FEN

Question 1

Total body water is about ___% of body weight

Answer 1

50-60%

Question 2

Total body water = __/3 intercellular fluid (ICF) and __/3 extracellular fluid (ECF)

Answer 2

Total body water = 2/3 intercellular fluid (ICF) and 1/3 extracellular fluid (ECF)

Question 3

What is the primary osmotically active solute in extracellular space?

Answer 3

Sodium

Question 4

What are the primary intercellular oncotic forces?

Answer 4

Potassium, magnesium, and phosphorus

Question 5

Total body water = ____ L/kg

Answer 5

Total body water = 0.5-0.6 L/kg

Question 6

Extracellular fluid is 1/3 TBW. How much of extracellular fluid is interstitial fluid and how much is intravascular fluid?

Answer 6

Interstitial fluid is 3/4 ECF and intravascular fluid is 1/4 ECF

Question 7

Which of the following IV fluid(s) are only distributed in the extracellular fluid?
A. 0.9% NaCl
B. D5W
C. 0.45% NaCl
D. Lactated Ringers (LR)
E. D5W/0.45% NaCl

Answer 7

A. 0.9% NaCl & D. Lactated Ringers (LR)

Question 8

What is the adult fluid requirement?

Answer 8

30-40 mL/kg/day

Question 9

Which of the following IV fluid(s) are best for volume resuscitation?
A. 0.9% NaCl
B. D5W
C. 0.45% NaCl
D. Lactated Ringers (LR)
E. D5W/0.45% NaCl

Answer 9

A. 0.9% NaCl and D. Lactated Ringers (LR)

Question 10

Which of the following IV fluid(s) are best in the setting of dehydration/free water deficit?
A. 0.9% NaCl
B. D5W
C. 0.45% NaCl
D. Lactated Ringers (LR)

Answer 10

B. D5W

C. 0.45% NaCl

Question 11

What is the reference range for sodium?

Answer 11

135-145 mEq/L

Question 12

What is the daily requirement for sodium?

Answer 12

1-2 mEq/kg

Question 13

Hyponatremia is classified by plasma osmolality. What is the normal range for plasma osmolality?

Answer 13

275-295 mOsm/kg

Question 14

SIADH is a type of _____
A. Hypovolemic hyponatremia
B. Euvolemic hyponatremia
C. Hypervolemic hyponatremia

Answer 14

B. Euvolemic hyponatremia

Question 15

The reference range for potassium is _____ mEq/L

Answer 15

3.5-5 mEq/L

Question 16

True or False: Potassium is the major intracellular cation.

Answer 16

True

Question 17

True or false: Beta-agonists such as albuterol can cause hypokalemia.

Answer 17

True

Question 18

True or false: both loop and thiazide diuretics can cause hypokalemia.

Answer 18

True

Question 19

True or false: Mineralocorticoids can cause hypokalemia.

Answer 19

True

Question 20

True or false: diarrhea does not cause hypokalemia.

Answer 20

False. Diarrhea can cause hypokalemia.

Question 21

What are some symptoms of severe hypokalemia?

Answer 21

Muscle contractility leading to weakness and constipation, cardiac arrhythmias in severe cases, and sudden death.

Question 22

10 mEq of potassium supplementation increases serum potassium by ___ mEq/L.

Answer 22

0.1 mEq/L

Question 23

True or false: when treating hypokalemia in patients with renal failure, it is best to reduce the supplementation dose by half.

Answer 23

True

Question 24

What are the most common side effects of oral potassium supplementation?

Answer 24

GI related adverse effects

Question 25

True or false: when treating hypokalemia, it is important to treat hypomagnesemia as well if present.

Answer 25

True

Question 26

If potassium supplementation is being given in powder form through a tube, 20 mEq should be diluted in ___ mL of water.

Answer 26

60 mL

Question 27

When can you check serum levels of potassium after administration of IV potassium supplementation?

Answer 27

2-4 hours after end of administration

Question 28

True or false: IV potassium can be administered rapidly.

Answer 28

False. Should be replaced slowly (usually at a rate of 10 mEq/hr or less)

Question 29

True or false: adding lidocaine to the IV container of IV potassium supplementation is recommended to decrease phlebitis and pain.

Answer 29

False. It is not recommended as it can mask the signs of problem or cause toxicity.

Question 30

Hypophosphatemia is defined as a serum phosphate < ___ mmol/dL.

Answer 30

< 2.5 mmol/dL

Question 31

The oral recommended dose for hypophosphatemia treatment is _____ mg/day for up to 7-10 day course.

Answer 31

1000-2000 mg/day

Question 32

True or False: oral phosphate can cause constipation.

Answer 32

False. It causes osmotic diarrhea

Question 33

The recommended rate for IV phosphate is less than ____ mmol/hr.

Answer 33

Less than 7.5 mmol/hr

Question 34

If hypophosphatemia is managed via IV phosphate replacement, levels may be checked ___ hours post-dose.

Answer 34

2-4 hours

Question 35

In setting of renal failure, it is recommended to reduce the dose of phosphate replacement by __%.

Answer 35

50%

Question 36

For mild hypophosphatemia (2.1-2.5), the recommended phosphorus dose is ____ mmol/kg.

Answer 36

0.16 mmol/kg

Question 37

For moderate hypophosphatemia (1.5-2), the recommended phosphorus dose is ____ mmol/kg.

Answer 37

0.32 mmol/kg

Question 38

For severe hypophosphatemia (2.1-2.5), the recommended phosphorus dose is ____ mmol/kg.

Answer 38

0.64 mmol/kg

Question 39

Symptoms of hypophosphatemia, such as diaphragm weakness, respiratory failure, impaired myocardial contractility and heart failure, proximal weakness, dysphagia, tremors, do not manifest until serum level is less than ___ mg/dL.

Answer 39

Less than 1 mg/dL

Question 40

The reference range for magnesium is ___ mg/dL.

Answer 40

1.7-2.3 mg/dL

Question 41

True or false: magnesium is bound to albumin.

Answer 41

True

Question 42

Low levels of magnesium are common and normal in the setting of ______.

Answer 42

Hypoalbuminemia

Question 43

True or False: chronic PPI use can cause hypermagnesemia.

Answer 43

False. It can case byponagnesemia.

Question 44

True or False: oral magnesium supplementation is preferred over IV.

Answer 44

False. IV magnesium supplementation is preferred to oral.

Question 45

The oral absorption of magnesium is variable, but usually between ____ and ___%.

Answer 45

15-40%

Question 46

True or False: Magnesium can cause osmotic diarrhea and GI intolerance.

Answer 46

True

Question 47

Magnesium starting oral dose is 300-600 mg daily and should be given in divided doses due to ____.

Answer 47

Diarrhea/GI intolerance adverse effect(s)