Renal Electrolytes- schoenwald (Exam 4)

Question 1

The normal range of sodium

Answer 1

135-145

Question 2

The primary circulating cation

a. chlorine
b. sodium
c. potassium

Answer 2

b. sodium

Question 3

Osmolality is the measure of what?

Answer 3

dissolved particles in the blood

Question 4

Normal serum Osmolality

a. 280-295
b. 200-250
c. 250-300

Answer 4

a. 280-295

Question 5

osmolality will _____with overhydration and _____with dehydration

a. increase, decrease
b. decrease, increase
c. increase, stay the same

Answer 5

b. decrease with overhydration and increase with dehydration

Question 6

Hypernatremia, hyperglycemia, ketosis, dehydration, diabetes insipidus will have what effect on osmolality

Answer 6

increase

Question 7

SIADH with have what effect on osmolality

Answer 7

decrease

Question 8

SIADH cause a ______ of serum sodium and a ______ in urine sodium

Answer 8

Decrease in serum and an increase in urine sodium.
You lose all of the sodium through urine.

**hyponatremia

Question 9

Diabetes Insipidus causes hypo or hypernatremia?

Answer 9

Hypernatremia.

Question 10

You have a patient that has an increased thrist as well as urinated ALOT of dilute urine. You draw their blood and they are hypernatremic. ______ is likely the cause

a. Diabetes insipidus
b. SIADH
c. overhydration

Answer 10

a. diabetes insipidus

Question 11

_____ _____ is a good way to test the ability of the kidney to concentrate urine

Answer 11

urine osmolality

Question 12

Urine osmolality normal range

Answer 12

50-1200

Question 13

match the disease with the correct effect on urine osmolality (Increase or decrease)
SIADH
Diabetes insipidus

Answer 13

SIADH–> increase urine osmolality (decrease serum osmolality)
Diabetes insipidus –> decrease urine osmolality (increased serum osmolality)

Question 14

CHF will cause a _______ urine osmolality

Answer 14

increased

Question 15

Two types of hyponatremia

Answer 15

sodium depletion - free water loss

dilutional - water intake greater than water output - renal failure

Question 16

What can casue hypernatremia?

Answer 16

impaired thrist mechanism

water loss without sodium loss - burns, fever

Question 17

what kind of urine test can help determine between renal and non renal causes of hyponatremia

Answer 17

urine sodium, spot or 24 hour

Question 18

The primary intracellular ion

a. sodium
b. chlorine
c. potassium

Answer 18

c. potassium

Question 19

as sodium is ______. potassium is _____

Answer 19

rebsorbed, lost

Question 20

normal range of potassium

Answer 20

3.5-5.5

Question 21

glucose administration can cause ______ .

Answer 21

Hypokalemia

Question 22

Aldosterone _______ potassium excretion

Answer 22

enhances

Question 23

ACEI can cause ________. (do not forget!)

Answer 23

hyperkalemia

Question 24

A possible finding on EKG of hyperkalemia

Answer 24

peaked t-waves

Question 25

Normal range for chloride

Answer 25

96-106

Question 26

in the renal proximal tubules chloride is exchanged for ______.

Answer 26

Bicarb ions

Question 27

Two causes of increased chloride

Answer 27

dehydration, metabolic acidosis

Question 28

Three causes of decreased chloride

Answer 28

overhydration, SIADH, Vomitting

Question 29

You have a patient that presents with altered mental status and a history of vomitting for three days. You notice marked edema. What might you suspect?

Answer 29

Acute renal failure

Question 30

causes of pre renal ARF (AKI)

Answer 30

Hypovolemia Hypotension CHF Renal artery stenosis

Question 31

acute increase of ______ or more than 50% over baseline levels of Creatinine is AKI

Answer 31

>= .5

Question 32

intrinsic renal failure will have a ______ BUN/cr

Answer 32

decreased

Question 33

prerenal failure will have ______ BUN/cr

Answer 33

increased

Question 34

Urine sodium of | Prerenal vs intrinsic

Answer 34

Prerenal: <20 | Intrinsic >40

Question 35

Fractional excretion of Na in Prerenal vs intrinsic

Answer 35

Prerenal : <1% | Intrinsic : >1-2%

Question 36

urine osmolality in | Prerenal vs intrinsic

Answer 36

Prerenal 500 | Intrinsic 250-300

Question 37

CKD stages (GFR)

Answer 37

``` stage 1: >90 Stage 2: 60-89 Stage 3: 30-59 Stage 4: 15-29 Stage 5: <15 ```

Question 38

_____kalemia will be present in AKI

Answer 38

hyper

Question 39

MUDPILES of metabolic acidosis

Answer 39

``` M- methanol U- uremia D- DKA P- Paraldehyde I- iron L- lactic acidosis E- Ethylene glycol S- salicylates ```