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Response to injury Flashcards

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1
Q

water constitutes ____ % of total body weight

A

50-60%

Male = 60%
Female = 50%
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2
Q

highest percentage of TBW is found in _____

A

newborns

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3
Q

Cite the three functional fluid compartment

A
  1. Plasma
  2. Interstitial fluid
  3. Intracellular fluid
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4
Q

The principal cation in the ECF is

A

Na

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5
Q

The principal anion in the ECF is

A

HCO3

Ions in the ECF

  1. Na
  2. Cl
  3. HCO3
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6
Q

The cations in the ICF are:

A
  1. Potassium

2. Magnesion

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7
Q

The principal anions in the ICF are

A
  1. Phosphate

2. Proteins

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8
Q

The maintains the concentration gradient between compartments

A

ATP driven NaK pumps

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9
Q

Cote the body composition of 70kg lean adult male as % body weight and volume

A 
60% water = 42L
40% ICF = 28L
20% ECF = 14 L
15% interstitial fluid = 10.5L 
5% plasma = 3.5L
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10
Q

Majority of the fluid output is due to?

A

Insensible losses

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11
Q

What is the daily Na requirement for Na in a 70 kg lean adult?

A

1-2 mEq/kg

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12
Q

What is the daily Na requirement for K in a 70 kg lean adult?

A

0.5 to 1.0 mEq/kg

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13
Q

What is the daily Na requirement for Ca in a 70 kg lean adult?

A

1000 mg/day

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14
Q

What is the daily Na requirement for PO4 in a 70 kg lean adult?

A

700 mg/day

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15
Q

What is the daily Na requirement for Mg in a 70 kg lean adult?

A

300-400mg/day

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16
Q

What is the daily Na requirement for Cl in a 70 kg lean adult?

A

1-2 mEq/kg

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17
Q

___ is the most common source of external fluid loss in a surgical patient is via?

A

the GIT

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18
Q

[Which part of the GIT]

highest Na

A

Duodenum, Ileum

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19
Q

[Which part of the GIT]

Highest K

A

Colon

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20
Q

[Which part of the GIT]

Highest Cl

A

Ileum

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21
Q

[Which part of the GIT]

Highest bicarbonate

A

Pancreas (115), Bile 35

Ileum (30)
Saliva (3)

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22
Q

[Which part of the GIT]

highest volume

A

Ileum 3000 mL

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23
Q

[among the electrolyte solutions for PN administration]

Which has the closest to body levels for Na

24
Q

[among the electrolyte solutions for PN administration]

Which has the closest to body levels for K

Study These Flashcards
A 
LR = 4
D5LR = 4
25
[among the electrolyte solutions for PN administration] Which has the closest to body levels for C
LR = 28
26
[Guess the electrolyte solution] ``` Osm = 280 Na = 130 K = 4 Cl = 109 Ca = 28 ```
LR
27
[Guess the electrolyte solution] ``` Osm = 308 Na = 154 K = 0 Cl = 154 Ca = 0 ```
PNSS
28
[Holliday Segar Method] 70kg man What is the maintenance fluid requirement needed?
2500 mL/day 10kg x 100 mkday = 1000 mL 10kg x 50mkday = 500mL 50 kg x 20mkday = 1000 mL Remember: 100 - 50 - 20 mkday
29
[classify the stage of dehydration] (+) thirst low urine volume reduced sweating
Mild 2-5% loss
30
[classify the stage of dehydration] ``` Severe thirst Nausea Dry axilla and groin Tachycardia Orthostatic hypotension Low CVP Poor skin rugor Apathy Oliguria Hemoconcentration ```
Moderate 6-10% loss
31
[classify the stage of dehydration] ``` stupor Hypotension severe oliguria Thready pulse shock ```
severe 11-15% loss
32
Cite causes of HAGMA
``` Methanol Uremia DKA Propylene glycol, paraldehyde Infection, Iron, Isoniazid Lactic acidosis Ethylene glycol Salicylates ```
33
Cite exogenous acid ingestion that causes HAGMA
Ethylene Glycol Salicylate Methanol Propylene glycol Paraldehyde
34
Cite endogenous causes of acid production in HAGMA
Ketoacidosis Lactic acidosis Renal insufficiency
35
Cite causes of NAGMA
``` Hyperalimentation Acetazolamide RTA Diarrhea Uteroenteric Fistula Pancreaticoduodenal fistula ```
36
[bicarbonate generation] Cite causes of increased bicarbonate generation that is chloride losing
Mineralocorticoid excess | Profound potassium depletion
37
[bicarbonate generation] Cite causes of increased bicarbonate generation that is chloride sparing
Loss from gastric secretion | Diuretics
38
[IV fluid of choice] In management of hypernatremia
PNSS Rate of decrease in serum Na = <1 mEq/l/hr
39
Rapid correction of hypernatremia can cause
cerebral edema | Herniation
40
[IV fluid of choice] In management of hyponatremia
None. Restrict Na
41
[what electrolyte imbalance] restlessness, irritability, seizures, coma can lead to SAH
hypernatremia
42
[what electrolyte imbalance] headache, confusion, seizures, coma increased ICF
hyponatremia
43
[IV fluid of choice] In management of symptomatic hyponatremia
3% normal saline until serum Na is 130 or resolution of symptoms rate: not more than 1mEq/l/hr
44
[IV fluid of choice] In management of asymptimatoc hyponatremia
3% normal saline rate: not more than 0.5 mEq/l/hr max goal: 12 mEq/l/hr
45
[what electrolyte abnormality] nausea/vomiting weakness, paralysis arrhythmia peaked T waves
hyperkalemia
46
In managing hyperkalema, how many mg of nebulized salbutamol will you administer
10-20mg
47
When will you immediately administer calcium chloride or calcium gluconate in hyperkalemic patients?
when ECG changes are present
48
[what electrolyte abnormality] ileus, constipation decreased paralysis cardiac muscle arrest flat T wave
hypokalemia
49
[management of hypokalemia] in mild asymptomatic hypokalemia, the treatment of choice is?
KCl 40 mEq/enteral access x 1 dose
50
[management of hypokalemia] what is the rate of IV repletion in patients with hypokalemia
no more than 10mEq/hr
51
[what electrolyte abnormality] neurologic impairment MSK weakness and pain T wave flattening shortened QT interval Prolonged PR and QRS interval AV block
hypercalcemia
52
what is the cut off serum Ca level wherein you should start treatment?
when serum level exceeds 12 mEq/L
53
[What electrolyte abnormality] prolonged QT interval T wave inversion VFib heart block
hypocalcemia
54
Ca level when neuromuscular and cardiac symptoms occur
iCa is below 2.5mg/dL
55
what electrolyte abnormality is associated with hypocalcemia?
hypomagnesemia hypokalemia Remember, hypomagnesemia can lead to hypocalcemia leading to persistent hypokalemia
56
[IV fluid of choice] In management of cute symptoms of hypermagnesemia
calcium chloride
57
[IV fluid of choice] This is given to counteract the adverse side effects of rapidly rising Mg level
calcium gluconate Remember, hypomagnesemia can lead to hypocalcemia leading to persistent hypokalemia

Surgery (19 decks)

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