Acid Base And Electrolyte Disorders

Front 1

clues to identify mixed acid-base disorder

Back 1

[HCO3−] and PCO2 move in opposite directions
pH changes in the direction opposite that expected from a known primary disorder.

Front 2

An uncommon cause of elevated AG metabolic acidosis

Back 2

phosphate intoxication. This can occur if NaH2PO4, present in some enemas and oral bowel cleansing prepar ations, is absorbed in excess of the kidney's ability to excrete phosphate. Dissociation into H+ and HPO42− results in markedly high phosphate levels and a proportionately elevated AG

Front 3

When calculating the AG in the setting of marked hyperglycemia, there is ?

Back 3

no need to correct sodium level for glucose.

Front 4

Sepsis and salicylate intoxication both may present with

Back 4

mixed respiratory alkalosis and elevated AG metabolic acidosis

Front 5

contraction alkalosis is seen in
(in which volume depletion causes extracellular fluid to “contract” around a fixed quantity of bicarbonate, raising [HCO3−] and thus inducing a metabolic alkalosis.)

Back 5

diuretics use

Front 6

test done to differentiate various type of metabolic alkosis is?

Back 6

urinary chloride

Front 7

chronic respiratory acidosis, what happens to chloride levels?

Back 7

chloride is excreted to neutralise bicarbonate absorption.
hypochloremia occurs.

Front 8

correction equation for acute respiaratry acidosis is ?

Back 8

for every 10mm of hg increase in pCO2, HCO3 increases by 1meq/l.

Front 9

correction equation for chronic respiratory acidoisis is ?

Back 9

for every 10mm of hg increase in pCO2 , HCO3 increases by 3.5meq/l

Front 10

benzodiazepine toxicity causes?

Back 10

acute respiratory acidosis.

Front 11

acute respiratory alkalosis, correction is ?

Back 11

for every 10mm of hg decrease in pCO2 , HCO3 decreases by 2 meq/l

Front 12

chronic respiratory alkalosis correction is?

Back 12

for every 10mm of hg decrease in pCO2 , HCO3 DECREASES by 5 meq/l

Front 13

clinical features of hypocalcemia are seen in which acid base disorder?

Back 13

respiratory alkalosis.

Front 14

whats the mechanism for hypocalcemia in alkalosis?

Back 14

in alkalosis, H+ is low, ca2+ takes the place of H+, lower free ca2+ ions.

Front 15

what is the role of demeclocycline in SIADH?

Back 15

demeclocycline is given in chronic symptomatic SIADH.
not responsive to fluid restriction.
it takes 1-3 days to inhibit the action of ADH on the kidney.

Front 16

causes for pseudohyponatremia( isotonic)

Back 16

hyperlipidemia
hyperprotenimia( multiple myeloma,waldenstorms macroglobulinimia)

Front 17

causes for hypertonic hyponatremia

Back 17

hyperglycemia
mannitol excess
urea
glycerol therapy

Front 18

psychogenic polydipsia is an example for

Back 18

hypotonic ,euvolemic hyponatremia.
hyponatremia is exacerbated by antidepressant and neuroleptic drugs.

Front 19

calculation of plasma osmolality
all values in mmol/l

Back 19

2Na+S.glucose+S.urea in mmol/l

Front 20

correction of S.Na when there is hyperglycemia

Back 20

corrected S.Na= observed S.Na +

1.4x{observed glucose-5}
---------------------------------------
5

Front 21

what are the values for percentage of TBW., total body water in the following

Back 21

percentage of TBW
in young men-------0.6
in young women and elderly men-----0.5
elderly women ---------0.4

Front 22

calcualtion of free water deficit-

Back 22

free water deficit = wt in kg x percentage of TBW x{S.Na/140) - 1}

to this value add insensible and ongoing losses.
this whole fluid is given in next 48 hrs.
infusion rate ---100ml/hr

Front 23

calculation of sodium deficit-

Back 23

Na+ deficit = { S.Na desired - S.Na observed} x ( body wt in kg x percentage of TBW)

Front 24

what empiric replacement fluids can be used for fluid losses?

Back 24

gastric----------D5 1/2 NS with 20-30KCL/L ( never give lactated ringer)

sweat------D5 1/4 NS with 5KCL/L

BILE, PANCREAS, SMALL BOWEL-------lactated ringers solution

colon------D5 1/2 NS with 30KCL/L

third space losses-----lactated ringers solution