DIT Renal 3. Metabolic Disorders Flashcards
What change in a basic metabolic panel might you expect in a young pt being treated for status asthmaticus?
hypokalemia
bc pt is probably taking beta agonists for asthma
What factors/substances cause hyperkalemia?
K+ sparing diuretics ACEI Acidosis Insulin deficiency Beta antagonists Hyperosmolarity Digitalis Cellular lysis
What factors/substances cause hypokalemia?
Loop or Thiazide diuretics Insulin Beta agonists Alkalosis Hypo-osmolarity DKA (even though they have elevated lab levels of K, they are actually peeing out a lot of K+) Heart failure pts Renal failure pts
A pt presents with hypertension, hypokalemia, metabolic alkalosis, and low plasma renin. What is the diagnosis and how do you treat it?
Primary hyperaldosteronism
Tx: Spironolactone
What are the actions of angiotensin II?
- direct vasoconstriction
- raises aldosterone levels
- constrict efferent arteriole of glomerulus (decr. RBF, incr. GFR –> incr. FF)
arrythmias
hyperkalemia
hypokalemia
hypomagnesemia
What are the causes of anion-gap acidosis?
MUDPILES
Methanol (formic acid) Uremia Diabetic ketoacidosis Paraldehyde or Phenformin Iron tablets or INH Lactic acidosis Ethylene glycol (oxalic acid) Salicylates
How does acidosis/alkalosis affect extracellular K+ concentrations?
Acidosis –> swap H for K –> Hyperkalemia
Alkalosis –> swap K for H–> Hypokalemia
What are the diagnostic features of diabetes insipidus?
Water Deprivation Test
-urine osmolality doesn’t increase
Desmopressin Test
- improvement: central DI
- no improvement: nephrogenic DI
correcting too rapidly may result in central pontine myelinosis
Hyponatremia
peaked T waves
Hyperkalemia
tetany
hypocalcemia
decreased deep tendon reflexes
Hypermagnesemia
flattened T waves, U waves on EKG
Hypokalemia
pCO2= 42
Metabolic alkalosis w/o compensation
