Fluid Electrolytes, Nutrition

Front 1

What lab values indicate pre-renal status?

Back 1

FeNa < 1

Urine Na < 20

BUN/Cr >30

Front 2

Which body fluids have the highest K concentration?

Back 2

Saliva (20 mEq)

Stomach (10 mEq)

Pancreas (5 mEq)

Front 3

What are the branched chain Amino acids and where are they metabolized?

Back 3

Valine, leucine and isoleucine

Muscle

Front 4

Pathway of vitD metabolism?

Back 4

made in skin --> liver for 25-OH --> kidney for 1-OH

Front 5

What route of VitA administration helps protect against adverse effects of steroids?

Back 5

systemic or topical

Front 6

What percentage of TBW does an infant have?

Back 6

80%

Front 7

Which has higher percentage of TBW, men or women?

Back 7

Men

Front 8

Do obese patients have higher or lower TBW?

Back 8

lower

Front 9

What is the normal distribution of water in a body?

Back 9

60% is total body water

40% of that is intracellular

20% is extracellular (15% interstitial, 5% plasma)

Front 10

What is the caloric amount in carbohydrates?

Back 10

3.4 kCal/g

Front 11

What is the caloric amount in protein?

Back 11

4 kCal/g

Front 12

What is the caloric amount in fat?

Back 12

9 kCal/g

Front 13

What is the basal calorie expenditure?

Back 13

25 kCal/kg/day

Front 14

How much protein is required in a day

Back 14

1 g protein/kg/ day

Front 15

Calculating nitrogen balance

Back 15

6.25 g ofprotein contains 1 g of Nitrogen.

N balance = N in - N out = (Protein/6.25) -(24 hr urine N + 4 g)

Front 16

What is the preferred nutrition for small bowel?

Back 16

glutamine

Front 17

What is the preferred nutrition for colon?

Back 17

short chain fatty acids

Front 18

What does exogenous administration of glutamine do?

Back 18

decreases translocation, increases mucosal health with chemo or RT to bowel

Front 19

Which fats are absorbed directly into the portal system?

Back 19

short and medium chain triglycerides

Front 20

How is fat absorbed?

Back 20

micelles transported into enterocytes which form chylomicrons which then enter the lymphatics

Front 21

What are the consequences of chromium deficiency?

Back 21

diabetes, neuropathy

Front 22

What are the consequences of zinc deficiency?

Back 22

perioral rash

hair loss

poor healing

change in taste

Front 23

What are the consequences of phosphate deficiency?

Back 23

respiratory weakness, encephalopathy

Front 24

What are the consequences of copper deficiency?

Back 24

anemia

neutropenia

Front 25

What are the consequences of linoleic acid deficiency?

Back 25

dermatitis, hair loss, change in vision

Front 26

What are the consequences of vitA deficiency?

Back 26

can decrease vitamin C stores

Front 27

What is the Cori cycle?

Back 27

glucose is converted to lactate and turned into glucose in the liver

Front 28

What does the normal brain rely on for metabolism?

Back 28

glucose

Front 29

What does the brain utilize in starvation?

Back 29

ketones from fatty acids

Front 30

Where does gluconeogenesis occur in late starvation?

Back 30

Kidney (liver is depleted of alanine)

Front 31

contents of LR

Back 31

Na130, K 4, Ca 2.7, Cl 109, bicarb 28*��_

Front 32

How does alkalosis cause hypokalemia?

Back 32

Alkalosiscauses hypokalemia by driving K into cells and into urine (exchange for H+)

Front 33

How do you calculate the sodium deficit?

Back 33

Na deficit= .6(wt in kg)(140-Na)

replace no more than 1 meq/hr to avoid CPM

Front 34

By how much does hyperglycemia lower serum Na?

Back 34

for every 100 glucose over 100, add 2 to Na

Front 35

Causes of Anion gap acidosis?

Back 35

methanol,uremia, DKA, paraldehyde, lactic acidosis, ethyleneglycol, salicylates.

Front 36

How do you calculate the anion gap?

Back 36

Aniongap = Na - (HCO3 + Cl)

Normal < 12

Front 37

Formula for serum osmolarity?

Back 37

(2 x (Na + K)) + (BUN / 2.8) + (glucose / 18)

Front 38

Why must you replace magnesium if trying to replete calcium?

Back 38

low magnesium --> inhibition of PTH

Front 39

Cardiovascular effects of metabolic acidosis

Back 39

peripheral arteriolar dilatation, a decrease in cardiac contractility, and central venous constriction--> cardiovascular collapse and pulmonary edema

Front 40

Main vasoconstrictors in intestine?

Back 40

angiotensin II and vasopressin

(also TRH and thromboxane A2 as well)

Front 41

What are early and late signs for hyperkalemia on EKG

Back 41

peaked T waves and shortened QT (early) and flattened p waves (late)

Front 42

highest potassium in secretions (descending order)

Back 42

colon>salivary>gastric>bile, pancreatic, duodenum, and ileum

Front 43

What is type 1 renal tubular acidosis?

Back 43

Distal in collecting duct

Failure of α intercalated cells to secrete H+ and reclaim K+

Front 44

What is type 2 renal tubular acidosis?

Back 44

Proximal tubules

Failure of proximal tubular cells to reabsorb HCO3−

Front 45

What is type 4 renal tubular acidosis?

Back 45

Defect in adrenal gland

Deficiency of aldosterone, or a resistance to its effects, (hypoaldosteronism or pseudohypoaldosteronism, hyperkalemia)

Front 46

Calculating postassium deficit

Back 46

drop of 1 mEq/L in = 100 to 200 mEq/L.

A further drop from 3.0 to 2.5 =100 to 200 mEq/L for each drop of 0.25 mEq/L

Front 47

What stimulates aldosterone?

Back 47

Angiotensin II

High extracellular potassium

Front 48

Mechanism for ACE inhibitors

Back 48

block angiotensin I from becoming angiotensin II