Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 4 > Electrolyte Imbalance > Flashcards

Electrolyte Imbalance Flashcards

1
Q

What can cause pseudohyperkalaemia?

A

Venepuncture technique.
Thrombocytosis/leucocytosis.
Haemolysis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can cause hyperkalaemia?

A 
Diet
Medications - beta blockers, digoxin, ACEi, NSAIDsetc. 
Tissue breakdown
Haemolysis
Metabolic acidosis
Hyperosmolality/hyperglycaemia
Insulin deficiency
Hypoaldosteronism
Reduced urinary excretion
Reduced GFR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What value is classed as hyperkalaemia?

A

> 5.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name some common medications that can raise potassium.

A 
ACEi/ARBs
Spironolactone
Trimethoprim
Beta-blockers
Calcineuric inhibitors
ForteJuice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the symptoms of hyperkalaemia?

A 
Generalised weakness
Flaccid paralysis
Paraesthesia hands and feet
Lethargy, confusion
Palpitations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the treatment of hyperkalaemia?

A 
Calcium gluconate
Insulin
Salbutamol
Sodium bicarbonate
Fluids
Loop diuretics
Calcium resonium with laxatives
Dialysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the indications for giving calcium gluconate?

A

Potassium >6

ECG changes present.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the management if potassium is between 6 and 6.5 but there are no ECG changes?

A

Give calcium resonium and monitor bloods.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

At what value is hypokalaemia present?

A

<3.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the causes of hypokalaemia?

A 
Diarrhoea
Diuretics
Hyperaldosteronism
Post-operative
Coronary ischaemia
Critical illness
Re-feeding
Hypomagnesium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the presentation of hypokalaemia?

A 
Muscle weakness
Arrhythmias
Polyuria
Rhabdomyolysis (rare)
Paralysis (rare)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which ECG changes can be seen in hypokalaemia?

A

Increased amplitude and width of P wave.
Prolongation of the PR interval.
T wave flattening and inversion.
ST depression
Prominent U waves
Apparent long QT interval due to fusion of T and U waves.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which kind of arrhythmias can be caused by hypokalaemia?

A 
Atrial fibrillation
Atrial flutter
Atrial tachycardia
Ventricular tachycardia
Ventricular fibrillation
Torsades de Pointes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the management of hypokalaemia?

A

Replace potassium. Rate of IV infusion should not exceed 10mmol/hour.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

At what value is hypercalcaemia?

A

Elevated corrected calcium >2.62

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the most common causes of hypercalcaemia?

A

Primary hyperparathyroidism.

Malignancy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the causes of hypercalcaemia?

A 
Calcium supplementation
Hyperparathyroidism
Iatrogenic, immobilization
Multiple myeloma, milk-alkali syndrome, medication
Parathyroid hyperplasia or adenoma
Alcohol
Neoplasm
Zollinger Ellison syndrome
Excessive vitamin A
Excessive vitamin D
Sarcoidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the symptoms of hypercalcaemia?

A 
"Bones, stones, groans, moans"
Pain - pancreatitis, renal stones, bony pain, abdominal pain
Nausea/vomiting, constipation
Delirium, seizures, coma
Malaise, weakness, anorexia
Polydipsia, polyuria
Cardiac arrhythmias
19
Q

What are the investigations in hypercalcaemia?

A 
Adjusted calcium
PTH
Serum electrophoresis
Urinary Bence Jones
TSH
ACE
Serum vitamin D
Urinary calcium
ECG
CXR
20
Q

What is the treatment for hypercalcaemia?

A

IV fluids (0.9% saline) - 1 litre, 8 hourly
Stop precipitants
After 24-48 hours of rehydration consider bisphosphonate.
May require dialysis
Investigate and treat underlying cause.

21
Q

What are the symptoms and signs of hypocalcaemia?

A 
Paraesthesia
Tetany
Confusion
Cardiac arrhythmia
Seizure
22
Q

What are the causes of hypocalcaemia?

A

Secondary hyperparathyroidism
Vitamin D deficiency
Resistance to PTH
Hypoparathyroidism

23
Q

Which investigations should be ordered for somebody with hypocalcaemia?

A 
Mg
Hb
Vitamin D
PTH
PO4
U&amp;Es
ECG
24
Q

What is the management of hypocalcaemia?

A

Correct hypomagnesaemia first.
Calcium gluconate
Continuous infusion of 40ml in 1 litre 0.9% sodium chloride

25
Q

What are the symptoms of hyponatraemia?

A 
Often asymptomatic
Gait disturbance
Muscle weakness
Nausea/vomiting
Weakness
Disorientation
Headache
Worsening confusion
Impaired consciousness
Seizures
Coma
Death
26
Q

What is the management of hyponatraemia?

A

Hypertonic saline

27
Q

What are the symptoms of hyponatraemia?

A

Confusion
Headache
Nausea

28
Q

At what rate should hyponatraemia be corrected?

A

8-12mmol/24 hours.

29
Q

What are the causes of SIADH?

A

Drugs
Carcinoma
Pulmonary disorders
Nervous system disorders

30
Q

What happens to osmolality in SIADH?

A

Serum osmolality <275Osm/kg
Urine osmolality >100 Osm/kg
Urine sodium concentration >30mmol/l

31
Q

At what value is hypernatraemia?

A

> 145

32
Q

What can cause hypernatraemia?

A

Decrease in total body water relative to electrolyte content:
- iatrogenic
water loss - diarrhoea, burns, dehydration, diabetes insipidus
- mineralocorticoid exccess

33
Q

What are the symptoms of hypernatraemia?

A

Thirst

Altered mental state

34
Q

What are the investigations for hypernatraemia?

A

U&Es
Glucose
Paired serum and urine osmolalities, urinary Na

35
Q

At what rate should Na be reduced in hypernatraemia?

A

No more than 10-12mmol/l per day

36
Q

At what value is hypomagnesaemia?

A

<0.7 mmol/l

37
Q

What are the symptoms of hypomagnesaemia?

A 
Confusion, agitation
Nausea and vomiting
Weakness, tremors
Paraesthesia
Tetany
Seizures
Arrhythmia
38
Q

What are the causes of hypomagnesaemia?

A 
Diarrhoea &amp; vomiting
Malabsorption
Osmotic diuresis
Hyperaldosteronism
Drug effects
Acute pancreatitis
Post DKA
Alcoholism
Malnutrition
39
Q

Which drugs are associated with hypomagnesaemia?

A 
Thiazide and loop diuretics
Cisplatin
Cyclosporin
Aminoglycoside antibiotics
Focarnet
Amhotericin B
PPI
40
Q

What is the management of hypomagnesaemia has caused Torsades de pontes?

A

IV bolus mangnesium 2g

41
Q

What is the management of somebody with a hypomagnesaemia of 0.3-0.7mmol/l and is asymptomatic?

A

Magnesium aspartate/magnesium hydroxide/magnesium glycerophosphate/magnesium oxide
Reduce in renal impairment
Note oral Mg can cause diarrhoea

42
Q

What is the management of somebody with a hypomagnesaemia of <0.3mmol/l or is symptomatic?

A

20-30mmol/day up to five days

Add 20 mmol (10ml of magnesium sulphate 50%) to 500ml infusion bag of glucose 5% and infused over 12-24 hours

43
Q

When is hypermagnesaemia seen?

A

In context of magnesium infusion and renal insufficiency.

44
Q

What are the symptoms of hypermagnesaemia?

A 
Flushing
Hypotension
Diarrhoea
Muscle weakness
Confusion
Coma
Cardiac arrhythmias
Hypocalcaemia.

Phase 4 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions