Acid-base
In response to a metabolic acidosis, this compensatory mechanism will develop
What is respiratory alkalosis?
Cells will do this when exposed to a hypertonic solution
What is shrink?
The largest of the fluid compartments
What is the intracellular space?
This 4 year old has a right abdominal mass. The cancer you are concerned about is
What is Wilm's tumor?
Your patient has been vomiting frequently for 48 hours. This acid-base disorder might be associated with this scenario.
What is metabolic alkalosis?
(due to loss of acid from stomach)
Mr. N’s respiration is depressed due to narcotic use. This acid-base disorder may develop
What is respiratory acidosis?
EKG changes associated with hyperkalemia
What are peaked T waves?
P.S. Actually, the changes progress as the K gets higher, but these are the first sign, starting when K+ is about 7.
These symptoms are associated with severe hyponatremia
What are seizures, coma, and death?
This kidney cancer is associated with tobacco use, but most cases have unknown cause
What is renal cell carcinoma?
The primary intracellular cation
What is K+?
Terry has a high pCO2 and a high serum bicarb. His blood pH = 7.35 They have this acid-base disorder
What is respiratory acidosis with a compensatory metabolic alkalosis?
P.S. To find out if they have another acid/base disorder also, you must assess whether the respiratory problem is acute or chronic (from the history) and also figure out whether the compensation is as expected for the situation.
The direction of K+ ion shift during acidosis
What is out of the intracellular space toward the extracellular space?
P.S. And when the acidosis is corrected, the K+ goes right back into the cells. This is why we give K+ with IVF in ketoacidosis even if the K+ is in normal range. It will drop quickly!
The major oncotic protein in human plasma
What is albumin?
P.S. when you pee out most of your albumin, you will get edematous due to loss of oncotic pressure within the vasculature.
This congenital kidney malformation can be associated with other GU tract anomalies
What is horseshoe kidney?
What does it mean if the compensation expected for a primary acid base disorder is not as expected?
What is another acid-base disorder is likely present?
This is the treatment of DKA, in general terms
What are fluids, insulin, watch the electrolytes (especially K+)?
In response to acute severe hyponatremia, this might happen to brain cells
What is swell?
What symptoms are associated with mild hyponatremia?
What are headache, mild mental status changes, nausea/vomiting.
Serum Ca+ measurements should be mathematically corrected if this blood component is low
What is albumin?
Three hormones that regulate sodium and water balance
What are aldosterone, ADH, and ANP?
Your patient has Na 132, K=4.8, Cl=85, HCO3=11
ABG: pH 7.23, pCO2=22
This type of acid-base disorder
What is metabolic acidosis with an anion gap (AGMA)?
P.S. Remember that many of these are quite dangerous!
You give your patient one liter of NS. What compartment(s) will this fluid distribute in?
What is the extracellular compartment?
Also correct: What are the interstitial compartment and the intravascular compartment (or plasma)?
This is the rare time when you might use hypertonic (3%) saline.
What is severe hyponatremia with seizures or stupor/coma?
P.S. Otherwise, treating the hyponatremia rapidly is MORE DANGEROUS than the hyponatremia!
Ms L had septic shock with very low BP for 24 hours. Her BP is now stable, but she has a rising creatinine. Her urine shows epithelial cells and muddy brown casts. She probably has this disorder
What is acute tubular necrosis (ATN)?
5 systemic disorders associated with kidney disease
What are diabetes, hypertension, SLE (lupus), cirrhosis (hepato-renal syndrome), scleroderma
Also multiple myeloma, sickle cell, infections (TB, Strep, ++)