Chapter 3

Question 1

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

Answer 1

Adipose tissue and lower muscle mass

Question 2

Where can you find 80% water percentage in TBW?

Answer 2

Newborns

Question 3

Extracellular water is ____%

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

Answer 3

20% , plasma , interstitial fluid

Question 4

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

Answer 4

40% skeletal muscle mass

Question 5

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

Answer 5

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

Question 6

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

Answer 6

Anion: sodium
Cation: Cl- and HCO3-

Question 7

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

Answer 7

ATP driven NA/K+ pump

Question 8

The physiologic activity of electrolytes depends on?

Answer 8

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

Question 9

What are the principal determinants of osmolality?

Answer 9

Sodium
Glucose
Urea

Question 10

Daily water loss in the stool?

Answer 10

250ml

Question 11

Daily water loss in the urine?

Answer 11

800-1500ml

Question 12

Daily water insensible loss?

Answer 12

600ml

Question 13

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

Answer 13

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

Question 14

Disorders in fluid balance? (Classification)

Answer 14

Disturbance in:
Volume
Concentration
Composition

Question 15

Acute volume deficit is associated with?

Answer 15

Cardiovascular and central nervous system signs

Question 16

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

Answer 16

Turgor, sunken eyes and tissue signs

Question 17

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

Answer 17

Loss of GI fluids

Question 18

Volume changes are senses by?

Answer 18

Osmoreceptors and Baroreceptors

Question 19

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

Answer 19

Osmoreceptors

Question 20

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

Answer 20

Tachycardia
Orthostasis
Hypotension
Collapsed neck veins

Question 21

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

Answer 21

Weight gain

Peripheral edema

Question 22

Changes in serum sodium concentration is ____proportional to TBW

Answer 22

Inversely

Question 23

An excess in extracellular water relative to sodium

Answer 23

Hyponatremia

Question 24

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

Answer 24

1.6 mEq/L

Question 25

What causes pseudohyponatremia?

Answer 25

Extreme elevations in plasma lipids and proteins

Question 26

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

Answer 26

Depletional cause of hyponatremia

Question 27

This shows increased sodium levels in the urine

Answer 27

Renal sodium wasting

Question 28

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

Answer 28

Dilutional

Question 29

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

Answer 29

Hypernatremia

Question 30

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

Answer 30

Hypervolemic hypernatremia

Question 31

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

Answer 31

Normovolemic hypernatremia

Question 32

Sodium concentration of

Answer 32

Hyponatremia

Question 33

Average intake of potassium is?

Answer 33

50 to 100 mEq/day

Question 34

Renal excretion of potassium?

Answer 34

10-700 mEq

Question 35

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

Answer 35

Hyperkalemia

Question 36

ECG changes in hyperkalemia

Answer 36

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

Question 37

Potassium decreases by _____ with ___ increase in pH

Answer 37

0.3 mEq/L , 0.1

Question 38

ECG changes in hypokalemia

Answer 38

U waves T-waves flattening ST segment changes Arrythmias

Question 39

Water constitutes how many % of the total body weight?

Answer 39

50% to 60%

Question 40

Earliest sign of volume overload is?

Answer 40

Weight gain

Question 41

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

Answer 41

SIADH

Question 42

Manifests dilute urine in the case of hypernatremia

Answer 42

Diabetes insipidus

Question 43

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

Answer 43

Refeeding syndrome

Question 44

Serum calcium | Is distributed among 3 forms and how many %

Answer 44

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

Question 45

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

Answer 45

0.8 | 1

Question 46

What is the daily calcium | Intake?

Answer 46

1-3 g/d

Question 47

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

Answer 47

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

Question 48

What is the mechanism | Of action of kayexelate

Answer 48

Secretes potassium In exchange with sodium For hyperkalemia

Question 49

Common cause of severe acidosis is

Answer 49

Lactic acidosis

Question 50

What happens if there is a decreased absorption of HCO3

Answer 50

Proximal renal tubular acidosis