Clinical Chemistry

Question 1

hyponatraemia symptoms

Answer 1

• can be caused due to many reasons

symptoms :
nausea
vomiting
seizures
headaches etc

IV saline
treat underlying cause

Question 2

what electrolyte imbalance does digoxin toxicity cause

Answer 2

it causes hyperkalaemia

it increases intracellular calcium, and so more potassium outside the membrane
this causes hyperkalaemia

Question 3

what is rhambomyolysis -

Answer 3

it is damage to the muscle tissue
this causes a spike in CK
this can cause high levels of potassium which can lead to a collapse

Question 4

what are the symptoms of hypocalacaemia

Answer 4

it can be caused by vitamin D deficiency

it will present with:

S – Spasms (Trousseau’s sign)
P – Perioral parasthaesia
A – Anxiety/Irritability
S – Seizures
M – Muscle tone increase (colic, dysphagia)
O– Orientation impairment (i.e. confusion)
D – Dermatitis
I – Impetigo herpetiformis
C – Chvostek’s sign

Manegement - calcium gluconate
Fluid resuscitation with 1L sodium chloride 0.9% infusion over 4 hours

Question 5

when is calcium gluconate used in hyperkalaemia management

Answer 5

when K levels are >6.5 OR ECG shows hyperkalaemia changes

Question 6

when is insulin and dextrose used in hyperkalaemia management

Answer 6

when K levels are <6.5 or there are ECG changes suggesting of hyperkalaemia

Question 7

what hypertension medication causes hyperkalaemia

Answer 7

Rampiril - Because it is an angiotensin converting enzyme inhibitor, which means that angiotensin 2 is not made so aldosterone is also not made

so low levels of aldosterone, means high levels of potassium

Question 8

symptoms of hypercalcaemia

Answer 8

bones stones moans groans

painful bones
renal stones and abdo pains
constipation - abdo groans
and psychiatric moans