RAB 2.5.25.Nephrology II

Electrolytes

100

Treatment of symptomatic isovolemic hypotonic hyponatremia

100-mL bolus of 3% saline

200

Therapeutic goal for chronic isovolemic hypotonic hyponatremia is an increase in serum sodium by (#) to (#) mEq/L in a 24 hour period

4-6 mEq/L

 ( not to exceed 8.0 mEq/L in 24 hours)

300

Replacement fluid for hypernatremia due to intravascular volume depletion

Isotonic saline

(otherwise, a hypotonic solution (half [0.45%] normal saline) can be used)

400

Antagonizes the effects of hyperkalemia on the cardiac membrane

Intravenous administration of calcium gluconate

500

ECG manifestations of hypokalemia

ST-segment depression, decreased T-wave amplitude, and increased U-wave amplitude.

Acid-Base I

100

Disorder defined by low serum bicarbonate

Primary metabolic acidosis

200

Most common cause of increased anion gap metabolic acidosis

Lactic acidosis

300

Serum Anion Gap (formula and assessment) 

If Metabolic acidosis (unmeasured organic anion)

Anion Gap = Serum Sodium (mEq/L) − (Serum Chloride [mEq/L] + Serum Bicarbonate [mEq/L]) )

400

Delta-delta (Δ-Δ) ratio of <0.5 to 1  

Indicates the presence of (General Disorder)

Presence of an increased anion gap metabolic acidosis

500

Renal tubular acidosis(type), impaired distal hydrogen ion excretion causes citrate reabsorption and increases the risk for nephrocalcinosis

In type 1 (hypokalemic distal)

Acid Base II

100

Acid Base disorder: decrease in PCO2, an increase in pH, and a slight decrease in bicarbonate

Respiratory alkalosis  

200

Most common causes of metabolic alkalosis (3)

vomiting, nasogastric suction, and diuretic use

(low urine chloride and chloride depletion)

300

Acid-base disorder with hypertension, hypokalemia, euvolemia, and an elevated urine chloride

(Type and *cause)

Metabolic alkalosis from mineralocorticoid excess

400

 Expected Compensation:

Acute and Chronic Respiratory acidosis ( [mEq/L] change in HCO3 - for each 10 mm Hg ↑ in PaCO2 )

Acute: 1 mEq/L ↑ in [HCO3–] for each 10 mm Hg ↑ in arterial PCO2

Chronic: 3.5 mEq/L ↑ in [HCO3–] for each 10 mm Hg ↑ in arterial PCO2

500

Expected Compensation:  

Acute and Chronic Respiratory alkalosis ( [mEq/L] change in HCO3 - for each 10 mm Hg ↓  in PaCO2 )

Acute: 2 mEq/L ↓ in [HCO3–] for each 10 mm Hg ↓ in arterial PCO2

Chronic: 4-5 mEq/L ↓ in [HCO3–] for each 10 mm Hg ↓ in arterial PCO2

Toxic and Basic

100

Alkalemia is defined as a pH >7.44. 

Metabolic alkalosis = [HCO3] >[***]mEq/L. Respiratory alkalosis = arterial PCO2 <[***] mm Hg.

Metabolic alkalosis = [HCO3] >26 mEq/L. Respiratory alkalosis = arterial PCO2 <36 mm Hg.

200

Salicylate intoxication presents in its early phase

Respiratory alkalosis and an increased anion gap metabolic acidosis

300

Expected Compensation: Expected change in PaC02 for Acute Metabolic acidosis

 Metabolic acidosis Acute:

 Δ arterial PCO2 = (1.5)[HCO3–] + 8 ± 2

 _{alkalosis: 0.7 mm Hg ↑ in  PaCO2 for each 1 mEq/L ↑ in [HCO3–]}

400

Anion Gap and Osmolar gap (alcohol) 

Methanol

Ethylene glycol

(Possible AG) Ethanol

500

Non-Anion Gap and Osmolar gap (alcohol) 

Isopropyl Alcohol

FUN: I tried to tell a joke about chemistry but there was no reaction.

100

Name the Artist:

Lyrics: "All about that bass, 'bout that bass, no treble."

Meghan Trainor

200

Name the Artist: 

Song Lyrics: "Pump up the bass! Pump up the bass!" – Clue a 1988 hit from this electronic music act.

Technotronic

300

Name the Artist:

Song Lyrics: "With a taste of your lips, I’m on a ride. You're toxic..."

Britney Spears

400

 Before modern dialysis, doctors used this time-intensive, laborious procedure—essentially an early peritoneal dialysis technique—to remove toxins from patients in renal failure.

Leech Therapy or Peritoneal Lavage

500

This children’s science show host, played by Bob Newhart, was a childhood hero to Sheldon Cooper and made multiple appearances as a ghostly mentor.

Professor Proton