Electrolytes

Question 1

Types of hypotonic hyponatremia

Answer 1

hypovolemic-diarrhea/vomiting/Addisons
euvolemic-SIADH, psychogenic polydipsia
hypervolemic-CHF, cirrhosis, nephrotic syndrome

Question 2

Cause isotonic hyponatremia

Answer 2

elevated protein or lipids in serum

pseudohyponatremia

Question 3

Cause of hypertonic hyponatremia

Answer 3

Glc or mannitol

Question 4

Tx for hypotonic hyponatremia

Answer 4

hypovolemic and euvolemic=IV NS

hypervolemic=diuretics

Question 5

Tx for isotonic and hypertonic hyponatremia

Answer 5

correct underlying problem

Question 6

Cause and tx of isovolemic hypernatremic

Answer 6

diabetes insipidus

tx=vasopression and oral fluids

Question 7

Cause and tx of hypervolemic hypernatremia

Answer 7

hyperaldosteronism/Cushing’s

tx=diuretics +D5W

Question 8

Cause and tx of hypovolemic hypernatremia

Answer 8

osmotic diuresis/diarrhea

tx=isotonic NS

Question 9

Relationship b/t Ca2+ and alkalosis

Answer 9

increases Ca2+ binding
decreases free Ca2+
causes hypocalcemia

Question 10

Causes of hypocalcemia (5)

Answer 10

hypoparathyroidism
Vit D deficiency
renal failure
acute pancreatitis
hypomagnesemia

Question 11

Sx of hypocalcemia

Answer 11

prolonged QT
tetany
basal ganglia calcifications

Question 12

Tx for hypocalcemia

Answer 12

IV Ca2+ gluconate

Vit D

Question 13

Causes of hypercalcemia (7)

Answer 13

hyperparathyroidism
malignancy (PTHrP and mets to bone)
Paget's of bone
excess Vit D
sarcoidosis
multiple myeloma
familial hypocalciuric hypocalcemia

Question 14

Sx of hypercalcemia (5)

Answer 14

shorted QT
nephrolithiasis
abd pain/muscle weakness
psych changes
osteitis fibrosa cystica

Question 15

Tx for hypercalcemia

Answer 15

IV NS most important
furosemide
bisphosphonates (pamindrone)
calcitonin
phosphate last resort (can cause metatstatic calcifications)

Question 16

Causes of hypokalemia

Answer 16

hyperaldosteronism
insulin/epinephrine
diuretics
diarrhea

Question 17

Sx of hypokalemia

Answer 17

flattened T waves
decreased DTR’s
paralytic ileus

Question 18

Tx for hypokalemia

Answer 18

oral KCl
10mEq increases by 0.1mEq/L
IV KCl burns, only used emergently
correct hypomagnesemia

Question 19

Causes of hyperkalemia (6)

Answer 19

renal failure
ACEI
Addison's
acidosis
rhabdomyolysis
beta blockers

Question 20

Sx of hyperkalemia

Answer 20

peaked T waves
wide QRS
arrhythmia

Question 21

Tx for hyperkalemia

Answer 21

IV Ca2+ if arrhthymia
insulin + Glc
kayexalate
diuretics

Question 22

Causes of hyperphosphatemia (5)

Answer 22

renal insufficiency
bisphosphonates
Vit D excess
hypoparathyroid
rhabdomyolysis

Question 23

Tx for hyperphosphatemia

Answer 23

Al(OH)3

bicarb

Question 24

Causes of hyperchloremic metabolic acidosis (4)

Answer 24

Renal tubular acidosis
acetazolamide
diarrhea
fistulas

Question 25

Causes of metabolic alkalosis (4)

Answer 25

vomiting
ECF volume contraction
villous adenoma
hyperaldosteronism