ABSITE FEN

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Author:
RCulwell
ID:
61476
Filename:
ABSITE FEN
Updated:
2011-01-23 16:01:10
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ABSITE FEN fluid electrolytes nutrition Swedish
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ABSITE Questions based on Fiser
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  1. Organize the following in order of HIGHEST total body water to LOWEST: woman, baby, man, body builder, fat woman
    • Muscle and babies have a lot of water, fat doesnt:
    • 1. Baby
    • 2. Body builder
    • 3. Woman
    • 4. Fat woman
  2. Roughly, what percentage of body weight is water?
    66% (2/3)
  3. First sign of volume overload?
    Weight gain
  4. Composition of normal saline (in mEq of Na and Cl)
    • Na 154 mEq
    • Cl 154 mEq
  5. Composition of LR (name all 5 electrolytes and their mEq in 1 L)
    • Similar to body fluid composition (except for Ca)
    • Na 130 mEq
    • K 4 mEq
    • Ca 3 mEq
    • Cl 109 mEq
    • lactate/HCO3 28 mEq
  6. What happens to the lactate in LR once it is infused?
    Turns into lactate.
  7. Formula for plasma osmolarity and the normal values
    • (2xNa) + (glucose/18) + (BUN/2.8)
    • 280-295
  8. Amount of fluid loss in an open operation:
    ~1 L per hour
  9. What are insensible fluid losses for an average person (in cc/kg/day)? What is the composition of these fluid losses?
    10 cc/kg/day all free water
  10. GI fluid secretion (in L/day):
    Stomach:
    Biliary:
    Pancreas:
    Duodenum:
    • Stomach: 1-2 L/d
    • Biliary: .5-1 L/d
    • Pancreas: .5-1 L/d
    • Duodenum: .5-1 L/d
  11. Daily Na+ requirement:
    Daily K+ requirement:
    • Daily Na+ requirement: 2 mEq/kg/d
    • Daily K+ requirement: 1 mEq/kg/d
  12. Acronym for treatment of hyperkalemia:
    • DC BIG K
    • Dialysis if refractory to the following:
    • Calcium
    • Bicarb
    • Insulin with Glucoe
    • Kayexalate
  13. Maximum rate at which you can correct hyponatremia?
    1 mEq/hr
  14. Formula for TBW:
    TBW = 0.6 x weight in Kg (duh!)
  15. What is pseudohyponatremia? What are 2 causes?
    • pseudohyponatremia results when excessive osmoles interfere with testing of serum Na concentration. Two causes:
    • 1 - Hyperglycemia (i.e. DKA)
    • 2 - Hyperlipidemia (as in pancreatitis)
  16. Formula for FeNa?
    • Pee nacr over blood nacr:
    • (urine na/ urine cr)/(serum na/serum cr)
  17. How many grams of dextrose in D10W? How many Kcal?
    D10 = 10 g/100 cc = 100 g/liter

    100 g x 3.4 kcal/g = 340 kcal in 1 liter D10W
  18. Effect of loop diuretics on CALCIUM:
    Effect of thiazide diuretics on CALCIUM:
    • Loops Lower Ca
    • ↑hiazides increase Ca
  19. Treatment of hypercalcemia:
    • NS at ~200 cc/h (patients are volume down)
    • Lasix (loops lower!)
  20. Acronym for treatment of hypercalcemia caused by malignancy:
    • D/C M Ad calcium:
    • -Dialysis if the folowing don't work:
    • -Calcitonin
    • -Mithramycin
    • -AlDaronic acid
  21. Treatment of hypocalcemia:
    Replace magnesium, calcium
  22. Most common malignancy to cause hypercalcemia:
    breast cancer
  23. Anion Gap formula:
    AG = Na - (HCO3- + Cl-)
  24. Causes of anion gap acidosis (acronym)
    • MUD PILES
    • Methanol
    • Uremia
    • DKA

    • Paraldehydes
    • INH
    • Lactic acidosis
    • Ethylene glycol
    • Salicylates
  25. Typical, surgical cause of normal AG acidosis:
    • High output ileostomy: loss of Na/HCO3-
    • Also: Excessive ressucitation with NaCl
  26. Describe the metabolic derrangement seen with excessive NGT fluid losses (also seen in pyloric stenosis...) Explain why this occurs:
    • Hypochloremic, hypokalemic metabolic alkalosis:
    • Loss of HCl from GI causes alkalosis and low Cl-
    • Loss of volume>reabsorb Na instead of K>low K
    • Low K+>try to reabsorb K, excrete H+>paradoxical aciduria
  27. What is tumor lysis syndrome? What metabolic derrangement results? What is the treatment?
    • Tumor lysis>purines/pyrimidines> ↑ PO4-, ↑uric acid, ↓ Ca++. This can increase BUN/Cr, cause EKG changes.
    • Tx: bolus with NS, allopurinol (decreased uric acid), diuretics (↑hiazides!), alkalinize pee

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