14.7.2013

Question 0

Why infants lose more fluid than adults?

Answer 0

• larger body surface area relative to body weight
• higher metabolic rate
• immature kidney function
• larger percentage of Extracellular body fluid

Question 1

Insensible fluid loss

Answer 1

Loss from lungs and skin

Question 2

Split up of daily fluid intake

Answer 2

Water- 1.5L
Food- 800ml
Water of oxidation-300ml

Question 3

Split up of daily fluid loss

Answer 3

Skin- 600ml
Lungs- 400ml
Urine -1.5L
Stools-100ml

Question 4

Intracellular fluid constitutes _______ % of TBW

Answer 4

40%

Question 5

Extracellular fluid constitutes ________ % of TBW

Answer 5

20%

Question 6

Interstitial fluid accounts for _____ % of Extracellular fluid

Answer 6

75

Question 7

Transcellular fluid

Answer 7

CSF
pleural
Eye
Joint
Lymphatics

Question 8

Interstitial fluid is ______ % of TBW

Answer 8

15%

Question 9

_______ % of full term neonates body weight is water

Answer 9

80%

Question 10

________ % of a 60 yr old man body weight is water

Answer 10

45%

Question 11

Why amount of water content in body decreases with old age?

Answer 11

In old age,
Skeletal muscle(contains water) mass decreases
Fat mass increases

Question 12

Difference btw osmosis and diffusion

Answer 12

Fluids move in osmosis

Solutes move in diffusion

Question 13

Urine concentrating ability appears after age of

Answer 13

3 months

Question 14

Kidneys must excrete ______ ml of fluid per hour to excrete solute load

Answer 14

20

Atleast 500ml per day

Question 15

Conversion of angiotensin 1 to angiotensin 2 takes place in

Answer 15

Lungs

Question 16

Angiotensin 1 formation takes place in

Answer 16

Liver

Question 17

Signs of dehydration in elderly

Answer 17

Confusion
Subnormal temperature
Tachycardia
Pinched facial expression

Question 18

Insensible water loss depends on

Answer 18

Humidity
BSA
respiratory rate and depth

Question 19

Normal serum sodium

Answer 19

135-145mEq/L

Question 20

Normal serum K+

Answer 20

3.5-5 mEq/L

Question 21

Total serum calcium

Answer 21

8.9-10.1mg/dl

Question 22

Ionised calcium level

Answer 22

4.4-5.3 mg/dl

Question 23

Normal serum phosphates

Answer 23

2.5-4.5 mg/dl
Or
1.8-2.6 mEq/L

Question 24

Normal serum magnesium

Answer 24

1.5 -2.5 mEq/L

Question 25

Normal serum chloride level

Answer 25

98-108 mEq/L

Question 26

Concentrations of various NaCl containing electrolyte solutions

Answer 26

5%. 855mEq/L 3% 513mEq/L 0.9% 154mEq/L 0.45% 77mEq/L

Question 27

Composition of ringer lactate

Answer 27

``` Na - 130mEq/L K - 4mEq/L Cl - 109mEq/L Ca - 3mEq/L Lactate - 28mEq/L ```

Question 28

Normal urine protein:creatinine ratio

Answer 28

Less than 0.2

Question 29

Indications for renal replacement therapy in CKD

Answer 29

Without diabetes- GFR less than 10ml/min | With diabetes- GFR less than 15ml/min

Question 30

Stages of CKD

Answer 30

``` 1- greater than 90ml/min 2- 60-89ml/min 3- 30-59ml/min 4- 15-29ml/min 5- less than 15ml/min ```

Question 31

Immunoglobulin deposited in IgA nephropathy

Answer 31

Polymeric IgA1

Question 32

Causes of secondary IgA nephropathy

Answer 32

Cystic fibrosis Celiac disease IBD

Question 33

Rx of IgA nephropathy

Answer 33

ACE inhibitors | Immunosuppression

Question 34

Bicarbonate is responsible for buffering

Answer 34

Blood | Interstitial fluid

Question 35

The kidneys of older adults can't handle excess acids because

Answer 35

Ammonia production decreases with age

Question 36

Causes of increased anion gap

Answer 36

Hypermagnesimia | Increase in paraproteins

Question 37

Blood pressure cuff,dimensions

Answer 37

Length 80% | Width 40% of upper arm circumference

Question 38

Positioning of blood pressure cuff

Answer 38

Medially Adults- 2.5 cm above antecubital fossa Children- just above antecubital fossa

Question 39

Normal CVP

Answer 39

2-8 mm Hg

Question 40

Normal PAWP

Answer 40

4-12 mm of Hg

Question 41

Lab findings in dehydration

Answer 41

Elevated Hct Na greater than 145mEq/L Serum osmolality greater than 300mosm/Kg Urine specific gravity above 1.030

Question 42

Signs of hypervolemia

Answer 42

S3 | Veins remain distended for more than 5s when elevated above heart level

Question 43

Rx of pts who cannot tolerate hemodialysis

Answer 43

Continuous renal replacement therapy(CRRT)

Question 44

Effect of heparin on Na level

Answer 44

Hyponatremia

Question 45

Drugs causing hypernatremia

Answer 45

Antacids containing soda.bicarb Sodium polystyrene Sulfonate Ticarcillin disodium clavulinate potassium IV NaCl

Question 46

Presentation of hypernatremia

Answer 46

Skin flushed Agitated Low grade fever Thirst SALT