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CEN Medical Emergencies > Electrolyte Disorders > Flashcards

Electrolyte Disorders Flashcards

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USMLE® Step 1 flashcards
1
Q

Hyperkalemia (Causes)

A

CELL DEATH

Rhabdo
tumor lysis syndrome - start tx for cancer when cells are destroyed, tumor cells release content into bloodstream

Crush injury
Burn
Renal Failure (don’t excrete K+)
Acidosis (DKA, Addison’s Disease)

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2
Q

Hyperkalemia EARLY symptoms (5-6 Range)

A

More K+ moving across the cell walls

Muscular Excitability
N,V,D, irrit

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3
Q

Hyperkalemia LATE symptoms (8-9)

A

SO much K+
Equal amounts on both sides of cell wall - less responsive

Fatigue, Tetany, RD, Ascending paralysis

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4
Q

Hyperkalemia - Cardiac Symptoms

A

Tall peaked T waves

Then the heart begins to relax - elongated PR , absent P wave, enlarged QRS, Sine Wave

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5
Q

1st thing you want to tx with hyperkalemia

A

Stabilize Cardiac Membrane

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6
Q

How do you stabilize cardiac membrane

A 
Calcium Chloride (10 - 20 ml)
Calcium Gluconate (10 - 30 ml)

Calcium is cardioprotective

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7
Q

2nd thing you want to tx with hyperkalemia

A

Shift K+ into the cells

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8
Q

How do you shift K+ into the cells

A

Insulin - 10 units IV push
Followed by 100ml of 50% dextrose

High-dose nebulized albuterol (15 - 25 mg)

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9
Q

What does insulin carry

A

K+ back into the cells

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10
Q

3rd thing you want to tx with hyperkalemia

A

Remove K+ from the cells

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11
Q

How do you remove K+ from the cells

A
  1. Hemodialysis
  2. Normal saline with Lasix
  3. Kaexylate (Ion exchange resin)
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12
Q

How can Hypokalemia happen?

A 
Loose through GI
Diuretics
K+ shifts (insulin , beta 2 agonists - albuterol)
Alkalosis
Decreased intake/Malnutrition
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13
Q

Hypokalemia symptoms

A

Causes WEAKNESS
U wave can become visible
ST depression (myocardial hypoxia)

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14
Q

Tx of hypokalemia

A

K+ replacement

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15
Q

What goes in hand w/ hypokalemia?

A

Hypomagnesemia

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16
Q

Hypermagnesium s/s

A

Decreased muscular irritability and activity

17
Q

Low magnesium causes

A

Increased muscular irritability and activity

18
Q

Hypomagnesemia and Hypocalcemia s/s

A

Chvostek’s Sign

Trousseau’s Sign

19
Q

Tx for hypomagensemia

A

Oral Magnesium or IV

Beans, Grains, Chocolate, Nuts, Seeds, Avacados, Bananas

20
Q

Tx for hypermagnesemia

A

Fluid administration
Loop Diuretics
Dialysis
Stop giving magnesium :)

21
Q

What are the inverse relationship?!

A

Calcium and Phosphate

22
Q

hypocalcemia? hyperphosphatemia

hypercalcemia? hypophosphatemia

A

Go through them in book

23
Q

Tx for Hypercalcemia

A

Treat Cause

  1. NS Infusion
  2. Clucocorticoids (increase renal calcium excretion by decreasing calcium absorption)
  3. Calcitonin (opposes the parathyroid)
24
Q

Hypocalcemia tx

A

1-2 ampules of 10% calcium gluconate with D5W over 10-20 mins

25
Q

Tx for Hypophosphatemia

A

High phosphate diet

Oral K+ phosphate

IV sodium phosphate

26
Q

Tx for hyperphosphatemia

A
  1. Diuretics / Fluids
  2. Limit phopshate Intake
  3. Oral phosphate - binding agents (aluminum hydroxide)
27
Q

Overhydration

A

HypOOOOatremia

28
Q

Dehydration

A

HypEEEEEratremia

29
Q

Water always follows…

A

Sodium

30
Q

What does sodium do?

A

Helps keep the body fluids in order

Helps nerve and muscle function

31
Q

Hypernatremia causes

A

Dehydration
AMS
Weakness
Diarrhea

32
Q

Hypoatremia Symptoms

A

Related to water retention

Impending doom
Seizures
Muscle Cramps
Confusion

33
Q

Tx for hypoatremia

A

MILD - Water restriction/Oral Sodium replacement

SEVERE - Over the course of 48 - 72 hours use hypertonic 3-5% saline solution

34
Q

Rapid correction of sodium can cause?

A

Demyelination of the brain - nerves are damaged nerve impulses slow or stop
Pontine Myelinolysis

Inc of sodium pulls water from the brain cells

35
Q

Hyperatremia tx

A

IV NS

Treat underlying cause
Lower

Give 0.5 mEq/hr with 1/2 NS

CEN Medical Emergencies (6 decks)

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