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Flashcards in Chapter 3 Deck (50)
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1

The lower percentage of TBW in females correlates with higher percentage of _____?

Adipose tissue and lower muscle mass

2

Where can you find 80% water percentage in TBW?

Newborns

3

Extracellular water is ____%
And is divided into _____(5%) and ____(15%)

20% , plasma , interstitial fluid

4

Intracellular water makes up how many percent of the TBW? And where is the largest proportion found?

40% skeletal muscle mass

5

What are the principal anions of the intracellular compartment? And the principal cations?

Anion: K+ and Mg+
Cation: phosphates, proteins from muscles and sulfates

6

What is the principal anion of the ECF? What are the principal cations?

Anion: sodium
Cation: Cl- and HCO3-

7

Concentration gradient between the ICF and ECF compartments is maintained by???

ATP driven NA/K+ pump

8

The physiologic activity of electrolytes depends on?

Number of particles per unit volume
Number of electric charges per unit volume
Number of osmotically active ions per unit volume

9

What are the principal determinants of osmolality?

Sodium
Glucose
Urea

10

Daily water loss in the stool?

250ml

11

Daily water loss in the urine?

800-1500ml

12

Daily water insensible loss?

600ml

13

To excrete metabolic products, kidneys must excrete a minimum of _____ of urine per day

500-800ml, regardless of the amount of oral intake

14

Disorders in fluid balance? (Classification)

Disturbance in:
Volume
Concentration
Composition

15

Acute volume deficit is associated with?

Cardiovascular and central nervous system signs

16

Chronic deficits display what in addition to cardiovascular and central nervous signs?

Turgor, sunken eyes and tissue signs

17

What is the most common source of volume deficit in surgical patients?

Loss of GI fluids

18

Volume changes are senses by?

Osmoreceptors and Baroreceptors

19

Are specialized sensors that detect even the smallest changes in fluid osmolality and drive changes in thirst and kidney diuresis

Osmoreceptors

20

What are the cardiac signs that occur if there is a volume deficit?

Tachycardia
Orthostasis
Hypotension
Collapsed neck veins

21

What are the generalized signs that occur if there is an excess in volume?

Weight gain
Peripheral edema

22

Changes in serum sodium concentration is ____proportional to TBW

Inversely

23

An excess in extracellular water relative to sodium

Hyponatremia

24

For every 100mg/dl of glucose above normal, sodium decreases by how many mEq/L?

1.6 mEq/L

25

What causes pseudohyponatremia?

Extreme elevations in plasma lipids and proteins

26

In the absence of renal disease, this is associated with low urine sodium

Depletional cause of hyponatremia

27

This shows increased sodium levels in the urine

Renal sodium wasting

28

This type of cause related hyponatremia is associated with hypovolemia in circulation

Dilutional

29

Loss of free water or gain of sodium in excess of water

Hypernatremia

30

This type of hypernatremia is caused by iatrogenic administration of sodium containing fluids

Hypervolemic hypernatremia

31

Can result from renal causes, diabetes insipidus, diuretic use or renal disease

Normovolemic hypernatremia

32

Sodium concentration of

Hyponatremia

33

Average intake of potassium is?

50 to 100 mEq/day

34

Renal excretion of potassium?

10-700 mEq

35

Above the normal range of potassium which is 3-5 to 5 mEq/L

Hyperkalemia

36

ECG changes in hyperkalemia

High peaked T waves
Widened QRS complex
Flattened P wave
Prolonged PR interval
Sine wave formation
Ventricular fibrillation

37

Potassium decreases by _____ with ___ increase in pH

0.3 mEq/L , 0.1

38

ECG changes in hypokalemia

U waves
T-waves flattening
ST segment changes
Arrythmias

39

Water constitutes how many % of the total body weight?

50% to 60%

40

Earliest sign of volume overload is?

Weight gain

41

Should be considered in patients who are euvolemic and hyponatremic with elevated urine sodium levels and urine osmolality

SIADH

42

Manifests dilute urine in the case of hypernatremia

Diabetes insipidus

43

Lethal condition that can occur with rapid and excessive feeding of patient with severe underlying malnutrition

Refeeding syndrome

44

Serum calcium
Is distributed among 3 forms and how many %

Ionized form 60%
Attached to phosphate ions 10%
Protein found 40%

45

Adjust calcium levels down by ___ mg/dL for every ___ g/dL decrease of albumin

0.8
1

46

What is the daily calcium
Intake?

1-3 g/d

47

Compute for the total amount of fluid needed for fluid therapy of a 70 kg man

1000 for 1st 10 kilo
500 for 2nd 10 kilo
1000 for thr last 50 kilos


48

What is the mechanism
Of action of kayexelate

Secretes potassium
In exchange with sodium
For hyperkalemia

49

Common cause of severe acidosis is

Lactic acidosis

50

What happens if there is a decreased absorption of HCO3

Proximal renal tubular acidosis