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50 Cards in this Set
- Front
- Back
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what compartment does ringers go to?
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intravascular (plasma), which is 1/12 of TBW
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when can you not use ringers
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when hyperkalemia is a concern (it contains potassium)
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how to calculate maintenance fluids
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100 ml/kg for first 10 kg
50 for 2nd 10 20 for each other 1 kg |
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tx for hypo, iso and hyper volemic hypernatremia
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hypo: isotonic NaCl, and then replace free water deficit
iso: vasopressin plus oral fluids or D5W hyper: furossemide |
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formula for ionied Ca
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total Ca - (serum Albumin x 0.8)
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effect of PTH
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increase Ca
decrease PO4 |
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effect of calcitonin
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decrease Ca and PO4
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effect of vitamin D
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increased Ca and PO4
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numbness, tingling
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hypoCa
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effect of hypomagnesemia
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decreased PTH
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Chvostek's
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decreased Ca
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TPH in pseudohypoPTH
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very high
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tx for hypocalcemia
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IV calcium gluconate, and replace
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tx for PTH deficiency
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vitamin D
thiazides to lower urinary Ca and prevent stones |
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Calcium in MM
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increased due to lysis and release of osteoclast activating facot
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mechanism for hypercalcemia in sarcoid
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increased renal reabsorption
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increased urinary cAMP
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primary hyperparathyroidism
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tx for hyper Ca due to vit D abnormalities, MM
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glucocorticoids
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tx for hyper calcemia
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IV fluids
diuretics |
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effect of alkalosis on K
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alKaLOsis (low K+)
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chronic volume depletion secondary to an autosomal-recessive defect in salt reabsorption in TAL
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Bartters
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EKG effects of hypokalemia
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T wave flattening/inversion
U wave |
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effect of rapid administration of beta blocker on K levels
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hyper K
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level of K for EKG changes
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?6.0
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effects of hyper K on EKG
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peak T
prolonged PR wide QRS Vfib, leading to MI |
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tx for severe hyperK
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- IV Ca (careful of digoxin)
- glucose, insulin and Na bicarb to send K into cells - kayexalate |
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effect of low Mg
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makes low Ca hard to treat
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relationship between Mg and K
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they go down together
M and Kecilia |
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increased Mg
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usually renal failure
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effect of Mg on EKG
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decreased Mg prolongs QT
flattens T torsades |
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anti Mg tx
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calciumgluconate
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anti K tx
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IV calcium
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effect of hyperphosphatemia
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soft tissue calcifications when [Ca]x[Ph]>70
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soft tissue calcifications
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hyperphosphatemia
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effect of acidosis on CNS
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depresses
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effect of alkalosis on CNS
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decreases blood flow
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nl anion gap
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8-15
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kussmaul breathing
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metabolic acidosis
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winter's formula
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expected PaCo2 = 1.5[HCO2]+8 +-2
this tells us the expected respiratory compensation to metabolic acidosis |
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causes of proximal tubular acidosis
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MM
cystinosis Wilson's disease (all feature decreased bicarb reabsorb) |
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causes of distal tubular acidosis
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SLE
Sjogrens Amphotericin B (can't make bicarb) |
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causes of normal AG acidosis
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renal or Gi losses of bicarb
- PTA - DTA - Acetazolamide - Diarrhea - Pancreatic fistulas - small bowel fistulas - ureterosigmoidostomy |
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causes of metabolic alkalosis
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with ECF contraction:
- vomit, NG suction, diuretics, villous adenoma with ECF expansion, HTN - hyperaldo, Cushings, Severe hypoK, Barrters, Diuretic abuse |
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tx for volume contraction alkalosis
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Na and K
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tx for volume expansion alkalosis
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spironolactone
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how many days for renal compensation in respiratory acidosis
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5 days
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headache
confusion papilledema |
acute CO2 retention
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in acute respiratory acidosis how much does bicarb increase with PaCO2
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1 for every 10
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in chronic respiratory acidosis how much does bicarb increase with PaCO2
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4 for every ten
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in acute respiratory alkalosis how much does bicarb decrease with decrease in PaCO2?
in chronic? |
2 for every 10
5-6 for every 10 in chronic |
