Fluids and electrolytes

Question 1

Water is __% of body weight in males

Answer 1

60

Question 2

Water is __% of body weight in females

Answer 2

50

Question 3

Water is __% of body weight in newborns

Answer 3

80

Question 4

Intracellular water: / of TBW
Extracellular water: / of TBW
- Extravscular water / of extracellular water
- Intravascular water / of extracellular water

Answer 4

2/3
1/3
3/4
1/4

Question 5

What compartments of fluid can colloids, saline and glucose enter?

Answer 5

Colloids - plasma
Saline - plasma and interstitial compartment
Glucose - Plasma, interstitial compartment, intracellular compartment

Question 6

Physical examination of a dehydrated patient reveals (hypovolemia):

Answer 6

Skin turgor, dehydration of mucous membranes, thready peripheral pulses, increased resting HR, decreased BP
Decreased urinary flow rate

Question 7

Hemodynamic measurements used in practice:

Answer 7

CVP
PA pressure

Question 8

Daily water intake/loss is approximately _____mL

Answer 8

2500

Question 9

Evaporative loss accounts for ____ heat loss

Answer 9

20-25%

Question 10

Normal maintenence requiremtns for fluid:

Answer 10

4mL/kg/hr for first 10kg of body mass
2ml/kg/hr for second 10kg of body mass
1mL/kg/hr for any Kg>20kg

Question 11

Difference b/w crystalloids and colloids

Answer 11

• Crystalloids - acqious solutuions of ions (salts) w/ or w/o glucose
• Colloids - contain high-molecular weight substances such as proteins or large glucose polymers
• Colloid - intravascular
• Crystalloid - entire extracellular fluid space

Question 12

Hypernatremia is sodium above ___mmol/L

Answer 12

145

Question 13

Hypernatremia causes:

Answer 13

Elevated sodium -> hyperosmolality -> cellular dehydration

Restlessness, lethargy, hyperreflexia -> seizures, coma, death

Question 14

Hypovolemic hypernatremia causes:

Answer 14

Body fluid loss
Diuretic use
GI loss
Heat injury
Osmotic diuresis

Question 15

Euvolemic hypernatremia:

Answer 15

Central diabetes insipidus
Nephrogenic diabetes insipidus
Fever
Hyperventialtion
Mechanical ventilation
Hypodipsia
Medications (amphoterecin, aminoglycosides, Li, phenytoin)
Sickle cell disease
Suprasellar and infrasellar tumors

Question 16

Hypervolemic hypernatremia:

Answer 16

Cushing syndrome
Hemodialysis
Hyperaldosteronism
Iatrogenic (salt, water, saline, enema, IV HCO3, enteral feedings)

Question 17

Hypernatremia treatment: oral ______ fluids

Examples:

Answer 17

Hypotonic
IV solution of 5% dextrose in water or hypotonic saline
Diuretics
Reduce level gradually 10meq/24h

Question 18

Rapid correction of hypernatremia can cause?

Answer 18

Cerebral edema

Question 19

Hypernatremic patients w/ decreased total sodium should be given ______ to restore plasma volume to normal prior to treatment w/ a hypotonic solution

Answer 19

isotonic fluid

Question 20

Hypernatremic patients w/ increased total body sodium should be treated w/ a _____ and 5% IV dextrose in water

Treatment for diabetes insipidus?

Answer 20

loop diuretic
desmopressin

Question 21

Dangers of saline and chloride rich crystalloids?

Answer 21

Hyperchloremic metabolic acidosis
Acute kidney injury

Question 22

Hyponatremia is <______mmol/L

Answer 22

135

Question 23

Most common cause of hyponatremia?

Answer 23

SIADH

Question 24

Hyponatremia and hypernatremia can cause cerebral edema, how?

Answer 24

Hyponatremia due to movement of water from the blood into cells

Hypernatremia - only occurs in rapid correction

Question 25

Hypovolemic patients are sensitive to the vasodilating and negative inotropic effects of:

Answer 25

vapor anesthetics, propofol adn drug-induced histamine release

Question 26

Hypovolemic patients are particularly sensitive to

Answer 26

sympathetic blockade from spinal or epidural anesthesia

Question 27

Which drugs are indicated in general anesthesia prior to collection of hypovolemia?

Answer 27

Etomidate or ketamine

Question 28

Hypokalemia can be induced by use of?

Answer 28

Diuretics

Question 29

How do diuretics cause hypokalemia?

Answer 29

Diuretic-induced hypocholermia -> bicarbonate is absorbed and potassium is excreted