Electrolyte abnormalities Flashcards
Symptoms of hyperkalaemia
Fast irregular pulse Chest pain Weakness Palpitations Light-headed
ECG changes of hyperkalaemia
Small/no P waves Prolonged PR Wide WRS Peaked T waves Slurring into ST VF
Causes of hyperkalaemia
Renal failure with oliguria/anuria Addisons disease K-sparing diuretics Rhabdomyolysis Metabolic acidosis (DM)
Symptoms of hypernatraemia
Lethargy Thirst Weakness Irritability Confusion Signs of dehydration Coma Fits
Causes of hypernatraemia
Fluid loss > Na loss Diarrhoea Vomiting Burns Diabetes insipidus Primary hyperaldosteronism Excessive fluid resuscitation
Symptoms of hypercalcaemia
'Bones, stones, groans and psychic moans' Abdo pain Vomiting Constipation Polyuria, polydipsia Depression Anorexia Weight loss Tired, weak HTN Confusion Renal stones/failure
An ECG finding of hypercalcaemia
Short QT interval
Causes of hypercalcaemia
Malignant - bone mets, PTHrP, myeloma
Primary hyperparathyroidism
Sarcoidosis
Lithium
Symptoms of hypokalaemia
Muscle weakness Hypotonia Hyporeflexia Cramps Tetany Palpitations/arrhythmias Light-headed Constipation
ECG changes in hypokalaemia
Small/inverted T waves
Long PR
ST depression
Prominent U wave
Causes of hypokalaemia
Diuretics Cushings syndrome/Steroids/ACTH Diarrhoea, vomiting Pyloric stenosis Conn's syndrome
Symptoms of hyponatraemia
Anorexia Nausea Malaise Headache Irritability, confusion Weakness Dropping GCS, seizures Oedema Falls HF
How do you assess causes of hyponatraemia
- Are they dehydrated or not - if yes do urinary Na, if not ask if they are oedematous
Dehydrated + urinary Na >20 = renal loss: Addisons, renal failure, diuretics
Dehydrated + urinary Na <20 = extra-renal loss: dirrhoea, vomiting, fistula, burns, bowel obstruction, trauma
Not dehydrated + oedematous: nephrotic syndrome, HF, liver cirrhosis, renal failure
Not dehydrated + not oedematous + urine osmolality >100: SIADH
Not dehydrated + not oedematous + urine osmolality <100: water overload, severe hypothyroidism, glucocorticoid insufficiency
Symptoms of hypocalcaemia
'SPASMODIC' Spasms (Chvosteks sign) Perioral paraesthesia Anxious/irritable/irrational Seizures Increased smooth muscle tone and colic Wheeze Dysphagia Disorientation/confusion Dermatitis/impetigo Cardiomyopathy/long QT
ECG finding in hypocalcaemia
Long QT interval
