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5 Written questions

5 Matching questions

  1. Hypervolemic Hypernatremia is caused by what?
  2. Treatment of Diabetes Insipidus, Nephrogenic DI is done by giving what?
  3. ratio of water to Na+, are related to what abnormality?
  4. Isovolemic Hypernatremia can cause Diabetes Insipidus Centrally, how?
  5. what is the treatment goal when Hypovolemic Hypotonic Hyponatremia is being treated?
  1. a -Na+ gain > Water gain
    -Iatrogenic = if give the patient a Na+ overload, its medically induced over infusion
    -Hyperaldosteronism = conserves Na+ = conns syndrome
  2. b -avoid increase in serum Na+ > 12 mEq/L in 24 hrs, because patient already has low tonicity, water will start to move outside the cells and cells will shrink, major effect is in the brain:
    -Osmotic demyelination syndrome= altered mental status, seizures, permanent brain damage
  3. c -Correct hypercalcemia and hypokalemia
    -Create mild ECFVd with thiazide diuretic and dietary Na+ restriction ↓ urine volume
    -Indomethacin 50 mg po tid (increase sensitivity to ADH)
    -Amiloride 5 - 10 mg po daily (lithium induced DI, antagonizes Li effects on kidney tubules)
  4. d -Head trauma
    -CNS malignancy
  5. e -ECF sodium concentration (hypernatremia vs. hyponatremia) are due to problems with water control mechanisms

5 Multiple choice questions

  1. -Administer 0.9% NaCl at 200 - 400 ml/h until symptoms of hypovolemia improve, then lower to 100 - 150 ml/h (calculate volume deficit)
    -No greater than 12 mEq/L/day increase in serum Na+
    -Monitor serum Na+ q2-4h, signs of hypovolemia, volume overload
  2. -Tubular unresponsiveness to ADH --> renal concentrating defect --> excessive renal losses of water -->hypernatremia
  3. 513mEq
  4. -Cases of abnormal ECFV size (hypervolemia vs. hypovolemia) are due to problems with the sodium control mechanism
  5. -Packed red blood cells, albumin 5%, albumin 25%, dextrans and hetastarch
    -Saved for certain things, typical hydration correction is done before colloids are initiated, more expensive only used with a compelling indication

5 True/False questions

  1. what is normal solute concentration?- (275 - 290 mOsm/kg)


  2. Hypovolemic Hypotonic Hyponatremia is caused by what?-Na+ gain > Water gain
    -Iatrogenic = if give the patient a Na+ overload, its medically induced over infusion
    -Hyperaldosteronism = conserves Na+ = conns syndrome


  3. Treatment of Hypovolemic Hypernatremia is done by treating how?-Initial: 200 - 300 ml/h of 0.9% NaCl until stable, regardless of what Na+ is (posterial hypotension).
    -Water deficit = Present TBW x [(SNa / 140) - 1] (140 is the goal) O-5 - 1.0 mEq/L/hr, no > 10 mEq/L/day, because tonicity outside the cells is less and water would move inside the cells and they can swell and cause edema (make sure Na is corrected b/f correct! 1.7)


  4. Interstitial fluid volume = in between cells?2/3 TBW


  5. tonicity can be defined as?-more solutes inside cells and less outside-more water outside and cell lysis-cerebral edema


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