Electrolyte Disturbances

Question 1

Hypokalemia: ECG and Etiology

Answer 1

1. Hypokalemia ECG: U waves, flat/inverted T waves, increased QT interval
   
   1. Very common in hospital or office
   2. Etiology
      
      1. Diuretics
      2. metabolic alkalosis (transcellular shift of K+ into cell)
      3. high aldosterone (Conn’s, Cushings)
      4. beta-agonist overdose
      5. diarrhea
      6. renal loss
   3. ECG
      
      1. “U” waves, inc QT interval, flat or inverted T wave

Question 2

Hyperkalemia: ECG and etiology

Answer 2

1. Hyperkalemia ECG: peaked T wave, wide QRS, increased PR interval, loss of P wave
2. Etiology
   
   1. Renal failure (insufficiency)
   2. metabolic acidosis
   3. DKA
   4. cell breakdown (hemolysis, Rhabdomyolysis)
3. ECG
   
   1. Peaked T wave
   2. wide QRS
   3. inc PR interval
   4. loss of P wave

Question 3

Hypocalcemia: EKG and etiology

Answer 3

Hypocalcemia: Prolongation of QT interval (QTc corrected for rate)

1. Etiology
   
   1. Chronic renal failure
   2. Vitamin D deficiency
   3. hypoparathyroidism
   4. acute pancreatitis
   5. hypomagnesium
2. ECG
   
   1. Prolongation of QT interval (QTc corrected for rate)

Question 4

Hypercalcemia: ECG and etiology

Answer 4

1. Hypercalcemia: short QT and ST
   
   1. Etiology
      
      1. Hyperparathyroidism
      2. malignancy
      3. granulomatous disorders (TB, sarcoid)
      4. endocrine disorders (adrenal insufficiency, hyperthyroid)
2. ECG
   
   1. Short QT interval
   2. Short ST segment

Question 5

Hypomagnesium: ECG and etiology

Answer 5

Hypomagnesemia: prolonged PR, QT, wide QRS, decreased T wave

1. Etiology
   
   1. Poor nutrition
   2. alcoholism
   3. dec absorption
   4. renal
   5. magnesium loss via diuretics
2. ECG
   
   1. Prolonged PR
   2. wide QRS
   3. prolonged QT
   4. dec T wave

Question 6

Hypermagnesmia

Answer 6

Hypermagnesemia

1. Etiology
   
   1. Renal failure
   2. magnesemia containing drugs
2. ECG: nothing in powerpoint except image of ECG

Question 7

Match the description

1. Tall symmetrically peake T waves with narrow base
2. T wave flattening
3. T wave duration normal
4. T wave flattening and inversion
5. prolonged T waves
6. diffuse, wide, deeply inverted T waves

Answer 7

1. Tall symmetrically peake T waves with narrow base: hyperkalemia
2. T wave flattening: hypokalemia
3. T wave duration normal: hypocalcemia
4. T wave flattening and inversion: digitalis
5. prolonged T waves: class 1a anti-arrythmics, phenothiazines, tri-cyclic antidepressants
6. diffuse, wide, deeply inverted T wave: CNS insult

Question 9

Answer 9

hypokalemia

Question 10

Answer 10

hypokalemia

Question 11

Answer 11

hypokalemia

Question 12

Answer 12

hypokalemia

Question 13

Answer 13

hyperkalemia

Question 14

Answer 14

hyperkalemia

Question 15

Answer 15

hyperkalemia

Question 16

Answer 16

hyperkalemia

Question 17

Answer 17

hyperkalemia

Question 18

Answer 18

hyperkalemia

Question 19

Answer 19

hypercalcemia

Question 20

Answer 20

hypercalcemia

Question 21

Answer 21

hypocalcemia

Question 22

Answer 22

hypocalcemia

Question 23

Answer 23

hypocalcemia

Question 24

Answer 24

hypomagnesium

Question 25

Answer 25

hypermagnesium