Term
|
Definition
AG Meta acidosis
Urine Ketones
Glucose > 500 usually
*pseudohypoNa, AKI*
*K elevated initially, but depleted overall* |
|
|
Term
| when to add glucose to DKA regimen? |
|
Definition
If AG acidosis persists, but glucose level <250
-add glucose to I-gtt and allow for further ketone metabolism |
|
|
Term
|
Definition
Na - (bicarb + chloride)
nrml < 10-15 |
|
|
Term
| what is gained/lost @ AG vs non AG acidosis? |
|
Definition
AG = gain of acid AND unmeasured ions
Non AG = gain HCL OR lose NaBicarb |
|
|
Term
|
Definition
| Diabetic Nephropathy -->aldosterone resistance |
|
|
Term
| PPhys of acidosis w/hypoALDOSTERONEism |
|
Definition
1. Dec Aldosterone = Hyper K+
2. K/H exchanger: excrete K+, reab H+
(NON AG MET ACIDOSIS) |
|
|
Term
| associated acid base disorder w/hypokalemia |
|
Definition
met ALKalosis
*K exchanged for H to counter alkalosis* |
|
|
Term
| Acid base dz w/gastric losses |
|
Definition
hypochloremic, hypokalemic, metabolic alkalosis
*w/paradoxical aciduria* |
|
|
Term
| Contraction alkalosis pphys |
|
Definition
loss of fluid/dehydration = relative inc in bicarb
*worsened by hypoK* |
|
|
Term
| Hypertensive forms of metabolic alkalosis |
|
Definition
1. Hyperaldosteronism
-Absorb Na, excrete K and H
-HypoK further drives H+ exchange
2. Cushing (high levels of glucocorticoids can have mineralocorti effects) |
|
|
Term
Diuretic induced contraction alkalosis
-tx |
|
Definition
NS bolus
Acetazolamide fi pt still overloded |
|
|
Term
| PPhys of hypochloremic, hypokalemic, met alkalosis w/aciduria |
|
Definition
1. HCL loss from stomach
2. water loss = renal reabs Na, excretes K ( hypoK)
3. kidney reabs K in exchange for H |
|
|
Term
hyperPhos
MCC
MC assoc electrolyte abn |
|
Definition
Renal fail
-80% have hypoCa
(other causes = hypo-parathy, tumor lysis synd) |
|
|
Term
|
Definition
Sevelamer chloride
low P diet
HD |
|
|
Term
|
Definition
PO4 shift from extra to intracellular
-often w/EtOH abuse-
MCCC = refeeding |
|
|
Term
hypoPhos
-sxs / consequences |
|
Definition
-failure to wean (dec ATP, weakness)
-inc infxn risk (dec leukocyte chemotaxis)
-AMS |
|
|
Term
|
Definition
|
|
Term
|
Definition
DECREASED DTR
*heart block if < 10, arrest > 13* |
|
|
Term
|
Definition
best = give calcium (competitive antag)
-diurese, dialysis |
|
|
Term
|
Definition
MCC sxsymptomatic: diuretics > EtOH, malnutrition
*majority are asympt* |
|
|
Term
Hypocalcemia
-MCC
-first sxs |
|
Definition
MCC hx thyroid surg
1st sx = perioral tinglging |
|
|
Term
|
Definition
| for every dec in albumin by 1 g, Ca dec 0.8 |
|
|
Term
| electrolyte abn causing DTR changes |
|
Definition
HYPER-mg and Ca= dec DTR
HypoCa = hyper-reflexia |
|
|
Term
|
Definition
hyperparathyroidism
-MC adenoma |
|
|
Term
|
Definition
lung Ca
Brast CA
*Tied for #1* |
|
|
Term
|
Definition
| Hx primary hyperparathyroidism, now undergoing another procedure |
|
|
Term
|
Definition
1. NS @200-300/hr (NO LR)
2. Lasix (NO THIAZIDES)
3. HD
4. Malig: bisphos, calcitonin, glucocorts, Mithramycin |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| correction rate for hypernatremia |
|
Definition
|
|
Term
| Free water deficit equation |
|
Definition
| 0.6 x Weight x [(Na/140) - 1] |
|
|
Term
|
Definition
max 0.5 mEq/L/hr
*avoid central pontine myelinosos* |
|
|
Term
| HypoNA treatment algorithm |
|
Definition
1. water restrict
2. diuresis
3. Hypertonic saline if severe sx |
|
|
Term
| effect on Na levels of hypertonic saline |
|
Definition
3% hypertonic saline has 513 meq NaCl
*1L = 10 meq increase in 70 kg man* |
|
|
Term
|
Definition
hyperglycemia
hyperlipidemia |
|
|
Term
| generally..when to use NS vs LR for initial resusc |
|
Definition
sweat, gastric = NS
panc/biliary/SB, colon = LR |
|
|
Term
|
Definition
*cc/kg/hr*
4 for the first 10 kg
2 for the 2nd 10 kg
1 for each kg after |
|
|
Term
| amount of insensible daily losses? |
|
Definition
10 cc/kg/day
*75% sweat, 25% resp. Hypotonic* |
|
|
Term
| Logic for glucose containing fluids |
|
Definition
5%Dextrose stimulates insulin release
-inc glucose/aa uptake ==>protein synth
-prevent catabolism |
|
|
Term
amount of daily output from..
1. stomach
2. panc
3. biliary |
|
Definition
1. 1-2L (HCL loss)
2. 1/2 to 1L (bicarb loss)
3. 1/2 to 1L (bicarb loss) |
|
|
Term
| electrolyte losses with SB fluid loss (fistula) |
|
Definition
|
|
Term
|
Definition
|
|
Term
| amount of sweat loss per day |
|
Definition
|
|
Term
| energy provided by glucose containing fluids |
|
Definition
D5 1/2 NS @ 125/hr
= 150 gm glucose
=525 kcal/day |
|
|
Term
TBW
-% of total weight?
-location |
|
Definition
2/3 total weight = water
-2/3 water = intra-cellular |
|
|
Term
| main determinant of ONCOTIC pressure |
|
Definition
|
|
Term
| Main determinant of OSMOTIC pressure |
|
Definition
|
|
Term
| Lyte composition of NS types |
|
Definition
1. NS: Na/Cl: 154
2. 1/2 NS (0.45%): NaCL 77
3. 3% NS: NaCl 513 |
|
|
Term
|
Definition
Na 130
K 4
Ca 2.7
Cl 109
Lactate 28 |
|
|
Term
plasma OSM equation
-nrml = ? |
|
Definition
(2 x Na) + (glucose/18) + (BUN/2.8)
-nrml = 290 +/- 10 |
|
|
Term
| Normal daily K and Na requirements |
|
Definition
K: 0.5-1 meq/kg/day
Na: 1-2 meq/kg/day |
|
|
