biochem Flashcards
causes of hyperkalaemia
↑intake: oral, parenteral, transfusion
transcellular movement: rhabdomylysis, DKA, acidosis
↓excretion: AKI, drugs (spironolactone, NSAIDs, ACEi, ARBs), Addison’s
management of hyperkalaemia (incl. dosage)
calcium gluconate (10ml 10%) 10 units insulin + dextrose (100ml 20%) neb salb \+ treat underlying cause IV sodium bicarb if acidotic
ECG findings hyperkalaemia
tented T waves
long PR interval
small / absent P waves
broad QRS
causes of hypercalcaemia
suppressed PTH: malignancy (mets, non-small cell lung cancer, multiple myeloma), sarcoidosis, vit D excess, thyrotoxicosis
normal / high PTH: primary / tertiary hyperparathyroidism
management hypercalcaemia
IV saline
bisphosphonates (alendronate)
steroids in sarcoidosis
causes of hypokalaemia
GI: vomiting, diarrhoea
renal: Conn’s syn, diuretics (non K-sparing e.g. furosemide)
redistribution into cells: alkalosis, drugs: beta-agonists, insulin, digoxin toxicity
causes of hypernatraemia
hypovolaemic: losses dehydration GI: vomiting, diarrhoea renal: loop diuretics skin: burns, sweating osmotic diuresis: HHS, glucose, mannitol euvolaemic: diabetes insipidus hypervolaemic: conn's syn
causes of hyponatraemia
hypovolaemic: losses
GI: vomiting, diarrhoea
renal: thiazide diuretics
euvolaemic: SIADH, hypothyroidism, adrenal insufficiency
hypervolaemic: cardiac failure, cirrhosis, nephrotic syn
causes of high anion gap metabolic acidosis
DKA paracetamol salicylates alcohol lactic acidosis e.g. in tissue hypoxia hyperkalaemia
causes of raised urea
AKI
upper GI bleed