Electrolyte Imbalances

Question 1

Hypovolaemic Hyponatremia
causes and urine osmol

Answer 1

Increased losses of water + Na

Urine Na <20 vomiting, lose stools

Urine Na >20 Diuretics (causing Na loss via kidneys, Addisons (reduced steroids = no Na reabsorbed by Kidneys)

Question 2

Evoleamic HypoNa
Causes

Answer 2

Urine Osmol > 100 SIADH, ACTH Def. Hypothyroidism

Urine Osmol < 100 primary polydipsia, Beer potomania

Question 3

Hypervolemic HypoNa
Causes and urine osmol1

Answer 3

More water in body, diluting Na

Urine Na< 20 HF, cirrhosis, nephrotic syndrome, hypoalbumin

Urine Na >20 Renal failure

Question 4

What are the main causes of Hypercalacemia

Answer 4

Hyperparathyroidism
Malignancy (Squamous cell lung ca, myeloma)
Vit D toxicity
Thyrotoxicosis
Dehydration
Pagets disease
Acromegally
Sarcoidosis

Question 5

What are the ECG signs of hypercalcemia?

Answer 5

Bradycardia + AV block
Shortened QTc
Osborne wave

Question 6

What is the treatment for hypercalcemia?

Answer 6

IV fluids
IV bisphosphonate
Resonium
Loop diuretics

Question 7

What are the main causes of Hypocalcemia?

Answer 7

Hypoparathyroidism
Low intake
Kidney disease
Burns
Tumor lysis syndrome (PO4 binds to calcium)
Acute pancreatitis (free fatty acids bind to calcium)
Massive transfusion

Question 8

What are the symptoms of hypocalcemia?

Answer 8

Chvotec + Trousseau sign
Muscle spasm
periaural tingling
Seizures

Question 9

What are the ECG changes of hypocalaemia?

Answer 9

ECG Changes, prolonged QTc, prolonged ST, Torsades d’ points

Question 10

What are the ECG signs of hypokalaemia?

Answer 10

Absent or flat T waves, U waves, prolonged PR, ST depression

Question 11

What are the ECG signs of hyperkalaemia?

Answer 11

T tented t waves, QRS prolongation, prolonged QTc, loss of P waves
VF