5 Written questions
5 Matching questions
- a Colloids can be defined as?
- Serum sodium concentration [Na+] is indicative of the amount of water relative to sodium. T/F?
- Isovolemic Hypernatremia can cause Diabetes Insipidus Centrally, how?
- Syndrome of inappropriate ADH release (SIADH) can be defined as?
- Hypertonic, can be defined as?
- a -solutes outside-more water inside cells and cells shrink-brain can shrink and cause damage
- 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
- 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!
- d -Head trauma
- 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
- -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!
- -more solutes inside cells and less outside-more water outside and cell lysis-cerebral edema
- -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!
- -Cases of abnormal ECFV size (hypervolemia vs. hypovolemia) are due to problems with the sodium control mechanism
- 2/3 TBW
5 True/False questions
Serum osmolality (calculated) (serum=blood in vessels) is calculated using what equation? → 1/4 ECFV
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
how is Determining volume status done? → - (275 - 290 mOsm/kg)
IVNa = sodium concentration of infusate 3% is how much mEq? → 154mEq
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+)
-Demeclocycline (antagonizes ADH receptor, and can induce Isovolemic Hypernatremia, when trying to treat SIADH