Fluids/ Questions and case studies

Questions

 * 1) What is the proportion (in % of whole body weight) of intracellular fluid on average in a healthy adult?
 * 2) *A – 60
 * 3) *B – 40
 * 4) *C – 25
 * 5) *D – 15
 * 6) The physiological range of plasma osmolality is 275-295 mmol/kg. At what value of osmolality does antidiuretic hormone begin to be secreted?
 * 7) *A – 295 mmol/kg
 * 8) *B – 300 mmol/kg
 * 9) *C – 278 mmol/kg
 * 10) *D – 270 mmol/kg
 * 11) Which statements are incorrect?
 * 12) * A - Plasma Na+ concentration is not a measure of the body's Na+ content
 * 13) * B - The level of plasma Na+ reflects the state (content) of Na+ in the whole organism
 * 14) * C - Plasma Na+ concentration is a measure of the action of osmoregulatory mechanisms
 * 15) * D - In patients with central diabetes insipidus, there is no increase in urine osmolality / plasma osmolality ratio above 50% after ADH administration
 * 16) What are the causes of K+ deficiency in the body when vomiting gastric juice?
 * 17) * A - Extrarenal loss of K+, which is contained in a relatively high concentration in acidic gastric juice
 * 18) * B - Dehydration-induced K+ transfer from ECF to ICF
 * 19) * C - Decreased circulating volume with consequent increase in aldosterone secretion and renal urinary K+ loss
 * 20) * D - Alkalemia is accompanied by proportional hypokalemia
 * 1) * C - Decreased circulating volume with consequent increase in aldosterone secretion and renal urinary K+ loss
 * 2) * D - Alkalemia is accompanied by proportional hypokalemia

Patient in a diabetic coma
A 15-year-old girl is brought in a coma to the Department of Anesthesiology, Resuscitation and Intensive Medicine. She is a diabetic for 7 years, she takes insulin. She already had several bouts of hypoglycemia and ketoacidosis. She's been studying a lot for school lately and may have neglected some insulin injections.

Questions:
 * 1) What is the diagnosis?
 * 2) Calculate the anion gap (AG), what is the cause of high AG?
 * 3) What is the significance of the increased osmolality?
 * 4) Why is chloride and bicarbonate reduced, what is the significance of "normal" sodium and increased potassium?

Obese patient with severe hydration
A 86-year-old woman did not eat or drink fluids for 10 days due to a fever associated with a urinary tract infection and anorexia. Later, she did not eat or drink because she did not leave the bed due to weakness and because she lived alone. A neighbor-called doctor found her in a diseased state and considerable dehydration (dry tongue and mucous membranes, weak skin turgor, she was very thirsty and was breathing fast).

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 * 1) '''What kind of indoor environment disorder is it?
 * 1) How is the water redeistributed in the body of this patient?