4-Fluid and Electrolyte
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Questions and Answers

What is the average daily water loss through urine for a 60kg male?

  • 850 mL to 1550 mL
  • 1250 mL to 2000 mL
  • 250 mL to 800 mL
  • 800 mL to 1750 mL (correct)

What is the normal osmolality range of extracellular fluid?

  • 310-335
  • 280-310 (correct)
  • 245-275
  • 155-185

How much is the daily insensible water loss for an average healthy male?

  • 700 mL
  • 500 mL
  • 800 mL
  • 600 mL (correct)

Which condition is likely to lead to an increased insensible water loss?

<p>Fever (C)</p> Signup and view all the answers

What is the range of stool water loss per day according to normal values?

<p>0-250 mL (B)</p> Signup and view all the answers

What is the median average water consumption recommended for a healthy person?

<p>2000 mL (C)</p> Signup and view all the answers

Which of the following is NOT a component of normal daily water loss?

<p>Bone metabolism (A)</p> Signup and view all the answers

What is the range of insensible water loss through skin and lungs in a day?

<p>600 mL to 800 mL (C)</p> Signup and view all the answers

What is the total body water for an average young adult female weighing 60kg, given that the percentage of body water is 50%?

<p>24 L (D)</p> Signup and view all the answers

If an average young adult male weighs 80kg and has a body water percentage of 60%, what is his total body water?

<p>48 L (B)</p> Signup and view all the answers

In terms of total body water, what percentage does an average young adult female and male respectively hold based on given data?

<p>50% for female and 60% for male (C)</p> Signup and view all the answers

In comparison to females, young adult males typically have what percentage of total body water?

<p>60% (A)</p> Signup and view all the answers

An average 1-year-old male has what typical body water percentage?

<p>60% (A)</p> Signup and view all the answers

What is a potential consequence when administering calcium to patients receiving digitalis?

<p>Digitalis toxicity (A)</p> Signup and view all the answers

Which condition requires immediate calcium administration to counteract the effects of hyperkalemia?

<p>ECG changes indicating cardiac distress (D)</p> Signup and view all the answers

In which scenario should dialysis be considered for treating hyperkalemia?

<p>After conservative measures have failed (A)</p> Signup and view all the answers

What are the appropriate potassium chloride (KCl) administration guidelines for a symptomatic patient?

<p>20 mEq IV every hour for 4 doses (B)</p> Signup and view all the answers

Which of the following conditions can lead to an endogenous load of potassium in the body?

<p>Hemolysis and rhabdomyolysis (B)</p> Signup and view all the answers

What percentage of total body weight does a newborn typically represent?

<p>80% (B)</p> Signup and view all the answers

How much of the total body water (TBW) for a 70kg male patient is intracellular fluid (ICF)?

<p>20L (D)</p> Signup and view all the answers

What is the total body water (TBW) of a significantly malnourished male patient weighing 50kg?

<p>35L (A)</p> Signup and view all the answers

What is the total body water of a 1-year-old male with a total body weight of 13kg?

<p>8.45L (C)</p> Signup and view all the answers

What percentage of total body weight does a 1-year-old male represent compared to adults?

<p>65% (D)</p> Signup and view all the answers

If a patient has a total body weight of 70kg and a total body water of 42L, what is the estimated interstitial fluid volume?

<p>17L (D)</p> Signup and view all the answers

For a male patient with 60% body water composition, what is the fat-free mass if the patient weighs 80kg?

<p>48L (A)</p> Signup and view all the answers

What is the total body water percentage for males younger than 2 years?

<p>65% (B)</p> Signup and view all the answers

What is the clinical manifestation associated with chronic volume deficits?

<p>Decreased skin turgor (B), Increased heart rate (C)</p> Signup and view all the answers

Which laboratory finding indicates reduced glomerular filtration?

<p>Elevated BUN level (A)</p> Signup and view all the answers

What could be a consequence of overly rapid correction of chronic hypernatremia?

<p>Cerebral edema (C)</p> Signup and view all the answers

Which fluid is commonly used for intravenous replacement in cases of hypernatremia?

<p>Half- or quarter-normal saline (B)</p> Signup and view all the answers

Which condition can cause hypernatremia related to excess fluid intake?

