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127 Cards in this Set
- Front
- Back
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TBW (total body water) is how much of BW?
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60%
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How much is ICF
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40%
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How much is ECF
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20%
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How much is interstitial fluid
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15%
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how much is plasma
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5%
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Posm eqn?
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2(serum Na) + serum glucose/18 + BUN/2.8
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Eosm eqn?
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Same but drop urea portion
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In osmosis, H2O moves
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low to high
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Serum Na x TBW approximately equals
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TBNa
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Dec TBNa produces signs of
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volume depletion
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Inc wt in pt in hosp
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Inc TBNa
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Isotonic loss: fx on TBNa, TBW
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both dec
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Examples?
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Loss whole blood, secretory diarrhea
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Isotonic gain: fx on TBNa, TBW
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both inc
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Examples?
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Xs saline infusion
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Hypertonic loss: fx on TBNa, TBW
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TBNa dec more so than TBW
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Examples?
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loop diuretic, Addison's, 21-hydroxylase def
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Hypertonic gain: fx on TBNa, TBW
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TBNa inc more so than TBW
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Examples?
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Xs NaHCO3, infusion with Na containing Abx
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Hypotonic loss: fx on TBNa, TBW
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TBW dec more so than TBNa
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Examples?
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Osmotic diuresis, sweating, DI
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Hypotonic gain: fx on TBNa, TBW
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TBW inc more so than TBNa
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Examples?
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SIADH
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How does Na resorption match CO?
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dec EABV -> inc FF -> P < p
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Why can acetazolamide cause proximal RTA?
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HCO3 is excreted with Na -> metabolic acidosis
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Mech of heavy metal poisoning causing Fanconi's syndrome?
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Coag necrosis of PCT
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Water proximal to Na/K/2Cl is
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obligated
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ADH can only resorb
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free water (free of electrolytes)
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What generates free H2O
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Na/K/2Cl
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Blocked by?
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Loop diuretic
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Thiazide block?
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Na/Cl in early DT
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Hypokalemia inc risk for which pH disturbance?
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metabolic alkalosis
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Bartter's syndrome is a defect in
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Cl reabsorption in Na/K/2Cl
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Fx on BP?
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Normotensive
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Why?
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PG vasodilation of arterioles
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Other fx? 4
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hypokalemia, metabolic alkalosis, inc aldosterone, inc renin
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Tx?
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K-sparing diuretic; NSAID
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Uosm in late DT/CD is approximately
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150 mOsm
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free water clearance eqn?
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CH2O = V - Cosm
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Cosm =
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UOSm x V/Posm
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Positive value indicate
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free water loss > obligated -> dilution -> absent ADH
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most common cause of SIADH
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Small cell lung CA
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Complication?
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Cerebral edema -> MS change
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Tx?
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Restrict H2O
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Difference b/t central and nephrogenic DI?
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Central lacks ADH; nephrogenic is refractoriness
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Sx? 2
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Inc thirst; polyuria
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Tx?
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CDI - desmopressin; NDI - thiazides
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most common cause of hypokalemia
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loop and thiazide diuretics
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hypokalemia change on EKG
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U wave
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Fx of insulin on serum K?
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hypokalemia
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Fx of b2 agonist on serum K?
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hypokalemia
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Fx of digitalis on serum K?
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hyperkalemia
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Fx of b-blocker on serum K?
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hyperkalemia
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Fx of succinylcholine on serum K?
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hyperkalemia
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Most common cause of hyperkalemia
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renal failure
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What pseudohyperkalemia?
