Electrolytes Flashcards
Digitalis
Shifts K out of cell (hyperkalemia)
Hyperosmolarity
Shifts K out of cell (hyperkalemia)
Insulin
Shifts K into cell (hypokalemia)
Lysis of cells
Shifts K out of cell (hyperkalemia)
Acidosis
Shifts K out of cell (hyperkalemia)
Alkalosis
Shifts K into cell (hypokalemia)
Beta-blockers
Shifts K out of cell (hyperkalemia)
Low sodium
nausea, malaise, stupor, coma
High sodium
irritability, stupor, coma
Low potassium
U waves on ECG, flattened T waves, arrythmias, muscle weakness
High potassium
Wide QRS waves and peaked T waves on EKG, arrhythmias and muscle weakness
Low calcium
tetany, seizures, QT prolongation
High calcium
Stones (renal), Bones (pain), Groans (ab pain), Pyschiatric Overtones (anxiety, altered mental status)
Low Magnesium
Tetany, torsade de pointes
High Magnesium
decreased DTRs, lethargy, bradycardia, hypotension, cardiac arrest, hypocalcemia
Low phosphate
Bone loss, osteomalacia
High phosphate
renal stones, metastatic calcifications, hypocalcemia
Metabolic Acidosis
Decreased pH, pCO2, HCO3
Metabolic Alkalosis
Increased pH, pCO2, HCO3
Respiratory Acidosis
decreased pH, increased pCO2 & HCO3
Respiratory Alkalosis
Increased pH, decreased pCO2 & HCO3
Hyperventilation
Compensatory response to metabolic acidosis
Formula for respiratory compensation for a simple metabolic acidosis
Winter’s Formula; if measured pCO2 differs significantly from predicted pCO2, mixed acid-base disorder is present
Increased Anion Gap (Met Acidosis)
MUDPILES (>12mEq/L)
Methanol (formic acid), Uremia, DKA, Propylene glycol, Iron tablets or INH, Lactic acidosis, Ethylene glycol (oxalic acid), Salicylates (late)
Normal Anion Gap (Met Acidosis)
Hyperalimentation, Addision Dx, Renal Tubular acidosis, Diarrhea, Acetazolamide, Spironolactone, Saline Infusion
Causes of Respiratory Alkalosis
Hyperventilation (hysteria), hypoxemia, high altitudes, Early salicylates, tumor, pulmonary embolism
Causes of Metabolic Alkalosis
Loops, Vomiting, Antacid, Hyperaldosteronism
Causes of Respiratory Acidosis
Airway obstruction, acute & chronic lung disease, opioids, sedatives, weakening of respiratory muscles
A disorder of renal tubules which leads to non-anion-gap hyperchloremic metabolic acidosis
Renal tubular acidosis
Defect in alpha-intercalated cells to secrete H+; associated with hypokalemia; increase calcium phosphate kidney crystals
Type 1 Renal tubular acidosis
distal, pH >5.5
Defect in proximal tubules HCO3- reabsorption, increased HCO3- excretion; urine is acidified by alpha-intercalated cells; assoc with hypokalemia
Type 2 Renal tubular acidosis
proximal, pH <5.5
Hypoaldosteronism, aldosterone resistance or K-sparing diuretics; Hyperkalemia causing ammoniagenesis in PT
Type 4 Renal tubular acidosis
hyperkalemic, pH <5.5
RTA with decreased buffering capacity so decrease H excretion into urine
Type 4 Renal tubular acidosis
hyperkalemic, pH <5.5
RTA from Fanconi syndrome, Wilson, lead, aminoglycosides and carbonic anhydrase inhibitors
Type 2 Renal tubular acidosis
proximal, pH <5.5
RTA from amphotericin B toxicity
Type 1 Renal tubular acidosis
distal, pH >5.5
Multiple Myeloma (light chains)
Type 1 Renal tubular acidosis
distal, pH >5.5
Chemical toxic to proximal tubule
lead and aminoglycosides
