Electrolyte abnormalities

Question 1

Hyperkalaemia management

Answer 1

• Stop drugs (ACEi/ARB, Spironolactone)
• Low K diet - remember plasma lyte contains potassium
• Correcting acidosis – oral NAHCO3
• Insulin/dextrose
• Calcium gluconate • Salbutamol nebs
• DIALYSIS

Question 2

Assessing Fluid Status

Answer 2

• JVP
• Peripheral Oedema
• Mucous membrane
• Skin Turgor
• Chest Examination
• BP – is there a postural drop ?

Question 3

PTH & High Ca

Answer 3

Normal or high PTH
– Primary Hyperparathyroidism
– FHH (Familial Hypocalciuric Hypercalcaemia )

Suppressed PTH
– Iatrogenic
– Sarcoidosis/TB
– Myeloma
– Underlying Malignancy (lung, kidney, prostate , breast)
– Metastaticbonedisease
– Immobilisation

Question 4

Hypercalcemia Management

Answer 4

Stop offending drugs
(Vit D, Calcium supplement, Alfacalcidol, Thiazide diuretics )
IV rehydration 0.9% saline IV Pamidronate
? Steroids