-
% of body weight that is water
66%
-
% of water weight that is intracellular
66%
-
% of water weight that is extracellular
33%
-
factor determining plasma/interstitial compartment osmotic pressures
proteins
-
factor determining intracellular/extracellular osmotic pressure
sodium
-
first sign of volume overload
weight gain
-
makeup of normal saline
Na 154, Cl 154
-
Makeup of lactated ringers
Na 130, K4,Ca 2.7, Cl 109,bicarb 28
-
Plasma osmolarity
(2 X Na) + (glucose/18) + (BUN/2.8)
-
fluid loss during open abdominal operations
0.5-1.0L/hr
-
daily insensible fluid losses
10cc/kg/day. 75% skin, 25% respiratory
-
daily secretion of stomach
1-2 L/day
-
daily secretion of biliary system
500-1000 mL/day
-
daily secretion of pancreas
500-1000 mL/day
-
daily secretion of duodenum
500-1000 mL/day
-
normal K requirement
0.5-1.0 mEq/kg/day
-
normal Na requirement
1-2 mEq/kg/day
-
electrolyte tonicity of sweat
hypotonic
-
predominant electrolyte in saliva
K
-
Predominant electrolytes in stomach (2)
H, Cl
-
Predominant electrolyte of pancreas
Bicarb
-
Predominant electrolyte of bile
Bicarb
-
Predominant electrolytes of small intestine (2)
K, HCO3
-
Predominant electrolytes of colon
K
-
Fluid to replace gastric losses
D5 ? NS + 20K
-
Fluid to replace biliary/small intestinal losses
LR
-
Fluid to replace large intestine (diarrhea) losses
LR + K
-
Mechanism of bicarbonate lowering K
K enters cell in exchange for H, causing alkalosis
-
Mechanism of insulin/dextrose lowering K
K driven into cells along with glucose
-
Sodium deficit
= 0.6 X (weight in kg) X (140-Na)
-
treatment for hyponatremia
water restriction, then diuresis, then NaCl
-
complication of correcting hyponatremia too fast
central pontine myelinosis
-
correction of hyperglycemia in determining pseudohyponatremia
add 2 points to Na for each 100 of glucose over normal
-
most common malignant cause of hypercalcemia
breast cancer
-
treatment of hypercalcemia
NS (200-300 mL/hr), lasix
-
Symptoms of hypocalcemia (5)
Hyperreflexia, Chvostek�s sin, perioral tingling, Trousseasu�s sign, prolonged QT
-
Symptoms of hypercalcemia (1)
Lethargy
-
Treatment of hypermagnesemia
Calcium
-
Anion gap
Na � (HCO3 + Cl)
-
Causes of anion gap acidosis (8)
Methanol, uremia, DKA, paraldehydes, isoniazid, lactic acidosis, ethylene glycol, salicylates
-
Cause of most normal gap acidosis
Loss of Na/HCO3 (ileostomies, small bowel fistulas)
-
Causes of metabolic alkalosis
Contraction alkalosis, NG suction,
-
Metabolic derangement of NG suction
Hypochloremic, hypokalemic, metabolic acidosis with paradoxical aciduria
-
Physiology of paradoxical aciduria during NG suction
Na/H exchanger activated in an effort to resorb water in kidney
-
Physiology of hypokalemia during NG suction
Loss of water causing kidney to resorb Na in exchange for K, thus losing K
-
Hendersen-Hasselbach equation
pH = pK + log [HCO3]/[CO2]
-
FeNa equation
= (urine Na/Cr)/ (plasma Na/Cr)
-
FeNa, urine Na, and BUN/Cr in prerenal failure
<1%, <20, and >20
-
reason myoglobin is toxic
is converts to ferrihemate in acidic environment, which is toxic to renal cells
-
release of purines and pyrimidines leading to hyperphosphatemia and inc. uric acid
tumor lysis syndrome
-
treatment of tumor lysis syndrome (4)
hydration, allopurinol, diuretics, urine alkalinization
-
location where vitamin D becomes 25-hydroxylated
liver
-
location where vitamin D becomes 1-hydroxylated
kidney
-
effect of vitamin D on calcium
inc calcium binding protein, causing increased intestinal Ca absorption
-
transporter of iron
transferring
-
storage form of iron
ferritin
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