Electrolytes

Question 1

Increase in Anion Gap

Answer 1

-Ketoacidosis (diabetes, alcoholic, starvation)
-Renal failure
-Lactic acidosis
-Citrate/Lactate/Carbenicillin/Penicillin use
-Poison: aspirin, salicylic acid, methanol, ethylene glycol, paraldehyde

= K SAD RAP PCLC SAME

Question 2

Decrease in Anion Gap

Answer 2

Hypoproteinemia, multiple myeloma, increase in Ca/Mg, hemodilution

Question 3

MAJOR CLINICAL CAUSES OF HYPEROSMOLALITY

Answer 3

-Dehydration
-Hyperglycemia, diabetic ketoacidosis
-Diabetes insipidus
-Uremia
-Ethanol ingestion
-Improper specimen collection
DDDGECU

Question 4

MAJOR CLINICAL CAUSES OF HYPOOSMOLALITY

Answer 4

-Over hydration
-Inappropriate ADH secretion: SIADH
-Compulsive water drinking (polydipsia)
POS

Question 5

Hypernatremia

Answer 5

-Dehydration
-Diarrhea (water loss)
-Cushing’s (hyperadrenalism)
-Aldosteronism

CDAD

Question 6

Hyponatremia

Answer 6

-Over hydration
-Diarrhea (Na loss)
-Intestinal fistula
-Addison’s (hypoadrenalism)
-Renal disease
-Salt losing nephritis
-Uncontrolled diabetes
-Dilutional hyponatremia w. hyperglycemia
-Diuretics
-SIADH

DDDDIOS NAR

Question 7

Hyponatremia with increased total body sodium

Answer 7

-Renal insufficiency
-Congestive heart failure
-Hepatic cirrhosis with ascites
-Nephrotic syndrome
-Protein deficiency

Water retention, edema

Question 8

Hyperkalemia

Answer 8

-Tissue damage or impairment of renal clearance of K+
-Shock
-Uncontrolled diabetes mellitus (tissue breakdown, utilization of protein for calories)
-Dehydration
-Adrenocortical insufficiency (Addison’s disease)

A STUD

Question 9

Hypokalemia

Answer 9

-Poor food intake
-Prolonged intravenous glucose or NaCl (without K+)
-Vomiting
-GI fistulas (mostly intestinal)
-Diarrhea
-Large intestinal adenomas
-Aldosteronism
-Hyperadrenalism
-Over dosage with ACTH and cortisone
-Familial periodic paralysis (intracellular K+ high)
-Diuretic abuse
-Laxative abuse

FFF LIVD DC AAAA

Question 10

Hyperchloremia

Answer 10

-Dehydration
-Hyperchloremic acidosis (diarrhea, renal tubular acidosis)
-Stimulation of respiratory center (anxiety, fever, hyperventilation, drugs, hysteria)
-High altitudes

Question 11

Hypochloremia

Answer 11

-Overhydration
-Hypoventilation (CO2 retention)
-Depression of central nervous system
-Pulmonary disease
-Chronic renal disease
-Diabetic ketosis
-Adrenal insufficiency
-Hyperfunction of adrenal cortex
-Over dosage with ACTH and cortisone
-Metabolic alkalosis
-Vomiting
-Fistulas of GI tract

OH FAM CAP RAK VAC