Electrolytes Flashcards
Hypercalcemia EKG changes
short QT
Hypercalcemia treatment
First: IVF!
- Bisphosphonates, calcitonin
- give steroids if vit D or MM related cause
- dialysis for ESRD pts
- NB: phosphate effective but avoided bc of risk of metastatic calcification
Hypocalcemia symptoms
- Numbness/tingling
- Tetany (Chvostek’-facial nerve, Trosseu’s-BP cuff)
- Long QT
- seizures
Causes of hypocalcemia
- HyperPTH most common
- Acute pancreatitis
- Renal insufficiency
- Vit D deficiency
- Hyperphosphatemia
- Blood transfusion w/ citrated products
- Hypomagnesemia (dec PTH secretion)
What causes a low calcium level with normal free (ionized) calcium?
Low albumin
correction: 0.8 (4-albumin) + serum calcium
Treatment of hypocalcemia
Emergent: IV calcium gluconate
Long-term: oral calcium supplements and vitamin D
CORRECT HYPOMAG
Alkalosis leads to hypo or hyperkalemia?
Alkalosis –> hypokalemia
Acidosis leads to hypo or hyperkalemia?
Acidosis –> hyperkalemia
Symptoms of hypokalemia
Weakness, paralysis, ileus, ST depression, flattening of T waves and long QT w/ prominent U waves
What are some causes of redistribution hypokalemia?
Alkalosis, beta-agonists (e.g. epi in trauma), insulin excess
Treatment of hypokalemia
Treat underlying cause. Usually just use oral KCl. IV KCl can be given if
Hyperkalemia EKG
EKG: peaked T waves, widened QRS, PR prolongation, loss of P waves, lastly sine wave pattern
Hyperkalemia symptoms
Like hypo- weakness, decreased DTRs, N/V
also diarrhea, respiratory failure
Treatment of hyperkalemia
If severe or ECG changess, first give calcium gluconate. Next glucose and insulin, beta agonists, Kayexalate. If desperate, sodium bicarb raises pH which sends K into cells. Dialysis for renal failure. Diuretics (e.g. furosemide).
Hypomagnesemia can cause what two other electrolye imbalances?
Hypomagnesemia is assoc with hypocalcemia and hypokalemia
