Electrolytes

Question 1

What does Na mainly control?

Answer 1

CNS

Question 2

What does K mainly control?

Answer 2

Heart

Question 3

What does Ca mainly control?

Answer 3

Neuro

Question 4

What does Mg mainly control?

Answer 4

Neuro

Question 5

What are the symptoms of Hyponatraemia?

Answer 5

Seizures, confusion, tiredness, abdo cramps, salt craving, nausea, vomiting, low BP

Question 6

What are the symptoms of Hypernatraemia?

Answer 6

Crave water, weakness, seizures, decrease in consciousness

Question 7

What are the causes of hyponatraemia?

Answer 7

Kidney failure, heart failure, diuretics (makes the body get rid of more Na in the urine), antidepressant and pain meds (cause more sweating and urinating), severe vomiting and diarrhoea, polydipisa

Question 8

What are the causes of hypernatraemia?

Answer 8

Vomiting, diarrhoea, burns, excessive sweating, intrinsic renal disease, loop diuretics, osmotic diuresis, diabetes insipidus, adrenal tumours secreting deoxycorticosterone

Question 9

What is the treatment of hyponatraemia?

Answer 9

Restrict fluid intake, IV NaCl, Fludrocortisone (Na sparing, used in Addison’s)

Question 10

What is the treatment in hypernatraemia?

Answer 10

Fluid replacement, Loop diuretics can increase renal Na excretion - but can also cause hyper…..

Question 11

What are the symptoms of hypoK?

Answer 11

U waves, leg cramps, decreased GI motility, increased DTR

Question 12

What are the symptoms in hyperK?

Answer 12

Cardiac arrest, weakness, increased GI motility, chest pain, palpitations, brady, decreased DTR, peaked T waves

Question 13

What are the causes of hypoK?

Answer 13

Excessive K loss from diuretics, vomiting, diarrhoea, CKD, diabetic ketoacidosis, excessive alcohol, primary aldosteronism

Question 14

What are the causes of HyperK?

Answer 14

Renal insufficiency, metabolic acidosis (K shifts from intracellular to extracellular), AKI, diabetes, cardiovascular disease

Question 15

What is the treatment for HypoK?

Answer 15

Stop diuretics or laxatives, K sparing drugs, stop vomiting and diarrhoea, oral potassium chloride
ACEi and ARB prevent renal K excretion

Question 16

What is the treatment for hyperK?

Answer 16

Calcium gluconate, insulin and dextrose
Remove sources of K intake
Correct metabolic acidosis with Na bicarbonate
Salbutamol - encourages K removal

Question 17

What are the symptoms of hypocalcaemia?

Answer 17

Weak bones, teeth, severe muscle cramps, trousseau, chvosteks sign, increased DTR, seizures

Question 18

What are the symptoms of hypercalcaemia?

Answer 18

Lethargy, bone pain, decreased DTR

Question 19

What are the causes of hypocalcaemia?

Answer 19

Hypoparathyroidism, could result from a decrease in albumin (as it is the carrier protein) so liver disease, nephrotic syndrome, malnutrition, hypomagnesemia, hypephosphataemia, PTH deficiency, Vit D resistance

Question 20

What are the causes of hypercalcaemia?

Answer 20

Primary hyperthyroidism
Associated with malignancy - ectopic PTH secretion
Drugs - thiazide diuretic, vit D, familial hypocalciuric hypercalcaemia

Question 21

What is the treatment for hypocalcaemia?

Answer 21

IV calcium gluconate if acute

Ca and Vit D supplements if chronic

Question 22

What is the treatment for hypercalcaemia?

Answer 22

Fluids, isotonic NaCl. Then a loop diuretic to stop the Na and Ca reabsorption into the thick ascending loop of henle
Reduction in dietary vit D and Ca
Prednisolone can help reduce plasma Ca levels by reducing the intestinal Ca absorption
Oral phosphate can be used to form Ca phosphate in the blood
Calcimimetic - mimics the activation of Ca to activate PTH

Question 23

What are the symptoms of hypomagnesemia?

Answer 23

Tremors, increased DTR, tachy, confusion

Question 24

What are the symptoms of hypermagnesemia?

Answer 24

Vasodilation, nausea, vomiting, weakness, hypotensive, decreased DTR, cardiac arrest

Question 25

What are the causes for hypomg?

Answer 25

``` Increased excretion due to hypercalcaemia, furosemide, inadequate intake, impairment of renal conservation or GI absorption Alcoholism Chronic PPI use Pregnancy and lactation DKA ```

Question 26

What are the causes of hypermg?

Answer 26

``` renal failure Excessive intake Hypothyroidism Addison disease Familial hypocalciuric hypercalcaemia, milk alkali syndrome and depression ```

Question 27

What is the treatment of hypomg?

Answer 27

Increase green veg intake | IV mg

Question 28

What is the treatment for hyperMg?

Answer 28

``` Calcium gluconate (antagonises the toxic effect of the mg) Diuretics promote Mg excretion Glucose and insulin can help to promote Mg entry into the cell ```