阿摩線上測驗
42.王先生因酮酸血症（ketoacidosis）住院，入院時抽血檢查，
128 mmol/L，glucose 800 mg/dL，BUN 50 mg/dL，其低血鈉屬於下列何種型態？
(A)等張性（isotonic）
(B)高張性（hypertonic）
(C)低張性（hypotonic）
(D)高容積性（hypervolemic）
答案：登入後查看
統計： A(178), B(2147), C(553), D(241), E(0) #2972396
統計： A(178), B(2147), C(553), D(241), E(0) #2972396
詳解 (共 8 筆)
Chung Shun Lin
#5816601
- Serum osmolality (mOsm/kg) = 2×[Na+]+glucose/18 (in mg/dL)+BUN/2.8 (in mg/dL)
此病人算起來約為318 mOsm/kg - Hypotonic hyponatremia (serum osmolality < 280 mOsm/kg H2O)
- hypovolemic hyponatremia can be caused by gastrointestinal losses, (such as diarrhea or vomiting), renal volume losses (due to diuretics, cerebral salt wasting, and adrenal insufficiency), and dermal losses (such as burns or sweating)
- euvolemic hyponatremia is often caused by syndrome of inappropriate antidiuresis (SIAD) and low solute intake (such as tea-and-toast diet and beer potomania); other causes include hypothyroidism, water intoxication, glucocorticoid deficiency, and exercise-associated hyponatremia
- hypervolemic hyponatremia can be caused by heart failure, cirrhosis, chronic kidney disease, and nephrotic syndrome
- Isotonic hyponatremia (serum osmolality 280-295 mOsm/kg H2O)
- pseudohyponatremia resulting from hyperlipidemia or hyperproteinemia
- Hypertonic hyponatremia (serum osmolality > 295 mOsm/kg H2O)
- hypertonic fluid infusion or hyperglycemia
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4
maomao
#6168363
感謝cpjjj的整理
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0
