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24 Cards in this Set

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central pontine demyelination
rapid correction of hyponatremia, water runs out of neurons to higher concentration of Na in blood. neurons dehydrate and ie in pons.
SIADH treatment
restrict fluids to 800-1000cc/m2 and treat underlying problem. Replace urinary Na losses.
Renal threshold for bicarb in term baby
20-21meq/L
Percent of maintenance lost as insensible, and what IVF to replace it with.
one third.
D5W
Addison's electrolytes
hyperkalemia, hyponatremia, mild acidosis. Decreased Urinary K, Increased Urinary Na.
CHF electrolytes
hyponatremia, edema, decreased Urinary Na.
dehydration electorlytes
Na lost through GI. Urinary sodium low <10mEq/L
ANP decreases, ADH increases, Urinary Osm increase.
SIADH electrolytes
hyponatremic with Na wasting (Urinary Na >20) due to upreg ANP, down reg ADH
Urine Osm very high, Serum Osm very low. normal K,
Rate of correction of Na in hypernatremic dehydration
over 48-72hrs correct deficit.
Na not to go down faster than 10-12 mEq/L each day.
proton secretion location in kidney
collecting tubules. Secrete to create acidic surroundings to acidifiy urine.
Barter syndrome
hypokalemic metabolic alkalosis from 2 hyperaldosteronism. kidneys spill K and Cl, normal BP
Conn S
Primary hyperaldosteronism. too much aldosterone. hypoK, hypertension.
normal anion gap
8-16
normal anion gap differential
Ureterosigmoidostomy
Small bowel fistula
Extra Cl
Diarrhea
Carbonic anhydrase inhibitors (CRF)
Addison disease
RTA
Parenteral nutrition
organic acidemias
methylmalonic, proprionic
Appear normal at birth but soon present with poor feeding, lethargy, dehydration, met acidosis.
Urea cycle defects
hyperammonemia, no acidosis CPS(carbamoyl synthetase) def, or OTC. CPS is AR, OTC is XR so males present immediately, heterofemales present later.
RTA type I
distal renal tubule cannot acidify urine. pH never < 5.5 adults or <6 baby
RTA type II
prox tubule cannot reclaim bicarb
non-gap acidosis. urine pH can get low.
high-altitude electrolyte disturbance from chronic hypoxia
hypoxia->hypocapnea->hypophosphatemia and ATP loss (no phosphate for ATP). FeNa > 1. kidneys lose bicarb,
CF dehydration electrolytes
hyponaremic
hypochloremia
hypokalemic
met acidosis
EKG with hypoK
PVCs
hypokalemia EKG
flat T, presence of U (after T) If severe = Toursades.
EKG changes with hyperkalemia
peaked T is K of 6-8.
severe hi K: wide QRS, AV block 2:1
muffled heart tones, no pulse (PEA) different from V tach
EKG change with hypoCa
prolonged QT, ST gets lengthened