Day 9 -GU2 Quiz Flashcards
HypoNa, low serum osmolality, high urine osmolality
SIADH
Next step mgt: peaked T waves
Calcium gluconate
Most common cause of death in dialysis pts
CV disease (prevent w/ daily ASA & statin)
Electrolyte abnormality: peaked T waves
Hyperkalemia
Electrolyte abnormality: flattened T waves
Hypokalemia
Electrolyte abnormality: U waves
Hypokalemia
Electrolyte abnormality: QT prolongation
Hypocalcemia
Electrolyte abnormality: QT shortening
Hypercalcemia
Distinguishing features of RTA Types
Type 1: high urine pH > 5.3, decreased serum K, variable serum bicarb (often low); Type 2: urine pH > 5.3, low serum K, bicarb low; Type 4: urine pH
Risk of correcting hypernatremia too rapidly - recommended rate
Cerebral edema; 12 meq/L/day
Risk of correcting hyponatremia too rapidly - recommended rate
CPM; Also 12 meq/L/day (definitely no more than 20 meq/L/day)
Options for correcting hyperkalemia (by shifting K+ into cells)
Sodium bicarb, Alb nebs, Insulin + glucose; Not by shifting: Loop diuretics, Kayexalate
DDx for euvolemic hyponatremia
SIADH, Hypothyroidism, Polydipsia
Meds known for causing hyperkalemia
ACEi/ARBs, beta blockers, digoxin, potassium-sparing diuretics
Meds known for causing hypokalemia
Diuretics (loops, thiazides, carbonic anhydrase inhibitors, etc.), Albuterol, Insulin
Tx Nephrogenic DI
HCTZ +/- Indomethacin; If Lithium induced, HCTZ + Amiloride
Sodium levels corrected for hyperglycemia
As glucose levels reach above 100, for 100 mg/dL of glucose add 1.6 mEq/L of Na; Above 400 of glucose, add 2.4 meEq
Total Ca levels corrected for hypoalbuminemia
As albumin drops below 4, for every 1 g/dL, Ca decrease 0.8 g/dL
DDx nongap metabolic acidosis
Diarrhea, RTA, TPN (i.e., hyperalimentation)
Meds necessary in pts w/ ESRD
Statins (reduce CVD risk & reduce sepsis risk for dialysis), Vit D, Iron, EPO (not want to get Hb above 11-12), Phosphate binders (calcium agents usually), Daily ASA (81 mg); Bp goal
