QuestionQA
QuestionComment
where do we find the deficit equation in the BNF?
17560
QuestionComment
It's not in the bnf sadly
17639
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Hereditary Hematoma
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Nightshift Relapse
QuestionComment
Should dehydration not be corrected over 48hrs?
17614
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Serpiginous NICU
QuestionComment
Is this fluid deficit equation just for children?
38829
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Relapse Complement
QuestionComment
This answer is wrong!! The equation is for 48 hours so you need to divide by 2 to get the amount for 24 hours? So the 900 should be divided by 2
39767
QuestionComment
For children with ≤5% dehydration, replace deficit in the first 24 hours
44457
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Sarah
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Just Another Med Student
QuestionComment
Also would you not need to add resuscitation fluids as well as replacement and maintenance?
39808
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RNA Yellow
QuestionComment
do you not need to minus the initial bolus from the fluid deficit as the patient isnt shocked?
60627
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Hereditary Myopathy
QuestionComment
why this equation, why not weight (grams) x Dehydration (as decimal)...... 18000*0.05=900
60777
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Ortho bro
QuestionComment
how do you even estimate someone as being 5% dehydrated...?!?
61719
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Positive Whiff Test
Concept
Chapter
Osteoporosis, otherwise known as thin bones, is a condition associated with high risk of low trauma fractures due to reduced bone mineral density. Osteoclast activity exceeds osteoblast activity, meaning that bone resorption is occurring at a greater rate than bone formation.

**Symptoms and Signs**

- Generally asymptomatic until a fragility fracture occurs
- Back pain
- Kyphosis (stooped posture)
- Fragility fractures

**Risk factors**

- Female sex
- Increasing age
- Smoking
- Corticosteroid use
- Low BMI (< 20-25kg/m<sup>2</sup>)
- Low body weight (<58kg)
- Vitamin D deficiency

**Protective factors**

- Higher BMI
- Exercise - mechanical loading stimulates bone formation

**Diagnosis**
Osteoporosis can be detected on dual-energy x-ray absorptiometry (DEXA) scan.
A T score of < -2.5 indicates osteoporosis

**Management**

- Fall prevention
- Vitamin D and calcium supplementation
- Hormone replacement therapy (postmenopausal women)
- Oral bisphosphonates
2657
3677
Fluid maintenance + replacement therapy
Topic
91
Paediatrics
The first 10kg of weight replaces fluid at a rate of 100 ml/kg/day.

The second 10kg of weight replaces fluid at a rate of 50 ml/kg/day.

Then any extra kg in weight above 20kg total weight is replaced at a rate of 20 ml/kg/day.

This patient weighs 18kg. Therefore he will need 1000ml for his first 10kg of weight and 400ml for his next 10kg of weight. Therefore this patient requires 1400ml of **maintenance** fluid therapy.

He is also 5% dehydrated. To calculate the amount of **replacement** fluid therapy you use the following equation:

Fluid deficit (mL) = % dehydration x weight (kg) x 10

So in this case the amount of fluid that needs to be replaced would be:

5 x 18 x 10 = 900ml

900 + 1400 = 2300ml total fluid needed over 24 hours.
10148
QuestionQAAnswer
2300
ml
Case Presentation:

A 4-year-old boy is admitted to the paediatric ward with diarrhoea and vomiting. Weight 18kg.

**On examination**

BP 104/62mmHg, HR 110, RR 23, patient is alert.

Mucus membranes appear to be dry.

Capillary refill time <2 seconds.

This patient is determined to be 5% dehydrated. It is therefore determined that they require fluid replacement therapy alongside their regular maintenance therapy.

What **total** volume of 0.9% sodium chloride + 5% glucose should be prescribed for this patient's daily fluid intake?