Sodio Y Agua Flashcards

1
Q
SIADH
Como se encuentran:
Na serico 
Osm seríca 
Osm U 
Na U 
volemia 
ACT
A
Na bajo
Osm seríca <270
Osm U >100
Na U >20 
Euvolemia 
ACT aumentada
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2
Q

Formula de ACT

A

Peso x 0.6 hombres
X 0.5 mujeres
X 0.45 mujer anciana
X0.51 hombre anciano

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3
Q

Cambio en Na serico formula

A
     ACT-1
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4
Q

Na corregido

A

Na medido+ 2.4 x glu -100 / 100

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5
Q

Tx hipomatremia crónica asintomático

A
  1. Restriccion de líquidos
    Moderada ingestaburea 30 -60
    Demeclociclina 600- 1200 mg
    Antag rec vaso *
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6
Q

Tx hipona aguda sintomática

A

Sol sal 3% 1 a 2 mmol/L hasta q este asintomatico

No mas de 8 en aguda

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7
Q

Tx hipomatremia asintomatica o cronica

A

0.5 meq/l/hr

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8
Q

Tx SIADH

A
Restricción  de agua libre
Tx causa subyacente
Sol sal hipertonica 
Diu asa 
Refractrio : Vaptanes
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9
Q
Diabetes Insipida 
Criterios 
Osm serica 
Na serico 
Osm u
Na U
A
Poliuria >50 ml=kg/h o >3litros/dia 
Polidipsia
Na elevado >143
Osm p >290
Osm U <300 central
Osm u 300-800 parcial 
Osm u 300-500 nefrogenica
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10
Q

Prueba de deprovacion de agua

A

Resteiccion de ingesta hasta perd. 3-5% peso o 3 mediciones consecutivas horaria de con Osm U <10% una de otra.
Administrar vasopresina 5ui o desmo 10 intranasal
Medir Osm >50% -cenrral
Osm inalterada - nefrogenica
Osm urinaria <300 DI central
300-500 DI nefrogenica
ADH deshidratacion Nula DI central
Nefrogenica 5 pg/l

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11
Q

Tratamiento DI

A

Central: desmo
Nefrogenica: causa subtacente
Restricción Na y tiazida
Parcial: carbamazepina, clorpropramida, clorfibrato *

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12
Q

Deficit de agua libre

A

NA - 140
__________ X ACT
140

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13
Q

Tx hiper natremia

A

Agua libre en 24 hrs

Bajar Na no mas de 0.5 meq/l/hr

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