fluid and electrolytes

Question 1

unmeasured osmoles occurs in

Answer 1

poisoning

Question 2

increased lipid and protein in the plama

Answer 2

pseudohyponatremia

Question 3

accepted osmolal gap

Answer 3

10 mOsm/kg

Question 4

Major intracellular cation

Answer 4

K

Question 5

Major extracellular anion

Answer 5

Cl

Question 6

Major intracellular anion

Answer 6

Phosphate

Question 7

Major extracellular cation

Answer 7

Na+

Question 8

predominant cation in plasma

Answer 8

Na

Question 9

causes of edema

Answer 9

1. Increased hydrostatic pressure
2. Lowered plasma osmotic pressure
3. Increased cap mem perm
4. Lymphatic channel obstruction

Question 10

components of maintenance therapy

Answer 10

water, glucose, Na, K

Question 11

maintenance therapy provides how much of normal cal needs

Answer 11

20%

Question 12

goals of maintenance fluids

Answer 12

Prevent:

1. dehydration
2. electrolyte d/o
3. ketoacidosis
4. protein degradation

Question 13

If the child is under 6 months nd no yet taking solid food, what i your treatment plan? (no dehydration)

Answer 13

ORS solution or water rather than food based fluid

Question 14

amount of zinc you should give in <6 mo old

Answer 14

10mg od for 10-14 days

Question 15

amount of zinc you should give in > 6 mo old

Answer 15

20 mg od for 10-14 days

Question 16

Rules in treatment plan A

Answer 16

1. Give the child more fluids than usual to prevent dehydration
2. Give supplemental zinc for 10-14 days
3. Continue to feed the child to prevent malnutrition
4. Take the child to health worker if there are signs of dehydration or other problems

Question 17

Amount of ORS to be given in treatment plan B

Answer 17

Amount of ORS = weight (kg) x 75 to be given in 4 hr

Question 18

what to do if there’s oral rehydration failure

Answer 18

ORS solution NGT

Ringer’s Lactatae (D5LR or plain LR) IV 75mL/kg for 4 hrs

Question 19

rate of ORS given in Treatment Plan C

Answer 19

20 mL /kg for 6 hrs

Question 20

signs that remain useful in diagnosing diarrhea

Answer 20

eagerness to drink
cool and moist extremeties
weak or absent radial pulse
reduced or absent urine flow
history of diarrhea

Question 21

Most important ion in regulating water balance

Answer 21

Na

Question 22

principal site of Na excretion

Answer 22

Kidney

Question 23

Renal tubule Na reabsorption is affected by what hormones?

Answer 23

ADH
Aldosterone
Renin/angiotensin

Question 24

hyponatremia with no evidence of

volume overload or depletion.

Answer 24

Euvolemic Hyponatremia

Question 25

example of hypervolemic hyponatremia

Answer 25

CHF cirrhosis Nephrotic syndrome Renal failure

Question 26

treatment for Severe Hyponatremia

Answer 26

2 mEq/ml

Question 27

formula for Na needed

Answer 27

Na needed = (desireed Na conc - actual) x Wt in kg x 0.6

Question 28

complication of immediately raising serum lvl to the normal lvl

Answer 28

Central Pontine Myelinolysis

Question 29

principal hormone regulator for secretion of K

Answer 29

aldosterone

Question 30

K is mostly absorbed in

Answer 30

SI

Question 31

Colon exchanges body potassium for

Answer 31

luminal sodium

Question 32

drugs that can cause hyperkalemia

Answer 32

``` ACE inhibitors K sparing diuretics Cycloporin NSAIDs Trimethoprim ```

Question 33

ECG changes in hypokalemia

Answer 33

Flattened T wave Depressed ST wave Appearance of a U wave

Question 34

ECG changes in Hyperkalemia

Answer 34

``` Peaking of T waves Increased P-R interval Flattening of P wave Widening of GR complex progress to v-fib ```

Question 35

3 forms of Calcium

Answer 35

Ionized Albumin bound Anion

Question 36

what is a buffer

Answer 36

substance that reduces the change in free hydrogen ion concentration of a solution on the addition of an acid or base

Question 37

increase in hydrogen ion conc

Answer 37

acidosis

Question 38

decrease in H ion conc

Answer 38

alkalosis

Question 39

3rd most common intracellular cation

Answer 39

Mg