Metabolic Alkalosis

Question: Which lab value helps to determine the type of metabolic alkalosis?Answer: Urine Chloride.  If Urine Cl < 15 then it is chloride responsive metabolic alkalosis, meaning that chloride is lost via vomiting or through the kidney.  If Urine Cl > 15 than it is chloride resistant, meaning that chloride is retained secondary to exogenous bicarbonate administration or hyperaldosteronism

Free Water Deficit

Question: 70kg man with serum sodium of 168 - what is the free water deficit?
Answer: Deficit = (Na - 140)/140 x total body water (Men = 50% of weight, Women = 40% of weight) = (168-140)/140 x 35 = 7 Liters (half of which should be replaced in the first 24 hours)

Oxygen-Hgb dissociation

Question: What shifts the oxygen-Hgb dissociation curve to the right and thus unloads oxygen?
Answer: (think increases! - increased acid (H+), increased CO2, increased temperature, increased ATP, increased 2-3 DPG (stored blood)