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AMC MCQ - Key points > Electrolytes > Flashcards

Electrolytes Flashcards

1
Q

Describe the normal range for sodium levels in the body.

A

135-145.

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2
Q

What is the main organ affected by changes in sodium levels?

A

CNS.

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3
Q

What are the main CNS manifestations of abnormal sodium levels?

A

Confusion, convulsion, coma.

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4
Q

What is the most common cause of hypernatremia?

A

Diabetes Insipidus.

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5
Q

What is the most common cause of hyponatremia?

A

SIADH.

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6
Q

What is the recommended fluid for treating hyponatremia?

A

Normal saline (0.9%).

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7
Q

What should be used for hyponatremia with confusion or seizure?

A

Hypertonic saline (3%).

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8
Q

What is the treatment for hyponatremia with severe neurological manifestations?

A

Hypertonic saline (3%).

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9
Q

What neurological condition can result from rapid correction of hyponatremia?

A

Central pontine myelinolysis leading to quadriplegia.

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10
Q

Describe the normal range for potassium levels in the body.

A

3.5-5.

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11
Q

What EKG changes are seen in hyperkalemia?

A

Hyper-acute T-wave (tall T-wave), wide QRS, prolonged PR.

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12
Q

What is the first-line treatment for hyperkalemia with EKG changes?

A

Calcium gluconate.

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13
Q

What should be administered first for hyperkalemia with severe chest pain, dyspnea, or palpitations?

A

Calcium gluconate.

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14
Q

What is the initial treatment for hyperkalemia with potassium levels above 7?

A

Calcium gluconate.

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15
Q

What is the treatment for hyperkalemia below 7 without EKG changes or manifestations?

A

Insulin and glucose.

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16
Q

How can potassium levels be rapidly decreased?

A

With insulin and glucose.

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17
Q

What is the only drug that removes potassium from the body?

A

Kayexalate (resonium).

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18
Q

What is the recommended treatment for hyperkalemia in end-stage renal disease patients?

A

Dialysis.

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19
Q

What action should be taken if potassium levels are less than 6?

A

Stop the offending drug only.

20
Q

Describe the treatment for emergency hypercalcemia.

A

IV fluids and diuretics.

21
Q

What is the first presentation of hypocalcemia?

A

Peri-oral numbness.

22
Q

What is the cause of hypocalcemia following total thyroidectomy?

A

Hypoparathyroidism due to removal of all 4 parathyroid glands.

23
Q

If a patient develops perioral numbness after surgery but total calcium levels are normal, what could be the cause?

A

Hypocalcemia.

24
Q

Describe the treatment for hypocalcemia requiring rapid correction before surgery.

A

IV calcium is administered.

25
Q

What is the long-term treatment for hypocalcemia?

A

Calcium plus vitamin D.

26
Q

What is the initial step in managing tetany caused by hyperventilation?

A

Breathing into a bag.

27
Q

How is hypocalcemia tetany managed if it persists after breathing into a bag?

A

With calcium gluconate.

28
Q

Define the cause of decreased total calcium but not ionized calcium due to hypoalbuminemia.

A

No tetany.

Hypocalcemia: Practice Essentials, Pathophysiology …

Medscape
https://emedicine.medscape.com › Nephrology
10 Nov 2022 — Patients with a decrease in total serum calcium may not have “true” hypocalcemia, which is defined as a decrease in ionized calcium. A reduction …

29
Q

What is the diagnosis for a post-operative patient on TPN who develops a skin problem?

A

Zinc deficiency.

30
Q

What is the most common cause of zinc deficiency?

A

TPN.

31
Q

Describe the diagnosis for a patient with hyponatremia, increased urine Na, and osmolarity.

A

SIADH.

32
Q

What is the most common drug causing SIADH?

A

Carbamazepine.

33
Q

What is the most common cancer causing SIADH?

A

Small cell lung cancer.

34
Q

How can any neurological insult lead to SIADH?

A

By causing a disruption in the body’s fluid balance.

35
Q

In SIADH, how do the serum osmolarity, urine osmolality, and urine sodium concentration change?

A

Serum osmolarity decreases, urine osmolality increases, urine sodium concentration increases.

36
Q

In Diabetes insipidus, how do the serum osmolarity, urine osmolarity, and urine sodium concentration change?

A

Serum osmolarity increases, urine osmolarity decreases, urine sodium concentration decreases.

37
Q

What are the treatment options for hyponatremia in SIADH based on severity?

A

Mild: fluid restriction, Moderate: normal saline plus diuretics, Severe or with CNS manifestations: hypertonic saline (3%).

38
Q

What is the initial step in managing a child with meningitis who develops a seizure and hyponatremia?

A

Administer hypertonic saline (3%).

39
Q

What is the diagnosis for a patient with hypernatremia, decreased urine Na, and osmolarity?

A

DI (Diabetes insipidus).

40
Q

What is the most common drug causing Diabetes insipidus?

A

Lithium.

41
Q

What is the diagnosis for a patient with hyponatremia, decreased urine Na, and osmolarity?

A

Psychogenic polydipsia.m

Psychogenic polydipsia, also known as primary polydipsia, involves excessive water intake driven by psychological factors. Key factors to know include:

  1. Symptoms: Excessive thirst and fluid intake, leading to polyuria (excessive urination).
  2. Risks: Can cause water intoxication, hyponatremia (low sodium levels), and associated symptoms like confusion, seizures, or coma.
  3. Diagnosis: Differentiation from diabetes insipidus and other causes of polyuria; involves water deprivation tests and psychiatric evaluation.
  4. Management: Fluid restriction, addressing underlying psychiatric conditions, and monitoring electrolytes.

For more details, refer to the RACGP guidelines.

42
Q

Describe how to differentiate between diabetes insipidus (DI) and psychogenic polydipsia using the H2O deprivation test.

A

Normalization of lab values after the test indicates psychogenic polydipsia, while no normalization and low urine osmolality indicate DI.

43
Q

Do you determine the diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH) in a patient with hyponatremia, increased urine sodium, and osmolarity?

A

Yes, those criteria suggest SIADH.

44
Q

Define the diagnosis of diabetes insipidus (DI) in a patient with hypernatremia, decreased urine sodium, and osmolarity.

A

DI is the likely diagnosis.

45
Q

How do you assess acid-base balance in a patient?

A

The first step is to assess pH levels, followed by evaluating CO2 and HCO3 levels for respiratory or metabolic changes.

46
Q

When does a patient require IV calcium administration?

A

IV calcium is needed when the patient is symptomatic, has serum calcium below 1.9 mmol/L, or rapid correction is necessary before an operation.

47
Q

What is the normal range for urine osmolarity?

A

The normal range for urine osmolarity is 500-800 mOsm/kg.

AMC MCQ - Key points (49 decks)

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