Prodigy- fluids, lytes, acid-base

Question 1

What is the primary derangement in metabolic alterations vs respiratory alterations

Answer 1

metabolic alterations - bicarb = level = primary derangement

respiratory alterations- CO2 level = primary derangement

Question 2

In the henderson-hasselbach equation, what 2 constants are used and what do they represent?

Answer 2

6.1 = pKa of carbonic acid
0.03 = solubility coefficient of CO2

Question 3

What’s the solubility coefficient of CO2?

Answer 3

0.03

How is this compared to Henry’s law numbers? I thought o2 was 0.003 and co2 was 0.067

Question 4

T/F: bicarb administration is not indicated in respiratory acidosis unless concomitant metabolic acidosis is identified

Answer 4

True

Question 5

T/F: drug-induced ventilatory depression due to opioids or inhalational anesthetics is the most common cause of respiratory acidosis in the perioperative period

Answer 5

True

Question 6

in treating hypernatremia, the total body water deficit should be replaced over what period of time?

Answer 6

24-48hrs

Question 7

Which would most likely lead to cerebral edema - hyponatremia or hypernatremia

Answer 7

hyponatremia

remember you dont want to give 1/2 NS cause it’s hypotonic and it will diffuse into cells and make them swell

Question 8

What ion has the highest concentration in the intracellular fluid?

Answer 8

K

Question 9

T/F- hypokalemia can lead to an ileus

why or why not

Answer 9

True

hypokalemia
-often coexisting with hypocalcemia
-muscle weakness, decreased peristalsis

Question 10

If the hypokalemia is severe enough to cause paralysis or cardiac dysrthimias, you can infuse potassium at rates as high as what?

what are the normal rates?

Answer 10

20meq over 30 minutes

-10meq/hr peripherally
-20meq/hr centrally

Question 11

What is the most common cause of hypocalcemia

normal level

Answer 11

hypoalbuminemia

*total blood calcium levels parallel the serum albumin. Albumin decreases and so does total body calcium

Question 12

why do chronic renal disease patients usually have low calcium levels

Answer 12

due to hyperphosphatemia

Question 13

what is the corrected serum calcium meausrement

Answer 13

calcium + (0.8 x (4-albumin)

Question 14

What does hypocalcemia in the presecne of a low or nomral phosphate level usually indicate?

Answer 14

vitamin D or mag deficiency

Question 15

What electrolyte abnormality is tamoxifen associated with?

Answer 15

hypercalcemia

Question 16

How is the ST segment affected by high calcium levels

Answer 16

shortened ST (&short QT)

Question 17

T/F: symptoms of hypomagnesemia are most similar to those of hyponatremia

Answer 17

false- hypocalcemia

muscle weakness, tetany, cardaic dysrythmias, and seizures

Question 18

The appropriate immediate treatement for severe hypermagnesemia is what (drug + dose)

Answer 18

calcium gluconate 15mg/kg IV

Question 19

The chornic use of which drug would most likely be contribuiting to hypophosphatemia

Sodium citrate or aluminum-based antacids

Answer 19

alumin based antacids

Question 20

Albumin, a colloid with a high oncotic pressure, distributes between the plasma volume and intersistial fluid volume in a ratio of about what

Answer 20

4:1

Question 21

What electrolyte abnormality is most likely to be seen in a patient with chronic renal failure?
A. hypophosphatemia
B. hypocalcemia
C. hypomagnesemia
D. hypokalemia

Answer 21

B

Question 22

You are performing the preoperative evaluation on a patient taking tamoxifen. What electrolyte abnormality would you most expect her to exhibit?
A. hyponatremia
B. hypernatremia
C. hypercalcemia
D. hyperkalemia

Answer 22

C

Question 23

Which of the following is not a cause of high anion gap acidosis?
A. Uremia
B. Renal tubular acidosis
C. Salicylate ingestion
D. Diabetic ketoacidosis

Answer 23

B

Question 24

A patient exhibits serious cardiac dysrhythmias due to hypokalemia. How fast can you administer 20 mEq of potassium to this patient intravenously?
A. Over 30 minutes
B. Over 3 hours
C. Over 60 minutes
D. Over 5 minutes

Answer 24

A

Question 25

All of the following would be a likely cause of respiratory acidosis except
A. pulmonary edema
B. extensive burns
C. hyperventilation
D. prolonged seizure activity

Answer 25

C

Question 26

Which of the following is a likely cause of hypocalcemia?
A. Hypermagnesemia
B. Hypoalbuminemia
C. Malignancy
D. Hyperparathyroidism

Answer 26

B

Question 27

Which of the following is representative of normal anion gap acidosis?
A. Lactic acidosis
B. Ketoacidosis
C. Uremia
D. Hyperchloremic metabolic acidosis

Answer 27

D

Question 28

Hypermagnesemia can potentially be caused by
A. hypoparathyroidism
B. forced diuresis using saline and loop diuretics
C. hyperthyroidism
D. excess ingestion of oral antacids

Answer 28

D

Question 29

Which of the following disorders will result in a normal anion gap acidosis?
A. Renal failure
B. Salicylate ingestion
C. Small bowel fistula
D. Diabetic keotacidosis

Answer 29

Not A…. perhaps C

Question 30

Which of the following would be least likely to aggravate hypophosphatemia?
A. hyperventilation
B. sodium bicarbonate administration
C. aluminum hydroxide antacids
D. acidosis

Answer 30

D

Question 31

Antidiuretic hormone increases the absorption of solute-free water in the
A. loop of Henle
B. proximal convoluted tubule
C. collecting ducts
D. glomerulus

Answer 31

C

Question 32

Which of the following factors is associated with elevated serum phosphate levels?
A. Fluid volume expansion with saline
B. Renal failure
C. Acetazolamide administration
D. Administration of oral aluminum hydroxide

Answer 32

B

Question 33

Which of the following would most likely be a cause of hypovolemic hyponatremia?
A. Cirrhosis
B. SIADH
C. Nephrotic syndrome
D. Diuretic use

Answer 33

D