Day 9 -GU2 Quiz

Question 1

HypoNa, low serum osmolality, high urine osmolality

Answer 1

SIADH

Question 2

Next step mgt: peaked T waves

Answer 2

Calcium gluconate

Question 3

Most common cause of death in dialysis pts

Answer 3

CV disease (prevent w/ daily ASA & statin)

Question 4

Electrolyte abnormality: peaked T waves

Answer 4

Hyperkalemia

Question 5

Electrolyte abnormality: flattened T waves

Answer 5

Hypokalemia

Question 6

Electrolyte abnormality: U waves

Answer 6

Hypokalemia

Question 7

Electrolyte abnormality: QT prolongation

Answer 7

Hypocalcemia

Question 8

Electrolyte abnormality: QT shortening

Answer 8

Hypercalcemia

Question 9

Distinguishing features of RTA Types

Answer 9

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

Question 10

Risk of correcting hypernatremia too rapidly - recommended rate

Answer 10

Cerebral edema; 12 meq/L/day

Question 11

Risk of correcting hyponatremia too rapidly - recommended rate

Answer 11

CPM; Also 12 meq/L/day (definitely no more than 20 meq/L/day)

Question 12

Options for correcting hyperkalemia (by shifting K+ into cells)

Answer 12

Sodium bicarb, Alb nebs, Insulin + glucose; Not by shifting: Loop diuretics, Kayexalate

Question 13

DDx for euvolemic hyponatremia

Answer 13

SIADH, Hypothyroidism, Polydipsia

Question 14

Meds known for causing hyperkalemia

Answer 14

ACEi/ARBs, beta blockers, digoxin, potassium-sparing diuretics

Question 15

Meds known for causing hypokalemia

Answer 15

Diuretics (loops, thiazides, carbonic anhydrase inhibitors, etc.), Albuterol, Insulin

Question 16

Tx Nephrogenic DI

Answer 16

HCTZ +/- Indomethacin; If Lithium induced, HCTZ + Amiloride

Question 17

Sodium levels corrected for hyperglycemia

Answer 17

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

Question 18

Total Ca levels corrected for hypoalbuminemia

Answer 18

As albumin drops below 4, for every 1 g/dL, Ca decrease 0.8 g/dL

Question 19

DDx nongap metabolic acidosis

Answer 19

Diarrhea, RTA, TPN (i.e., hyperalimentation)

Question 20

Meds necessary in pts w/ ESRD

Answer 20

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