Acute & Critical Care Medicine (NAPLEX) Exam Questions & Answers, rated A+

Acute & Critical Care Medicine (NAPLEX) Exam Questions & Answers, rated A+ IV fluids are characterized as... - -crystalloids or colloids What are crystalloids? - -Solutions containing fluids and electrolytes that are normally found in the body Crystalloids - the volume doesn't remain in the intravascular space (inside the blood vessels), but moves.... - -into the extravascular space or interstitial space Colloids are ____ _____ (typically proteins or starch) and primarily remain in the intravascular space and increase oncotic pressure - -large molecules What are the most common agents used for volume resuscitation in stock states? - -Lactated ringers and normal saline What products are crystalloids? - -D5W (all dextrose volumes) Normal saline Lactated ringers Multiple electrolytes (Plasma-Lyte A, others) What products are colloids? - -Albumin (all strengths) Dextran Hydroxyethyl starch (Hespan, Hextend) Albumin is useful in what patient? - -a patient with significant edema (i.e. cirrhosis) Hydroxyethyl starch use is limited due to what? - -its boxed warning to avoid use in critically ill patients (including sepsis) due to mortality and renal injury At what level of hyponatremia does the symptoms start? - -when the sodium reaches 120 mEq/L How do you treat hypovolemic hyponatremia? - -administered sodium chloride IV solutions How do you treat hypervolemic hyponatremia? - -diuresis with fluid restriction What drugs are Arginine Vasopressin (AVP) receptor antagonists? - -conivaptan or tolvaptan What are conivaptan or tolvaptan used for? - -to treat SIADH and hypervolemic hyponatremia by increasing the excretion of free water while maintaining sodium How quickly can you fix hyponatremia? - -you cannot go more rapidly than 12 mEq/L over 24 hours What happens if you try to fix hyponatremia too quickly? - -osmotic demyelination syndrome (ODS) or central pontine myelinolysis, which causes paralysis, seizures and death Tolvaptan (Samsca) is limited to 30 days due to what? - -hepatotoxicity What are the side effects of Tolvaptan (Samsca)? - -thirst, nausea, dry mouth, and polyuria Hypernatremia (Na 145 mEq/L) is associated with what? - -water deficit and hypertonicity How do you treat hypokalemia (K3.5)? - -by fixing the underlying causes (i.e metabolic alkalosis, overdiuresis, amp B, or insulin) and giving oral or IV potassium A drop of 1 mEq/L in serum K below 3.5 mEq/L equals? - -a total body deficit of 100-400 mEq What is the maximum infusion rate and maximum concentration that you can give IV potassium replacement through a peripheral line? - -10 mEq/hr and 10 mEq/100 mL IV potassium can be fatal if administered - -undiluted or IV push When hypokalemia is resistant to treatment, what should be checked? - -magnesium because its necessary for potassium uptake What form of magnesium is recommended for