Patho Acid-Base & Electrolytes

Front 1

If you see a high ion gap, what does that mean?

Back 1

You have an abnormal acid in the body that needs to be discovered

Front 2

Normal pH range

Back 2

7.35 - 7.45

Front 3

Normal PaCO2 range

Back 3

35-45 mmHg

Front 4

Normal HCO3 range

Back 4

22-26 mEq/L

Front 5

What fraction of your total body fluids are inside the cells

Back 5

2/3

Front 6

What fraction of your total body fluids are outside the cells

Back 6

1/3

Front 7

Most of your extra-cellular fluid is found where

Back 7

Interstitial spaces around the cells

Front 8

If someone is given 100mL of isotonic saline, how much of it will go into their cells?

Back 8

None

Front 9

In someone with a saline deficit, their serum Na+ would be __________

Back 9

normal

Front 10

Is Ringer's lactate hypotonic, isotonic, or hypertonic?

Back 10

isotonic

Front 11

Does glucose in a solution affect the osmolality?

Back 11

Functionally, no. In the body it gets taken up and doesn't stay an osmol for long. D5W is basically the same osmolality as water.

Front 12

Someone with a saline excess will have ________ serum Na+

Back 12

normal

Front 13

Lowering serum osmolality will result in the cells __________

Back 13

filling with more fluid; expanding

Front 14

Someone with hypernatremia will have _________ serum Na+

Back 14

elevated

Front 15

Hypernatremia will result in the cells _________

Back 15

shrinking

Front 16

Treatment for someone with hypernatremia

Back 16

Hypotonic fluids

• Water
• D5W
• Half or quarter NS

Front 17

Can water be given by IV? Can D5W? Why?

Back 17

Water shouldn't be given by IV. It is hypotonic and can lyse the initial cells it comes into contact with. The sugar in D5W makes it less harsh and allows it to not harm the cells while it disperses.

Front 18

If you give 90mL of water, how much of it will go into the cells?

Back 18

60mL

Front 19

If you give 100mL of saline, how much of it will stay in the extracellular compartment?

Back 19

All 100mL

Front 20

Treatments for hyponatremia

Back 20

• Restrict free water
• Maybe diuretics
• Maybe hypertonic saline (3%)

Front 21

Chronic diarrhea can put you at risk for

Back 21

hypernatremia

Front 22

Crystalloids vs Colloids

Back 22

Crystalloids

• Do not contain proteins
• Fluid and electrolytes

Colloids

• Contain proteins
• Increase serum osmotic (oncotic) pressure (pull fluid from the interstitium into the bloodstream)

Front 23

Ca++ ions in the bloodstream can be free ions or

Back 23

bound to albumin

Front 24

Normal serum potassium level

Back 24

3.5 - 5.0 mEq/L

Front 25

Steve has renal problems and likes eating a lot of fruit. What problem might he experience from this?

Back 25

Hyperkalemia. Fruit generally has lots of potassium, and with renal failure the body may be unable to clear all of it.

Front 26

A lab for your patient comes back showing that they have elevated serum calcium. What do you think of that?

Back 26

Cancer until proven otherwise

Front 27

Manifestations of hypercalcemia

Back 27

• decreased neuromuscular excitability
• weakness
• CNS depression

Front 28

What effects do hypermagnesemia and hypercalcemia have on muscles?

Back 28

They raise the threshold; it's harder for muscle fibers to reach action potential. This is because the ions hug around the cell membrane and block the fast sodium channels.

Front 29

Who is at risk for developing hyperphosphatemia

Back 29

People with renal failure

Front 30

Muscular symptoms of hyperkalemia

Back 30

Weakness, poor muscle tone

Front 31

Muscular symptoms of hypokalemia

Back 31

Weakness, poor muscle tone

Front 32

Muscular symptoms of hypercalcemia

Back 32

Weakness, poor muscle tone

Front 33

Muscular symptoms of hypermagnesemia

Back 33

Weakness, poor muscle tone

Front 34

Muscular symptoms of hypocalcemia

Back 34

Twitchy, crampy muscles

Front 35

Muscular symptoms of hypomagnesemia

Back 35

Twitchy, crampy muscles

Front 36

The kidneys are required to activate _________ so it can be used

Back 36

Vitamin D

Front 37

Normal range for serum creatinine

Back 37

0.5 - 1.5 mg/dL

Front 38

Normal range for serum BUN

Back 38

10-20 mg/dL

Front 39

Serum _________ level will change slower than serum _________ level, but it is a more reliable indicator of kidney function

Back 39

creatinine, BUN

Front 40

Which is a more reliable indicator of kidney function, creatinine or BUN?

Back 40

creatinine

Front 41

Which has serum levels that change faster, creatinine or BUN?

Back 41

BUN

Front 42

BUN can rapidly rise if a person is becoming

Back 42

hypovolemic

Front 43

Should there be any protein in urine?

Back 43

No

Front 44

Should there be any ketones in urine?

Back 44

No

Front 45

__________ in the urine is an indication of a UTI

Back 45

nitrites

Front 46

In a urinalysis, WBCs are present and noted to be entangled with casts. This indicates what?

Back 46

That the WBCs crossed in the kidney tubules, not lower in the collecting system. Upper UTI.

Front 47

Causes of hematuria

Back 47

• Cystitis - inflammation of bladder.
• Neoplasm
• Stones
• Glomerulonephritis

Front 48

Unexplained hematuria (not cytitis, not nephritis, etc), what do you make of it?

Back 48

Cancer until proven otherwise homie

Front 49

What increase in serum creatinine level can you expect to see per day with acute renal failure? (in other words, how much Cr is your body producing per day that will accumulate?)

Back 49

1 to 1.5 mg/dL per day

Front 50

Normal range for BUN:Creatinine ratio

Back 50

10:1 - 20:1