By Alluru S. Reddi

Written in a succinct query and solution layout, this complete source covers all parts of nephrology and customary medical situations. approximately one thousand questions with precise solutions supply nephrology fellows, practising nephrologists and clinicians a greater figuring out of nephrology and reduction arrangements for nephrology and inner medication forums. Absolute Nephrology assessment good points the most recent facts and guidance whereas enjoyable a severe desire in the nephrology community.

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Disorders of water balance: Hypernatremia. In Reddi AS. Fluid, Electrolyte, and Acid-Base Disorders. Clinical Evaluation and Management. New York, Springer, 2014, pp. 133–150. 32. Assuming the patient had no oral intake and daily urine output of 700 mL, approximately how many days it would have taken to develop serum [Na+] from 140 to 168 mEq/L? A. B. C. D. E. 2 Days 3 Days 5 Days 7 Days 9 Days The answer is D To answer this question, one needs to calculate the total daily fluid loss. This can be calculated from daily urine output and insensible loss (approximately 500 mL/day).

New York, Springer, 2014, pp. 133–150. 33. The patient received 2 L of normal saline, and his BP improved. His mental status improved and says he is hungry. His serum [Na+] remains at 167 mEq/L and glucose 198 mg/dL. What is your further management of this patient? A. B. C. D. E. Continue normal saline Ringer’s lactate Free water by mouth Half-normal saline Half-normal saline and D5W The answer is C The patient requires free-water repletion. In a mentally alert patient, oral ingestion of water is strongly advised.

B. C. D. E. Salt intake KCl Mg sulfate Eplerenone All of the above The answer is E This patient needs life-long supplementation of high salt intake, KCl, and MgCl2 (magnesium sulfate or magnesium oxide, which causes more diarrhea than magnesium chloride). Eplerenone (spironolactone-receptor blocker) seems to be better than either spironolactone or amiloride to maintain normal serum [K+]. 1 Fluids, Electrolytes, and Acid–Base Disorders 25 Suggested Reading Bonnardeaux A, Bichet DG. Inherited disorders of the renal tubule.

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