01 - Response to Injury, Fluids, and Nutrition

Question 1

Most common source of external fluid loss in a surgical patient:

Answer 1

through the GI tract

Question 2

Most common fluid disorder in surgical patients:

Answer 2

Extracellular volume deficit

Question 3

Most common cause of volume deficit in surgical patients:

Answer 3

loss of GI fluids

Question 4

This cytokine induces muscle breakdown and cachexia

Answer 4

TNF - Alpha

Question 5

This cytokine induces fever

Answer 5

IL - 1

Question 6

This cytokine promotes lymphocyte proliferation, immunoglobulin production

Answer 6

IL - 2

Question 7

This cytokine prolongs activated neutrophil survival and is a mediator of acute phase response

Answer 7

IL - 6

Question 8

This cytokine is a chemoattractant

Answer 8

IL - 8

Question 9

This cytokine activates macrophage via TH1 cells

Answer 9

IFN - y

Question 10

This function as intracellular chaperones for ligands such as bacterial DNA and endotoxin and alert the immune system of the tissue damage

Answer 10

HSP

Question 11

It is associated with eosinophil and mast cell release

Answer 11

Histamine

Question 12

wound healing is impaired by cholesterol through reduction of

Answer 12

TGF - B IGF

Question 13

This promotes protein synthesis and insulin resistance and enhance mobilization of fat stores

Answer 13

GH IGF - 1

Question 14

What is the total body water percentage of male

Answer 14

60%

Question 15

What is the total body water percentage of female

Answer 15

50%

Question 16

What is the total body water percentage of newborn

Answer 16

80%

Question 17

This is used as maintenance fluid therapy in postoperative period

Answer 17

D5 0.45% NaCl -for patients unable to tolerate enteral nutrition and started 24 to 48 hours post operative

Question 18

This is used in patietns with closed head injuries

Answer 18

D5 7% NaCl

Question 19

Ways of preventing refeeding syndrome

Answer 19

1. underlying electrolyte or volume deficit should be corrected 2. thiamine should be administered before feeding 3. caloric repletion at 20/kcal/kg/day

Question 20

consequence of rapid correction of hypernatremia

Answer 20

cerebral edema and herniation

Question 21

consequence of rapid correction of hyponatremia

Answer 21

central pontine myelinosis

Question 22

Drugs that are aldosterone antagonist

Answer 22

1. spironolactone 2. eplerenone

Question 23

Drugs that are Na channel blockers

Answer 23

1. amiloride 2. triamterene

Question 24

ECG changes in hyperkalemia

Answer 24

1. Peak T waves 2. prolong PR interval 3. flattened p waave 4. widened QRS complex 5. sine wave formation 6. ventricular fibrillation

Question 25

What happens to deep tendon reflex in hypokalemia

Answer 25

decrease

Question 26

What happens to deep tendon reflex in hypocalcemia, and hypomagnesemia

Answer 26

increase

Question 27

ECG changes in hypercalcemia

Answer 27

1. shortened QT interval 2. prolonged PR interval 3. increase QRS voltage 4. T wave flattening and widening 5. AV block

Question 28

What is the critical level of serum calcium

Answer 28

5 meq/l

Question 29

ECG changes in hypocalcemia

Answer 29

1. prolonged QT interval 2. T wave inversion 3. heaert block 4. ventricular fibrillation

Question 30

what is a concomitant electrolyte imbalance in metabolic alkalosis

Answer 30

hypokalemia

Question 31

Potassium repletion is difficult in the presence of hypomagnesemia

Answer 31

true

Question 32

hypocalceia will be refractory to treatment if coexisting hypomagneseia is not corrected first

Answer 32

true

Question 33

Tumor lysis syndrome electrolyte imbalance

Answer 33

1. hyperkalemia 2. hyperphosphatemia 3. hyperurecemie 4. hypocalcemia

Question 34

what are the electrolyte imbalance in rhabdomyolosis

Answer 34

hyperkalemia hyperphosphatemia

Question 35

causes of acute hypophosphatemia

Answer 35

1. respiratory alkalosis 2. insulin therapy 3. refeeding syndrome . hungry bone syndrome