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5 Written Questions

5 Matching Questions

  1. hypotonic, can be defined as?
  2. Nephrogenic diabetes insipidus (have ADH, but no kidney response) can be caused by?
  3. what is normal solute concentration?
  4. tonicity can be defined as?
  5. a Crystalloids can be defined as?
  1. a -Fluids that contain water, dextrose, Na, Cl and other electrolytes
    -0.9% NaCl (or normal saline [NS]), 0.45%NS, lactated ringer, Dextrose 5% Water (D5W)
  2. b -more solutes inside cells and less outside-more water outside and cell lysis-cerebral edema
  3. c - (275 - 290 mOsm/kg)
  4. d -Tubular unresponsiveness to ADH --> renal concentrating defect --> excessive renal losses of water -->hypernatremia
  5. e -Ability of combined effect of all solutes to generate osmotic driving force that causes H2O movement from one compartment to another (if osmolality is high in EC-compartment, compared to what's inside cells, will be hypertonic)

5 Multiple Choice Questions

  1. 3/4 ECFV
  2. 1/4 ECFV
  3. -Head trauma
    -CNS malignancy
  4. -Cases of abnormal ECFV size (hypervolemia vs. hypovolemia) are due to problems with the sodium control mechanism
  5. -ECF sodium concentration (hypernatremia vs. hyponatremia) are due to problems with water control mechanisms

5 True/False Questions

  1. Signs and symptoms of hypernatremia include?-seizures, coma, permanent brain damage, respiratory arrest, brain herniation, death (severe <115)

          

  2. Syndrome of inappropriate ADH release (SIADH) can be defined as?-Nonosmotic ADH release leading to water retention & hyponatremia (go down because hanging on to more water diluting [Na+]
    -Hanging on to more water than Na+, serum Na goes down!

          

  3. Non-Emergent Hypervolemic Hypotonic Hyponatremia is treated how?-3% NaCl (preferred, only in severely symptomatic patients)
    -Goal: serum Na+ > 120 mEq/L; No greater than 12 mEq/day increase in serum Na+

          

  4. Intracellular fluid volume (ICFV = inside cells)?2/3 TBW

          

  5. what are potential causes of Euvolemic Hypotonic Hyponatremia?-SIADH (UOsm > 100 mOsm/kg) = [ADH] is high, and hang on to water and this dilutes Na+
    -Diseases: Tumors, CNS disorders, pulmonary disease
    Medications: desmopressin = vasopressin analog, carbamazepine, cyclophosphamide, SSRI's, TCA's, NSAIDs, "ecstasy"

          

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