electrolyte disorders Flashcards
what are the signs and symptoms associated with hyperkalemia ?
arrhythmia
muscle weakness
peaked T waves
QRS widening
what are the causes of hyperkalemia ?
KILLS D
kidney disease both acute and chronic
Insulin defeciency
Leaky acidosis
Lysis of cells (TLS)
Spironolactone
Digoxin
hyperosmolarity
what hormone is needed for potassium secretion ?
aldosterone
what are the signs and symptoms associated with hypokalemia ?
arrythmias
muscle weakness
EKG changes - u waves and flattened T waves
what are the clinical causes associated with hypokalemia ?
DIG BLAST
diuretics
insulin
GI loss
beta agonists
laxative abuse
aldosterone excess
shift into cells
tube drains - NG tube suction
6- hypomagnesemia
why does hypomagnesiumeia cause hypokalemia ?
low levels of magnesium are associated with increased potassium excretion in the urine
what is the most common symptom associated with acute hypercalcemia ?
polyuria
what are the findings associated with long standing hypercalcemia ?
stones
bones
groans
psychiatric overtones
what are the most common clinical causes associated with hypercalcemia ?
hyperparathyroidism
malignancy
hypervitaminosis D ( sarcoidosis )
Milk alkali syndrome
why is there an increase of vitamin d in sarcoidosis ?
granulomatous macrophages release 1 alpha hydroxylase
what are the signs and symptoms associated with hypocalcemia ?
tetany - muscle twitching
seizures
what are the 2 classic signs of tetanty ?
trousseaus sign: hand spasm with BP cuff inflation
chvostek’s sign : facial contraction with tapping on the nerve
what are the shift into cells causes that cause hypokalemia ?
insulin administration
alkalosis
beta agonists
epinephrine release
refeeding syndrome
what are the general causes of hypocalcemia ?
hypoparathyroidism
renal failure
pancreatitis
drugs
magnesium
what are the main causes associated with hyperphophatemia ?
acute or chronic kidney disease
and any huge phosphate load :
tumor lysis syndrome
rhabdomyolysis
large amounts of phosphate laxatives
what is the calcium phosphate levels associated with kidney disease ?
sick kidneys cannot excrete phosphate , so the levels rise, which causes a decrease in serum calcium and an increase in PTH
how does PTH have an effect on increased phosphate excretion ?
PTH inhibits the sodium phosphate co transporter
which means more phosphate stays in the urine
what are the symptoms associated with hyperphosphatemia ?
most patients are asymptomatic
most of the symptoms come from hypocalcemia
think of renal failure
what are the consequences of longstanding high phosphate levels ?
metastatic calcifications , calciphylaxis
where there is vascular wall calcification
painful nodules and skin necrosis
what are the signs and symptoms associated with hypophosphatemia ?
main symptom is weakness
often presents as respiratory muscle weakness
what are the common causes associated with hypophosphatemia ?
1ry hyperparathyroidism
DKA
Refeeding syndrome
Antacids ( aluminium hydroxide)
urinary wasting like with fanconis syndrome
what are the signs and symptoms associated with hypermagnesiemia ?r
neuromuscluar toxicity
bradycardia hypotension
can cause hypocalcemia
increase Mg means low PTH means low calcium
what is the main cause of hypermagnesiumia ?
renal insuffeciency
what are the symptoms associated with hypomagnesemia ?
like the symptoms of hypocalcemia
including seizure and tremors
HYPOCALCEMIA AND HYPOKALEMIA
