
Hypervoleomic hypernatremia is usually caused by
Iatrogenic administration of sodium containing fluids
75
Excess sodium bicarbonate & mineralocorticoid is seen in patients with
Cushing's sydrome & Congenital adrenal hyperplasia
76
Can contribute to hyperkalemia in patients renal insufficiency
NSAIDS
77
Causes decrease deep tendon reflexes
Hypokalemia
78
Causes increase deep tendon reflexes
Hypomagnesemia & Hypocalcemia
79
In hyperkalemia, first ECG change seen in most patients.
Peaked T waves
80
Postoperative patient with a potassium of 2.9 is given 1mEq/kg replacement show the serum K to be 3.0. Give dx.
Hypomagnesemia
81
Will change serum potassium
Alkalosis
82
Measurement of total calcium levels. Adjust total serum calcium down by __________ for every 1g/dL decrease in labumin.
0.8mg/dL
83
Formula for serum calcium albumin computation (2.0 albumin & 6.6 calcium)
0.8 x 2 = 1.6 + 6.6 = 8.2
84
Caused by intracellular shift of phosphate in association with respiratory alkalosis, insulin therapy & refeeding syndrome.
Acute Hypophosphatemia
85
Occurs when excess calories are given to a starved person. Potentially lethal condition that occur with rapid and excessive feeding of patients with severe underlying malnutrition.
Refeeding syndrome
86
Associated with hyperkalemia & hyperphosphatemia
Rhabdomyolysis
87
Hypomagnesemia clinically resembles with
Hypocalcemia
88
Is essential for proper function of many enzyme systems. Depletion is characterized by neuromuscular and CNS system.
Magnesium ion
89
A patient presents obtunded to the ER with ff labs Na 130 Cl 105 K 3.2 HCO3 15. What is the most likely diagnosis?
GI losses
90
Formula of Anion Gap
AG= (Na) - (Cl+HCO3)
91
Best choice to replace isotonic(serum) fluid loss. Best approximates serum electrolytes and would be the fluid of choice to replace isotonic serum fluid loss.
Lactated ringer
92
First treatment administered to a patient with a potassium level of 6.3 and flattened P waves on either ECG
Insulin & Glucose
93
Potassium can be removed from the body using a cation exchange resin such as this that binds potassium in exchange for sodium
Kayexalate
94
Approximate IV rate maintenance fluids for a 50kg patient would be
90 mL/hr
95
Water constitutes how many percent of TBW
50-60%
96
TBW water for male
60%
97
TBW water for female
50%
98
TBW adjusted downward approximately 10-20% for
Obese individual
99
TBW adjusted upward by 10% for
Malnourished individuals
100
Is the largest fluid compartment in the body and makes up approximately 40% of TBW
Intracellular fluid
101
Extracellular fluid is composed of
Plasma & Interstitial fluid
102
Percentage of ECF
20%
103
Percentage of plasma
5%
104
Percentage of Interstitial fluid
15%
105
Most common cation present in ICF
Potassium
106
Most common cation present in ECF
Sodium
107
Virtually absent in intracellular fluid and is present only in small amounts in ECF.
Calcium
108
Principal determinants of osmolality
Sodium, Glucose & Urea
109
Formula & conversion for serum osmolality
SO= 2 sodium + (Glucose/18) + (Urea/2.8)
110
A patient develop a high output fistula following abdominal surgery, the fluid is sent for evaluation with the ff results Na 135, K 5 & Cl 70. What is the source of the fistula.
Pancreas
111
Diagnosis for a patient with normovolemic hyponatremia
SIADH
112
Can be seen with an excess of solute relative to free water, such as with untreated hyperglycemia or mannitol administration.
Hyponatremia
113
Exerts an osmotic force in the extracellular compartment, causing a shift of water from intra to extracellular compartments.
Glucose
114
For every 100mg/dL increment in plasma glucose above normal, the plasma sodium should decrease by
1.6 mEq/L
115
Results from either loss of free water or a gain of sodium in excess water
Hypernatremia
116
Hypervoleomic hypernatremia is usually caused by
Iatrogenic administration of sodium containing fluids
117
Excess sodium bicarbonate & mineralocorticoid is seen in patients with
Cushing's sydrome & Congenital adrenal hyperplasia
118
Can contribute to hyperkalemia in patients renal insufficiency
NSAIDS
119
Causes decrease deep tendon reflexes
Hypokalemia
120
Causes increase deep tendon reflexes
Hypomagnesemia & Hypocalcemia
121
In hyperkalemia, first ECG change seen in most patients.
Peaked T waves
122
Postoperative patient with a potassium of 2.9 is given 1mEq/kg replacement show the serum K to be 3.0. Give dx.
Hypomagnesemia
123
Will change serum potassium
Alkalosis
124
Measurement of total calcium levels. Adjust total serum calcium down by __________ for every 1g/dL decrease in labumin.
0.8mg/dL
125
Formula for serum calcium albumin computation (2.0 albumin & 6.6 calcium)
0.8 x 2 = 1.6 + 6.6 = 8.2
126
Caused by intracellular shift of phosphate in association with respiratory alkalosis, insulin therapy & refeeding syndrome.
Acute Hypophosphatemia
127
Occurs when excess calories are given to a starved person. Potentially lethal condition that occur with rapid and excessive feeding of patients with severe underlying malnutrition.
Refeeding syndrome
128
Associated with hyperkalemia & hyperphosphatemia
Rhabdomyolysis
129
Hypomagnesemia clinically resembles with
Hypocalcemia
130
Is essential for proper function of many enzyme systems. Depletion is characterized by neuromuscular and CNS system.
Magnesium ion
131
A patient presents obtunded to the ER with ff labs Na 130 Cl 105 K 3.2 HCO3 15. What is the most likely diagnosis?
GI losses
132
Formula of Anion Gap
AG= (Na) - (Cl+HCO3)
133
Best choice to replace isotonic(serum) fluid loss. Best approximates serum electrolytes and would be the fluid of choice to replace isotonic serum fluid loss.
Lactated ringer
134
First treatment administered to a patient with a potassium level of 6.3 and flattened P waves on either ECG
Insulin & Glucose
135
Potassium can be removed from the body using a cation exchange resin such as this that binds potassium in exchange for sodium
Kayexalate
136
Approximate IV rate maintenance fluids for a 50kg patient would be
90 mL/hr
