Acid-Base/Fluid and Electrolytes

1. Hypokalemia is the most frequent electrolyte disorder seen in Ambulatory Family Medicine. Identify the common etiologies of this disorder and associated clinical effects.

2. List three therapeutic maneuvers used to prevent the development of hypokalemia in patients using cortical and medullary loop diuretics.

3. Outline the historical symptoms, the physical signs and the laboratory which would typify a classical presentation of volume contraction due to the following:

A. Vomiting
B. Decreased oral intake
C. Profuse sweating
D. Osmotic diuresis
E. Diuretic use

4. Describe four mechanisms of edema formation.

5. Identify a common etiology for each of the four acid-base disturbances and explain both the primary and compensatory physiologic events (e.g., metabolic acidosis - primary event is decreased serum bicarbonate and compensatory event is decreased partial pressure of carbon dioxide).

6. Describe how the urinalysis is used as a tool in the evaluation of fluid, electrolyte and acid-base disturbances.

7. Explain how each of the following laboratory values aid in diagnostic evaluation.

A. Serum sodium.
B. Serum potassium.
C. Serum chloride.
D. Serum bicarbonate.
E. Serum creatinine.
F. Blood urea nitrogen.

Sources:

Family Medicine:  Ambulatory Care and Prevention, Chapter 27, Pages 152-159

Reading Resources:  

"Fluid, Electrolyte and Acid-Base Disorders"  Joseph Hobbs, M.D., Department of Family Medicine, Medical College of Georgia