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RBC hemolysis from difficult venipuncture
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hyperkalemia change on EK
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peaked T waves
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Most common cause resp acidosis
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Chronic bronchitis
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Definition of resp acidosis
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PCO2 > 45
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Expected HCO3 compensation (DHCO3) in acute resp acidosis
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0.1 x DPCO2
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Expected HCO3 compensation (DHCO3) in chronic resp acidosis
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0.4 x DPCO2
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If compensations are not met, it suggest
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multiple disorders
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Most common cause resp alkalosis
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Anxiety
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Definition of resp alkalosis
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PCO2 < 33
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Expected HCO3 compensation (DHCO3) in acute resp alkalosis
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0.2 x DPCO2
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Expected HCO3 compensation (DHCO3) in chronic resp alkalosis
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0.5 x DPCO2
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Tetany commonly causes acute resp
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alkalosis
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Definition of metabolic acidosis
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HCO2 < 22
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Expected PCO2 compensation (DPCO2) in metabolic acidosis
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1.2 x DHCO3 +/- 2
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AG eqn?
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Na - (Cl + HCO3)
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What is a norm AG?
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12 mEq
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Inc AG metabolic acidosis patho
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xs H+ is being buffered by HCO3 -> dec HCO3 -> inc gap
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Most common inc AG met acidosis
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lactic acidosis (ex/ anaerobic glycosis in shock)
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Norm AG met acidosis patho
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Cl inc to balance looss of HCO3 anions when HCO3 is being lost
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Most common cause met alkalosis
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Loop & thiazide diuretic
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Definition of metabolic alkalosis
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> 28
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Expected PCO2 compensation (DPCO2) in metabolic alkalosis
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0.7 x DHCO3 +/- 2
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2 clues for mixed d/o
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norm pH; extreme change in pH
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What defines what is the primary disorder and what is the compensation?
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pH
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Give the fx of the following situations:
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69, 71, 72
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ALS
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resp acidosis
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Anxiety
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resp alkalosis
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Asbestosis
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resp alkalosis
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Barbituates
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resp acidosis (depressed CNS center)
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CF
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resp acidosis
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cholestyramine
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norm AG metabolic acidosis
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Chronic bronchitis
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resp acidosis
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Croup
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resp acidosis (obstruction)
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diarrhea
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norm AG metabolic acidosis
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drainign of bile or panc secretions
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norm AG metabolic acidosis
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ethylene glycol
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inc AG metabolic acidosis
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Guillain-Barre
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resp acidosis
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High alt
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resp alkalosis
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hyperventilation from pain
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resp alkalosis
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hypokalemia
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resp acidosis
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hypophosphatemia (dec ATP)
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resp acidosis
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ketoacidosis
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inc AG metabolic acidosis
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lactic acidosis
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inc AG metabolic acidosis
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loop diuretics
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metabolic alkalosis
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methyl alcohol
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inc AG metabolic acidosis
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Mild asthma
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resp alkalosis
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Mineralocorticoid excess
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metabolic alkalosis
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Norm preg
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resp alkalosis
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PE
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resp alkalosis
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Phrenic nerve injury
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resp acidosis
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poliomyelitis
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resp acidosis
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renal failure
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inc AG metabolic acidosis
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Salicylate poisoning 2
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resp alkalosis, inc AG met acidosis
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Sarcoidosis
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resp alkalosis
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Shock
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resp alkalosis
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thiazides
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metabolic alkalosis
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Type 1 RTA
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norm AG metabolic acidosis
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Type 2 RTA
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norm AG metabolic acidosis
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Type 4 RTA
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norm AG metabolic acidosis
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Vomiting
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metabolic alkalosis
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Transudate v. exudate?
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Exudate > 3g/dL & cell rich
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Pitting edema is an example of
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transudative edema
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2 causes pitting edema
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RHF (inc hydrostatic pressure); Cirrhosis (dec oncotic pressure)
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Myxedema is
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xs hyaluronic acid in interstitial tissue
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Signs of amniotic fluid embolism: 3
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abrupt dyspnea, hypotension, bleeding (DIC)
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Mech of decompression sickness
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N2 gas bubble occlude vessel lumen
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3 other complications of scuba diving
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PTX, PE, asceptic necrosis in bones
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Best indicator of tissue hypoxia
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MVO2
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Most common cause hypovolemic shock
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hemorrhage
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Most common cause cardiogenic shock
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MI
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Most common cause septic shock
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E. coli
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What is the anomalies of septic shock?
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Pt is warm, red, and has inc MVO2
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