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5 Written questions

5 Matching questions

  1. a Colloids can be defined as?
  2. Serum sodium concentration [Na+] is indicative of the amount of water relative to sodium. T/F?
  3. Isovolemic Hypernatremia can cause Diabetes Insipidus Centrally, how?
  4. Syndrome of inappropriate ADH release (SIADH) can be defined as?
  5. Hypertonic, can be defined as?
  1. a -solutes outside-more water inside cells and cells shrink-brain can shrink and cause damage
  2. b -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
  3. c -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!
  4. d -Head trauma
    -CNS malignancy
  5. e -true, Total amount of sodium in ECF is major determinant of size of ECFV
    -Amount of Na+ in ECF (& ECFV size) determined by balance between Na+ intake and Na+ excretion by kidneys

5 Multiple choice questions

  1. -Uvol > 3 L/day, Uosm < 250 mOsm/kg = high urine volume and low osmolality
    -Response to Desmopressin determines if central or Nephrogenic
    -central-yes, DI (urine volume will go down)
    -nephrogenic-no, DI (urine volume remains high)-give thiazide instead!
  2. -more solutes inside cells and less outside-more water outside and cell lysis-cerebral edema
  3. -1.) Water restriction (< 1 to 1.2 L/day = from food and drinks)
    -NaCl tablets (1g tabs up to 9g/day)= increase Na load to kidney and forces the kidney to excrete Na and water
    -Demeclocycline 300 mg 2 - 4 times/day; antibiotic that antagonizes the Vasopressin receptors, allowing patients to increase peeing!
  4. -Cases of abnormal ECFV size (hypervolemia vs. hypovolemia) are due to problems with the sodium control mechanism
  5. 2/3 TBW

5 True/False questions

  1. Serum osmolality (calculated) (serum=blood in vessels) is calculated using what equation?1/4 ECFV

          

  2. Treatment of Diabetes Insipidus central is done by giving what?-Desmopressin (vasopressin analog)
    -Intranasal formulation preferred (DDAVP) 5 - 20 mcg intranasally q12-24h
    -Goal: 1.5 - 2 L/day urine volume = normal urine output

          

  3. how is Determining volume status done?- (275 - 290 mOsm/kg)

          

  4. IVNa = sodium concentration of infusate 3% is how much mEq?154mEq

          

  5. Isovolemic Hypernatremia can cause Diabetes Insipidus Nephrogenic (make ADH but kidneys arent responding to it), how?-Lithium toxicity
    -Hypercalcemia (reduce response to ADH and K+)
    -Hypokalemia
    -Demeclocycline (antagonizes ADH receptor, and can induce Isovolemic Hypernatremia, when trying to treat SIADH

          

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