Electrolyte Disorders Lecture Powerpoint

Question 1

Principle of hypercalcemia treatment

Answer 1

Want to inhibit bone resorption and increase urinary calcium excretion, diet has little impact

Question 2

Blood calcium levels range to determine treatment

Answer 2

• Asymptomatic or mildy symptomatic <12mg/dL does not require immediate treatment
• 12-14mg/dL may be tolerated well if chronic but not if acute
• > 14mg/dL requires urgent treatment regardless of symptoms

Question 3

Hypercalcemia treatment (4)

Answer 3

• Isotonic saline to correct for volume depletion and vomiting
• Exogenous salmon calcitonin for rapid short term treatment but wears off (tachyphylaxis)
• Biphosphonates (takes a few days to activate but eventually take over from the calcitonin)
• Calcimimetics such as cincalcet in patients in parathyroid dz

Question 4

3 types of hyponatremia and common causes

Answer 4

Hypovolemia - GI losses, renal losses from thiazide diuretics
Euvolemia - SIADH, primary polydipsia
Hypervolemia - heart failure, cirrhosis