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30 Cards in this Set

  • Front
  • Back
H2O shift between ECF and ICF; controlled by serum Na+ and glucose
Serum Na+ ~ TBNa+/TBW
decreased TBNa+ dehydration; increased TBNa+ pitting edema
Isotonic loss
serum Na+ normal; adult diarrhea, loss whole blood; Rx with 0.9% saline
Isotonic gain
serum Na+ normal; Rx with salt and H2O restriction
ICF expanded; central pontine myelinolysis with rapid IV correction
Hyponatremia hypotonic gain pure water:
inappropriate ADH syndrome
Hyponatremia hypotonic gain TBNa and TBW:
pitting edema; cirrhosis, RHF
Hyponatremia hypertonic loss TBNa
dehydration; loop diuretic, Addison's, 11-hydroxylase deficiency
Hypertonic state
hypernatremia or hyperglycemia; ICF contraction
Hypernatremia hypertonic gain TBNa
pitting edema; sodium bicarbonate
Hypernatremia hypotonic loss of water
diabetes insipidus
Hypernatremia hypotonic loss of TBNa and TBW
osmotic diuresis, sweat, baby diarrhea
potential for hyperkalemia (shift out of ICF)
potential for hypokalemia (shift into ICF)
loop and thiazide diuretics MCC; alkalosis, albuterol/insulin; U wave
renal failure MCC; acidosis, beta-blocker, digitalis toxicity; peaked T wave
Rx for hyperkalemia
calcium gluconate -+ insulin with glucose-+ loop diuretic
Respiratory acidosis
PaCO2 > 45 mm Hg; compensation metabolic alkalosis
Causes of Respiratory acidosis
chronic bronchitis, ARDS, barbiturate poisoning, paralysis diaphragms
Respiratory alkalosis
PaCO2 < 33 mm Hg; compensation metabolic acidosis
Causes of Respiratory alkalosis
pulmonary embolus, anxiety, early bronchial asthma, restrictive lung disease
Metabolic alkalosis
HCO3 -> 28 mEq/L; compensation respiratory acidosis
Causes of Metabolic alkalosis
loop/thiazide diuretics, vomiting, primary aldosteronism
Metabolic acidosis
compensation respiratory alkalosis
inc Anion Gap metabolic acidosis
add anions of acid to extracellular fluid
Causes of Anion Gap metabolic acidosis
lactate, AcAc, R-OHB, salicylate, oxalate (ethylene glycol), formate (methyl alcohol, phosphate/sulfate (renal failure)
Ethylene glycol, methyl alcohol pathogenesis
compete with alcohol for alcohol dehydrogenase
Ethylene glycol poisoning
antifreeze; converted to oxalic acid; renal failure
Methyl alcohol poisoning
window wiper fluid; converted to formic acid; blindness
Normal AG metabolic acidosis
lose HCO3 ; e.g., diarrhea, proximal/distal renal tubular acidosis