Electrolyte Imbalances

Question 1

What are the causes of hyperkalemia?

Answer 1

Reduce Kidney excretion - AKI/CKD / Addisons
Drugs - Spironelactone (k+sparing diuretic) / ACEi/ BB
DKA

Question 2

How would hyperkalaemia present on an ECG

Answer 2

Tall Tented T wave
No P wave
Wide QRS
Prolonged PR

Question 3

How would hyperkalemia present?

Answer 3

Arrhythmias
Palpitation
reduced power/flacid

Question 4

Hyperkalemia TX

Answer 4

Calcium Gluconate - cardiac protector
non urgent - insulin and dextrose

Question 5

What are the causes of hypokalemia

Answer 5

Increased excretion - Renal disease/ Thiazides/ diarrhea and vomiting/ Conns syndrome
Intracellular - Insulin / B2 agonists laba/saba

Question 6

Hypokalemia sx

Answer 6

hyporeflix
arryhtmias

Question 7

How would hypokalaemia present on an ECG

Answer 7

Inverted t wave
U wave
St depression
Long PR

Question 8

Hypokalemia TX

Answer 8

Spironelactone + K+ supps

Question 9

What are the causes of hypercalcemia

Answer 9

CHIMPANZEE

Ca2+ supplements
Hydrochlorothiazide
Iatrogenic
Multiple myeloma
Parathyroid hyperplasia/adenoma
Alcohol
z-
Excess VIT D
Sarcoidosis

Question 10

How would hypercalcaemia present - SX + ECG

Answer 10

ECG - Short QT

“Stones” refers to kidney stones and the renal system.

“Bones” refers to bone-related complications: pain and sometimes pathological fractures

“Groans” refers to gastrointestinal symptoms of constipation, indigestion, nausea, and vomiting.
——-Hypercalcemia can lead to peptic ulcers and acute pancreatitis due to increases gastric acid secretion stimulated by Ca2+

“Moans” – malaise, fatigue, lethargy.

“Thrones” refers to polyuria, polydipsia, and constipation. Throne refers to the porcelain toilet you sit on as a throne.

“Psychiatric overtones” refers to effects on the CNS. Symptoms include confusion, lethargy, fatigue, depression, memory loss, psychosis, ataxia, delirium, and coma.

Question 11

How ould you treat hypercalciemia

Answer 11

calcium memetics - Cincaclet
+ Biphosphonates, electrolytes

Question 12

How would hypocalcaemia present - SX + ECG

Answer 12

Long QT

CATS go numb
Convulsion
Arrhythmias
Tetany - spasms

Numbness / Parathesia

+
Chvostek’s signs
Trousseau’s Sign

Question 13

What are causes of hypocalcemia?

Answer 13

reduced absorption - CKD/renal function
hypoparathyroidism
acute pancreatitis

Question 14

Hyponatremia causes?

Answer 14

As Na+ and H2O is intertwined

Underlying causes is associated with volume status:

Hypovolemic:
GI loss - D/V
Renal loss - diuretics
Addisons - increased excretionn

Euvolumic
SIADH
Hypothyroidism

Hypervolumic
Cardiac, renal and liver failure

Question 15

Hyponatremia Sx

Answer 15

Levels of sodium ~ Severity

Mild 130-135mmol/l
Nuasea
vomiting
lethargy
headache

Moderate 125-129mmol/L
Wekaness
confusion
muscle aches
ataxia

Sever <125mmol/L
seizures
Resp arrest
Reduced GCS

Question 16

What are the complication of hyponatremia

Answer 16

hyponatremia encephalopathy due to increase tissue osmotic powere - causing brain herniation

Long term complication - SLOW CORRECTION IS VITAL
centra pontine myelinosis - rapid correction of na can cause osmotic demyelination - lock in syndrome

Question 17

TX Hyponatremia

Answer 17

acutely - hypertonic saline 3%

if its chronic saline 0.9% and tx underlying cause (siadh - tolvaptan)