<p>Excessive intravenous fluids (D)</p> Signup and view all the answers

Which diuretics interfere with aldosterone activity and may inhibit normal potassium excretion?

<p>K-sparing diuretics (A)</p> Signup and view all the answers

What is the expected urine osmolality in the context described?

<p>300 mOsm/L (A)</p> Signup and view all the answers

Which of the following is NOT a consequence of burns as described?

<p>Enhanced urinary sodium excretion (B)</p> Signup and view all the answers

What is the primary goal in treating potassium abnormalities?

<p>Reduce total body potassium and shift it intracellularly (D)</p> Signup and view all the answers

What clinical symptom is typically associated with hypernatremia?

<p>Lethargy (A)</p> Signup and view all the answers

Which symptom is NOT associated with potassium abnormalities?

<p>Hearing loss (C)</p> Signup and view all the answers

What is a critical consequence of potassium being primarily in the intracellular space?

<p>It maintains cardiac and neuromuscular function (A)</p> Signup and view all the answers

Which of the following signs indicates fluid loss in the context of volume deficits?

<p>Sunken eyes (D)</p> Signup and view all the answers

What might indicate mineralocorticoid excess in a patient?

<p>Hypokalemia (B)</p> Signup and view all the answers

Which of the following ECG changes is early and indicative of potassium abnormalities?

<p>High peaked T waves (A)</p> Signup and view all the answers

What is a common dietary intake range of potassium per day?

<p>50-100 mEq/d (B)</p> Signup and view all the answers

Flashcards

Total Body Water (TBW)

The percentage of body weight that is composed of water.

TBW in Females

The average TBW for young adult females is 50% of their body weight.

TBW in Males

The average TBW for young adult males is 60% of their body weight.

Calculating TBW

Calculate the TBW by multiplying the body weight by the percentage of water for the individual's gender and age group.

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TBW in Infants

The TBW of an average 1-year-old male is around 65% of their body weight.

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Hyperkalemia

High potassium levels in the blood.

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Kayexalate

A medication used to treat hyperkalemia by removing potassium from the body through the intestines.

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Excessive potassium intake

Oral or intravenous potassium supplements can cause hyperkalemia if taken in excess.

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Endogenous potassium load

Conditions like hemolysis, rhabdomyolysis, and crush injuries can lead to hyperkalemia by releasing potassium from damaged cells.

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Calcium infusion for hyperkalemia

Calcium infusion can help counteract the harmful effects of hyperkalemia on the heart, but it should be administered cautiously in patients taking digoxin, as it might increase the risk of digoxin toxicity.

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Fluid Volume Excess (Hypervolemia)

A condition characterized by increased fluid volume in the body.

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Edema

The movement of fluid from the blood vessels into the surrounding tissues, leading to swelling.

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Fluid Volume Deficit

A condition where the body loses too much fluid, resulting in a decreased volume of circulating blood.

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Glomerular Filtration

A test that measures the ability of the kidneys to filter waste products from the blood.

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Urine Osmolality

A measure of the concentration of dissolved substances in urine.

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Urine Sodium

A test that measures the concentration of sodium in urine.

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Serum Osmolality

A measure of the concentration of dissolved substances in blood.

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Potassium's Importance

Potassium is essential for cardiac and neuromuscular function.

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Hyperkalemia Symptoms

Hyperkalemia can cause symptoms in the gastrointestinal, neuromuscular, and cardiovascular systems.

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Hyperkalemia ECG Changes

Signs of hyperkalemia on an ECG include high peaked T waves, widened QRS complex, flattened P wave, prolonged PR interval, sine wave formation, and ventricular fibrillation.

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Hyperkalemia Treatment

The goal of hyperkalemia treatment is to reduce total body potassium, shift potassium from the extracellular to the intracellular space, and protect cells from its effects.

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Hyperkalemia: Exogenous Potassium

Removing exogenous sources of potassium is an important step in treating hyperkalemia.

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Hyponatremia Correction

Rapid correction of hyponatremia can lead to serious complications like cerebral edema and herniation.

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Hyperkalemia: Medications

K sparing diuretics, ACE inhibitors, and NSAIDs can impair potassium excretion, potentially leading to hyperkalemia.

