assorted electrolytes Flashcards
main intracellular ion
potassium
main extracellular ion
sodium
osmolarity
the concentration of a solution expressed as the total number of solute particles per litre
isotonic
denoting or relating to a solution having the same osmotic pressure as some other solution, especially one in a cell or a body fluid.
hypovolaemia
also known as volume depletion or volume contraction, is a state of abnormally low extracellular fluid in the body.
This may be due to either a loss of both salt and water or a decrease in blood volume. Hypovolemia refers to the loss of extracellular fluid and should not be confused with dehydration
corrected with hypertonic saline
causes of hyponataemia
diuretics diarrhoea heart failure liver or renal disease ADH secretion inappropriate
symptoms of hyponataemia
headache
lethargy
dizziness
confusion
hypernataemia is caused by dehydration from not drinking, diarrhoea, diuretics or kidney dyfcntion what are the symptoms - raised serum sodium
thirst
fever
dry mucous membranes restlessness
hyperkalemia is caused by what and what are the symptoms
high serum potassium
Tissue damage, acidosis, aldosterone impairment
- Restlessness, intestinal cramping, loss of muscle tone, peaked T wave, Sine wave QRS
how to treat hyperkalaemia especially if severe and shown on the ECG with a sine wave
insulin and glucose administration and maybe calcium if severe
hypokalaemia is causes by what
alkalosis , primary aldosteronism
symptoms fo hypokalaemia
Decreased muscle function, weakness, decreased smooth muscle tone, delayed ventricular repolarisation and bradycardia
causing membrane hyperpolarisation
how to treat hypokalaemia
Oral or slow intravenous K+ administration is needed
how does hypocalcaemia show on an ECG
prolonged QT interval as prolonged ventricular depolarisation
how does hypercacaemia show on an ECG
shortened QT segment , depressed T waves , hypertension and kidney stones
where is phophate mostly stored
bones
hypophosphataemia causes
reduced intestinal absorption
primary hyperparathyroidism
alcohol abuse
symptoms of low phosphate
reduced oxygen transport so left shift causing arrhymias and HF
muscle weakness , confusion and headaches
how to treat low phosphate
O2 therapy or intravenous in severe cases
hyperphosphataemia is only caused by one thing what is it and what are the symptoms
chronic kidney disease
Similar to hypocalaemia presentation
- Associated with hypocalcaemia due to calcium phosphate formation which precipitates in tissues such as the lungs, kidneys and joints
hypomagnesaemia is caused by malnutrition or defective gut absorption, urinary loss, alcoholism and diuretics
what are the symptoms and what is seen on the ECG
Increased reflexes, confusion, irritability and tremor, carpopedal spasm and hallucinations
- Progressive QRS widening, PR interval prolongation and flattened T waves
- Oral/IV replacement and correct underlying cause
Hypermagnesaemia Is caused by Kidney disease or magnesium containing laxatives or antacids- what are the symptoms
Depressed skeletal muscle contraction and nerve function, hyporeflexia proceding narcosis
Repiratory paralysis and cardiac function defects
Bradycardia, prolonged QT interval and heart blocks
Tx–> If renal function is normal, when magnesium therapy is stopped, levels return to normal
chronic kidney disease can be associated with hypocalcaemia due to
increased serum phosphorus that will complex with serum calcium and deposit into bone and other tissues
decreased renal production of 1,25 (OH) 2 vitamin D that will reduce the absorption of calcium from GI track
what are the consequences of prolonged elevation of plasma phosphorus ion
calcium phosphate formation and deposition
John was admitted to hospital with altered ECG showing sine wave pattern. history of HF and is on mineralcorticodi blockers what is most likely happening
hyperkalaemia
short term stablaise myocardium with calcium and reduce circulating potassium by promoting cellular uptake (salbutamol and insulin dextrose)
long term solution Is to treat underlying cause and adjust spironolactone regimen
if a patent has high sodium , high chloride , high blood urea , low urine sodium and concentrated urine that present as oliguria
what is this suggesting and what is the condition
low urien sodium volume depletion ( kidney is conserving salt)
increase urine osmolarity suggest ADH is conserving water so the patient is dehydrated
Hypovolaemic hyernatraemia
correction of hypovolaemic state is a priority and the patient should receive IV saline
what is CKD
what is it caused by
Structural or functional anomalies of the kidney for greater than three months
diabetes, hypetension , glomerulonephrtis and polycytic kidneys
what are the symptoms of CKD
Can be with or without decreased GFR
- GFR <60ml/min/1.73m2 for more than three months – CAGE – creatinine, age, gender, ethnicity
- Several stages, stage 5 and end stage are when transplants are needed
common to get anaemia
need renal replacement therapy
Complications of CKD include
- Cardiovascular – IHD or heart failure
- MSK – CKD related metabolic bone disease
- Endocrine – secondary and tertiary hyperparathyroidism
- Haematological – normocytic anaemia
- metabolic acidosis , hyperkalaemia
what management strategies can be put in place
Lifestyle, exercise, weight loss, stop smoking
- Pharmacological – ACEi – stopping RAAS, relieving pressure so reducing protein being filtered ou
Acute kidney injury is due to a decline of renal function with risk of significantly toxicity which is potentially reversible but couldn’t potentially require RRT
it presents as low urine output and what other major symptom
raised serum creatinine and urea
other symptoms
increased pulmonary vascular permeability - crackling in lung fields
increased Cardiac apoptosis - bidirectional cardio-renal syndrome
