acid base and electrolytes Flashcards

(38 cards)

0
Q

Diuretics cause what acid base disturbance? (except which class?)

A

Metabolic alkalosis (except CAHs)

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1
Q

Aspirin/salicylate OD will cause what metabolic disturbance?

A

Respiratory alkalosis and metabolic acidosis

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2
Q

How can you speed excretion of ASA?

A

Alkalinize the urine with HCO3

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3
Q

Sleep apnea and other chronic lung conditions can cause what kind of heart failure?

A

right-sided (cor pulmonale)

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4
Q

How low does someone’s pH need to get before you give bicarbonate?

A

7.0

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5
Q

What kind of hyponatremia is caused by Addison’s disease/hyperaldosteronism?

A

hypovolemic

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6
Q

What kind of hyponatremia is caused by SIADH?

A

euvolemic

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7
Q

If water restriction fails, what can you use to treat SIADH?

A

Demeclocycline

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8
Q

What does demeclocycline induce?

A

Nephrogenic diabetes insipidus

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9
Q

What happens when hyponatremia is corrected too quickly?

What is the max rate of correction?

A

Central pontine myelinolysis

0.5-1 mEq/L/hr

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10
Q

what three things can cause false hyponatremia?

A

hyperglycemia with the glucose level greater than 200 MG/DL

Hyperproteinemia

Hyperlipidemia

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11
Q

what is the relationship between sodium level and glucose?

A

for each rise and glucose of 100 MG/DL, sodium decreases by 1.6 mEq/L

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12
Q

in adrenal insufficiency what will you see in terms of potassium, sodium, and blood pressure?

A

Hyponatremia, hyperkalemia, and low blood pressure

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13
Q

how can sickle cell disease affects sodium levels (this is rare).

A

Hypernatremia

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14
Q

what metabolic Derangements of potassium and calcium can impair the kidneys concentrating ability, thus causing hypernatremia?

A

hypokalemia and hypercalcemia

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15
Q

what is the classic cause of hyponatremia in pregnant patients about to deliver?

16
Q

what findings will you see on EKG with hypokalemia?

A

– Loss of the T-wave or to a flattening
– U waves
– Premature ventricular and atrial complexes
– Ventricular and atrial tachyarrhythmias

17
Q

what metabolic Derangement causes hypokalemia?

What metabolic derangement. causes hyperkalemia?

A

hypokalemia – alkalosis

Hyperkalemia – acidosis

18
Q

what is the max rate of replacement for potassium?

19
Q

what will you see on EKG with hyperkalemia?

A
– Tell Peaked T waves
– Widened QRS
– Prolonged PR interval
– Loss of P waves
– Sine wave pattern
20
Q

adrenal insufficiency and hypoaldosteronism will cause what problem with potassium?

21
Q

what is the treatment for hyperkalemia <6.5?

A

– Decreased potassium intake and Kayexalate

22
Q

what is the treatment for hyper kalemia greater than 6.5 or with a parent cardiac toxicity?

A

– Calcium gluconate thirst, which is cardioprotective but does not change potassium level
– Sodium bicarbonate next, which causes potassium to shift inside cells
– Glucose with insulin, which also forces potassium inside cells
– Beta-2 agonist, which also drive potassium into cells

23
Q

what do you do for a patient with hyperkalemia who has renal failure?

A

emergent dialysis

24
what is chvostek sign and trousseau sign. and what causes them?
Chvostek sign is when tapping the facial nerve causes contraction of the facial muscles Trousseau's sign is when inflation of a blood pressure cuff elicits hand muscle spasms
25
what is the classic EKG findings with hypocalcemia?
QT interval prolongation
26
what is the relationship between calcium and albumin?
Hypoalbuminemia will cause hypocalcemia because the protein-bound fraction of calcium is decreased
27
how do you calculate corrected calcium in hypoalbuminemia?
for every 1g/dL decrease in albumin below 4g/dL, correct the calcium by adding 0.8 mg/dL to the given calcium value
28
how do DiGeorge syndrome, hyperparathyroidism, vitamin D deficiency, renal tubular acidosis, acute pancreatitis, and renal failure affect calcium levels?
they all cause hypocalcemia
29
Low calcium is difficult to correct until what other low electrolytes is corrected?
magnesium
30
what is the classic EKG finding in the hypercalcemia?
QT interval shortening
31
what is the most common cause of hypercalcemia in outpatients? what is the most common cause of hypercalcemia in inpatients?
outpatients – hyperparathyroidism | Inpatients – malignancy
32
how does vitamin a or D intoxication, sarcoidosis, thiazide diuretics, immobilization affect calcium levels?
they all cause hypercalcemia
33
how do you treat hypercalcemia?
– First give IV fluids – After patient is well hydrated, give furosemide to cause calcium diuresis – Other treatments include phosphorus, calcitonin, plicamycin
34
what are the specific treatments for hypercalcemia in Paget disease and malignancy induced hypercalcemia?
– paget disease: bisphosphonates | – Malignancy induced: prednisone
35
what is the classic EKG sign of hypomagnesemia?
A prolonged QT interval
36
what drug can be given to cause magnesium diuresis in hypermagnesemia?
furosemide
37
what is the maintenance food of choice in patients who are not eating?
D5 1/2 with 10 to 20 mEq per day of potassium chloride