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Average Water Loss (Urine & Stool)

The average daily water loss through urine and stool for a 60kg male is between 800 mL and 1750 mL.

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Extracellular Fluid Osmolality

The normal osmolality of the extracellular fluid is between 280 and 310 mOsmol/kg.

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Insensible Water Loss

Insensible water loss refers to the water lost through evaporation from the skin and lungs. A healthy male typically loses around 600 mL per day.

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Increased Insensible Water Loss

Conditions such as fever and hyperventilation can increase insensible water loss.

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Fluid Gains & Losses

The body gains and loses most of its fluid directly through the extracellular compartment, which includes blood and lymph.

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Average Water Consumption

The average daily water consumption for a healthy person is 2000 mL.

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Hypothyroidism & Insensible Water Loss

Hypothyroidism is a condition characterized by decreased metabolic activity, which may lead to decreased insensible water loss.

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Hyperventilation & Insensible Water Loss

Hyperventilation is a condition where breathing is abnormally fast and deep, resulting in increased insensible water loss through evaporation.

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What is total body water (TBW)?

Total body water (TBW) is the amount of water contained within an organism. It is typically expressed as a percentage of total body weight, and it varies depending on age, gender, and body composition.

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What percentage of body weight is water in newborns?

In newborns, approximately 80% of their total body weight is composed of water.

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What percentage of body weight is water in one-year-olds?

In one-year-old children, the percentage of body water decreases to approximately 65% of their total body weight.

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What percentage of body weight is water in adults?

Adults typically maintain a total body water percentage of around 60% for males and 55% for females. This percentage remains relatively constant throughout adulthood.

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What is intracellular fluid (ICF)?

Intracellular fluid (ICF) refers to the fluid contained within cells. It represents approximately 40% of total body water in males.

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What is extracellular fluid (ECF)?

Extracellular fluid (ECF) refers to the fluid found outside of cells. It includes interstitial fluid (the fluid surrounding cells) and plasma (the fluid component of blood).

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What is the Gibbs-Donnan equilibrium?

The Gibbs-Donnan equilibrium describes the distribution of ions across a semipermeable membrane, such as the cell membrane, when there are non-diffusible charged molecules present. It explains the slightly higher protein content and cation composition in plasma compared to interstitial fluid.

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How does malnutrition affect total body water?

Malnutrition significantly impacts body composition, including total body water. Malnourished individuals typically have a higher percentage of body water than well-nourished individuals.

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Study Notes

Total Body Water

  • Water accounts for ~50-60% of total body weight.
  • The ratio of total body water to total body weight is stable and reflects body fat.
  • Lean tissue (muscle and solid organs) has a higher water content compared to fat and bone.
  • Younger, lean males have a higher proportion of water in their body weight than older or obese individuals.
  • Average young adult male: 60% of total body weight is water.
  • Average young adult female: 50% of total body weight is water.
  • Obese individuals have a lower percentage of total body water (~10-20% less than average).
  • Malnourished individuals have a higher percentage of total body water (~10% more than average).
  • Newborns have ~80% of their body weight as water.
  • Total body water decreases to ~65% by one year of age.

Fluid Compartments

  • Three main fluid compartments:
    • Extravascular interstitial fluid
    • Plasma
    • Intracellular fluid (primarily in skeletal muscle).
  • Extracellular water is ~20% of total body weight (approximately 1/3 of total body water).
  • Intracellular water is ~40% of total body weight (approximately 2/3 of total body water).
  • Skeletal muscle has the largest proportion of body fluid.

Fluid Composition

  • Extracellular fluid (ECF) components: primarily sodium (principal cation), chloride, and bicarbonate (principal anions).

  • Intracellular fluid (ICF) components: primarily potassium (principal cation), magnesium, phosphate, sulfate, and proteins (anions).

  • Sodium is primarily found in extracellular fluid.

  • Potassium is primarily found in intracellular fluid.

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4-Fluid and Electrolyte PDF

Description

Test your knowledge on the mechanisms and amounts of water loss in the human body, focusing on daily urine output, insensible water loss, and total body water calculations. This quiz covers essential physiological concepts and normal ranges related to hydration and water balance.

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