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FEK AB Flashcards

1
Q

Transfusion amount for pediatrics

A

10cc/kg

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2
Q

Components of LR

A 
Na 130
Cl 109
K 4 **
Ca 3 **
Lactate 28
pH 6.5
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3
Q

pH NS

A

6

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4
Q

How much Na do pts need mEq/kg/day? K?

A

Na - 1-2 mEq/kg/day (~1L 1/2NS)

K - 0.5-1 (~20mEq added to fluids)

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5
Q

Replace high NGT output with…?

A

NS

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6
Q

Replace high volume bile leak with…?

A

LR (bc lose bicarb)

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7
Q

Replace severe diarrhea with…?

A

LR (need potassium)

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8
Q

Largest GI loss of potassium is where?

A

colon

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9
Q

Equation: serum osms

A

2NA + glucose/18 + BUN/2.8

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10
Q

Max rate of hyponatremic correction

A

max. 1 mEq/hr

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11
Q

Mgmt SIADH

A
  1. fluid restrict
  2. hypertonic saline
  3. demeclocycline, vaptan (V2-R antag)
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12
Q

Urine osm vs. Serum osm: dilutional hypoNa

A

urine osm low

serum osm low

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13
Q

Urine osm vs. Serum osm: SIADH

A

urine osm high

serum osm low

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14
Q

What is pseudohypoNa?

A

2/2 hyperglycemia, hyperproteinemia, hyperTG

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15
Q

Equation: Na deficit

A

(desired Na - actual Na) x TBW = mEq Na needed

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16
Q

Equation: free water deficit

A

(actual Na - desired Na) / (desired Na) * TBW

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17
Q

Urine osm vs. Serum osm: diabetes insipidus

A

urine osm low

serum osm high

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18
Q

Urine osm vs. Serum osm: iatrogenic hyperNa

A

urine osm high

serum osm high

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19
Q

Mgmt: central diabetes insipidus

A

DDAVP

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20
Q

Correcting Ca in hypoalbuminemia pt

A

for every point <4 (nl albumin), add 0.8 to calcium

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21
Q

Non-gap metabolic acidosis

A 
[HARDASS]
hyperalimentation
addison's disease
renal tubular acidosis
diarrhea (or high stomal output)
acetazolamide
spironolactone
saline infusion
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22
Q

MCC metabolic alkalosis (2)

A
  • NG suction

- contraction alkalosis (CHF pt that is over-diuresed) - need to give them back Cl

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23
Q

Change of ? in pH for every ? change of CO2

A

0.1 change in pH for every 12 of CO2

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24
Q

Sepsis resuscitation bolus amount

A

30cc/kg bolus

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25
Resuscitation bolus for peds? How about for blood?
bolus 20 cc/kg. | transfuse 10 cc/kg.
26
Urine abnormality in pyloric stenosis baby s/p emesis
paradoxical aciduria + hypoCl hypoK met alkalosis
27
Hyperhomocystinemia associated with...? (vascular)
increased risk arterial and venous thrombi
28
Persistent elevation of K always associated with...?
impaired urinary excretion of K
29
Primary reasons of decreased urinary K excretion are...?
- hypovolemia - hypoaldo - renal failure - drugs (spironolactone, NSAIDs)
30
EKG changes: hyperK
- quick repolarization -> peaked T-waves and short QT interval - delayed depolarization -> loss of P-wave and widened QRS interval
31
Cytokines stimulate release of what chemicals during sepsis?
cortisol + glucagon + catecholeamines
32
Lab tests to eval short-term nutrition status vs. long-term
short: prealbumin (1/2 life 2d) + retinol-binding protein (1/2 life 12hrs) long: albumin (10d) + transferrin (20d)
33
Why excess carbs -> RQ>1?
bc excess carbs -> lipogenesis -> large amts CO2 produced
34
Equation: FENa%
100 x Pcr*Una/Pna*Ucr
35
Sxs hypoP (<0.07)
muscle weakness (affects diaphragm most) -> resp failure
36
K+ secretion highest in...?
colon>salivary>gastric>bile,panc,duo,ileum
37
What kind of feeding for burn pts?
Enteral feeding (decreases gastroparesis)
38
What kind of feeding for major head or torso trauma pts?
Postpyloric enteral feeding
39
Min amount exogenous glucose needed per day to decrease protein breakdown
100g glucose
40
In metabolic acidosis, renal regulation of serum pH dependent on what transporter?
Na+/H+ antiporter in proximal tubules
41
Why not give bicarb for lactic acidosis?
bicarb + protein -> carbonic acid + CO2 -> conversion metabolic to respiratory acidosis, which has greater neg inotropic effects
42
What is ceruloplasmin?
storage and transport cuproprotein
43
Zn deficiency sxs
eczematoid rash, papular perioral, and perianal eruptions, taste atrophy, diarrhea
44
Cu deficiency sxs
microcytic anemia, neuro (ataxia, spasticity, muscle weakness)
45
Selenium deficiency sxs
cardiomyopathy
46
Essential fatty acid deficiency sxs
dry, scaly dermatitis, loss of brittle nails, easy bruising, diarrhea
47
Essential amino acid deficiency sxs
decreased immune function
48
Energy source during fasting/starvation?
Primary fuel: glucose Next option: glycogen (avail for 6hrs) Next option: FFA (avail 5 days) Starvation phase: glucose taken from breakdown of muscle of protein into AA, which are then converted to glucose by liver
49
Majority of ingested proteins are absorbed in intestines as...?
dipeptide vs. tripeptides via peptide transporter 1 (PEPT1)
50
MCC endogenous hypercortisolism (Cushing syndrome)
ACTH-dependent 2/2 pituitary adenoma (Cushing disease)
51
How many gram protein in 1g nitrogen?
6.25g protein
52
Equation: non-protein caloric requirement for burn pts
25 kcal/kg/d*kg + (30 kcal/day * %TBSA)
53
Equation: protein gram req for burn pts
1 g/kg/d*kg + (3 g/day * %TBSA)
54
Definition of respiratory quotient (RQ)
ratio CO2 produced to O2 consumed
55
Starvation vs. hypermetabolism
Starvation: goal to preserve lean body mass and reduce protein wasting (fat is primary fuel source - RQ 0.7) Hypermetabolism: will have rapid loss of lean body mass; mobilization of proteins + increase gluconeogenesis -> mixed RQ 0.8-0.95
56
Why use D1/4NS+20K in children <2 as opposed to D1/2NS?
children <2 have ineffective concentrating ability of distal nephrons so have difficulty with Na excretion
57
Prerenal BUN/Cr ratio
>20
58
Prerenal FEna
<1%
59
Prerenal spot urine Na
<10
60
How to calculate ideal body weight (used for TPN req calculations)
IBW (male) = 50kg + 2.3kg x height(in)-60in | IBW (female) = 45.5kg + “”

QUESTION NOTES (28 decks)

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