Electrolytes

Question 1

Na Excess

Answer 1

Irritable, stupor, coma

If overtreat … cerebral edema and herniation (“from high to low your brain will blow”)

Question 2

Na Def

Answer 2

Nausea, malaise, stupor, coma, sz

If overtreat … osmotic demyelination syndrome (“from low to high pons will die”)

Question 3

K Excess

Answer 3

Wide QRS and peaked T waves

Arrhythmia

Muscle weakness

Question 4

K Def

Answer 4

U waves and flat T waves

Arrhythmia

Muscle cramps, spasm, weakness (not enough hyperpolarization)

Question 5

Ca Excess

Answer 5

Stones (renal)

Bone pain

Groans (ab pain)

Thrones (inc urinary frequency)

Psych overtones (anxiety and altered mental status)

Question 6

Ca Def

Answer 6

Tetany, sz, QT prolongation

Chvostek sign - facial nerve tap (chin)

Trousseau sign - BP cuff (tricep)

Question 7

Mg Excess

Answer 7

Dec deep tendon reflexes

Lethargy

Bradycardia

Hypotension

Cardiac arrest

Hypocalcemia

Question 8

Mg Def

Answer 8

Tetany, torsades, hypokalemia, hypocalcemia (check Mg w/ Ca)

Question 9

Phos Excess

Answer 9

Renal stones

Metastatic calcifications

Hypocalcemia (Ca binds extra phos)

Question 10

Phos Def

Answer 10

Bone loss, osteomalacia, rickets

Question 11

What causes K+ to shift out of cell? (7)

Answer 11

Digitalis (blocks Na-K pump - no K in)

Hyperosmolarity (everything is high outside cell)

Cell lysis

Acidosis

Beta-blockers

Insulin def

Succinylcholine

Question 12

What causes K+ to shift into cell? (4)

Answer 12

Hypo-osmolarity (everything low outside cell)

Alkalosis

Beta-adrenergic agonists - inc Na-K pump

Insulin - inc Na-K pump