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5 Written questions

5 Matching questions

  1. if the Osmolal gap (OSM GAP) = OSM(measured) - OSM (calculated), is greater than 10 what does this indicate?
  2. when treating Hypovolemic Hypotonic Hyponatremia with Diuretics, what has to be considered?
  3. Serum sodium concentration [Na+] is indicative of the amount of water relative to sodium. T/F?
  4. Treatment of Diabetes Insipidus, Nephrogenic DI is done by giving what?
  5. ratio of water to Na+, are related to what abnormality?
  1. a -there are substances in the blood that aren't being measured, there are exogenous compounds that aren't in the equation (Mannitol=hyperosmolol diuretic, sorbitol=induce diarrhea, ethanol, methanol=blindness cheap alcohol, ethylene glycol=antifreeze poisoning)
  2. b -ECF sodium concentration (hypernatremia vs. hyponatremia) are due to problems with water control mechanisms
  3. c -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
  4. d -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)
  5. e -Loop diuretics: proportional loss of Na+ and water (don't become hyponatremic!)
    -Thiazides: more Na+ loss than water (high chance of having a low serum Na)

5 Multiple choice questions

  1. 513mEq
  2. -Tubular unresponsiveness to ADH --> renal concentrating defect --> excessive renal losses of water -->hypernatremia
  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. 3/4 ECFV
  5. -Head trauma
    -CNS malignancy

5 True/False questions

  1. hypotonic, can be defined as?-solutes outside-more water inside cells and cells shrink-brain can shrink and cause damage

          

  2. IVNa = sodium concentration of infusate 0.9% is how much mEq?154mEq

          

  3. what are the two Vasopressin Antagonists (last line) used to TX?-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"

          

  4. the Main solutes of ECFV are?-Na+, glucose and urea

          

  5. Hypervolemic Hypernatremia is caused by what?-Water loss > Na+ loss
    -Insensible water loss in patients deprived of water, fever, mechanical ventilation, Diarrhea, vomiting,
    -Osmotic diuresis = have high serum glucose pulls water with it