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ClinMedEx 4 > Electrolytes Paulson > Flashcards

Electrolytes Paulson Flashcards

1
Q

What diagnostics should be ordered for hypermagnesia?

A
  • Mg level
  • BMP
  • EKG
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2
Q

What EKG findings might you see with hypermagnesia?

A
  • Diminished conduction
  • Wide QRS
  • Prolonged PQ interval
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3
Q

What is the treatment for hypermagnesia when you want to stabilize the cardiac membrane?

A

Calcium gluconate given IV

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4
Q

What med helps renal excretion of Mg?

A

Loop diuretics (cause ppl to pee out Mg)

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5
Q

What are three things that can cause HYPOmagnesia?

A
  • diuretics
  • diarrhea
  • chronic PPI usage
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6
Q

Are Chvostek and Trousseaus sign for hyper or hypomagnesia?

A

hypomagnesia

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7
Q

Patients with hypomagnesia often have concurrent _________ & _________

A
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8
Q

For a patient with hypomagnesia with severe symptoms (tetany, arrythmias, seizures) what is the tx?

A

IV Mg sulfate

Severe = sulfate

*Need continuous cardiac monitoring

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9
Q

For a patient with hypomagnesia with asymptomatic or minimal symptoms, what is the treatment? What is a major s/e

A

-Oral replacement

=MgCl or Mg oxide

**Diarrhea is a major s/e

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10
Q

What major ddx should be on the top of your list of a patient with hypercalcemia?

A
  • ***Malignancy
  • Endocrine (***hyperparathyroidism)
  • Granulomatous disease
  • *Thiazide diuretics
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11
Q

Stones, bones, groans, psychiatric overtones are symptoms of what?

A

Hypercalcemia

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12
Q

ST elevation and short QT interval are classic findings of what?

A

Hypercalcemia

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13
Q

What dx to order for hypercalcemia?

A

Serum total calcium in blood

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14
Q

When checking for hypercalcemia, you need to correct for ______

A

albumin

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15
Q

A patient comes in and has hypercalcemia, what do you do next?

A
  1. Check Ca again
  2. Check PTH
  3. Still elevated –> check Vit D and PTHrP (if elevated could be a malignancy)
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16
Q

What is the treatment for hypercalcemia?

A

-IV fluids and cardiac monitoring

17
Q

What tx should be AVOIDED in hypercalcemia?

A

Furosemide (Lasix)

18
Q

What are some osteoclast-inhibiting treatments for hypercalcemia?

A
  • Bisphosphonates
  • Calcitonin
  • Glucocorticoids (pred)
19
Q

Pt has hypercalcemic crisis + hyperparathyroidism, what is the tx?

A

Parathyroidectomy

20
Q

An EKG finding in hypercalcemia is ______ QT whereas hypocalcemia is a ______ QT

A

short QT, prolonged QT

21
Q

What are the three most common pathophysiology reasons of hypocalcemia?

A
  • Vit D deficiency
  • PTH resistance
  • Renal disease
22
Q

Two main clinical features of hypocalcemia?

A

Trosseau & Chvostek sign

23
Q

DIagnostics for hypocalcemia?

A
  • Total serum calcium (corrected for albumin)
  • Serum phosphate
  • Vit D level
  • Serum pth
  • Mg level
  • EKG
  • BMP
24
Q

A patient comes in with acute and severely symptomatic hypocalcemia, what is the treatment??

A

IV calcium gluconate

25
Q

What is the treatment for mild hypocalcemia?

A

Oral calcium + vitamin D

26
Q

T/F: Treat any concurrent hypomagnesmia first to effectively treat the hypocalcemia

A

T

27
Q

Calcium does the _____ of phosphate, so when the calcium is high, the phosphate is ______. What regulates the two of these?

A

opposite, low, PTH

28
Q

What are three acute causes of hyperphosphatemia?

A
  1. Acute renal Failure
  2. Tumor lysis syndrome
  3. Parathyroidectomy
29
Q

What are two main chronic causes of hyperparathyroidism?

A
  1. CKD

2. Hypoparathyroidism

30
Q

What labs to order for hyperphosphatemia?

A
  • Serum phosphorous
  • PTH to see if this is the cause
  • serum calcium
  • Vit D
31
Q

Treatment for acute hyperphosphatemia and normal renal fxn?

A

Saline + diuresis

32
Q

Treatment for hypoparathyroidism causing hyperphosphatemia?

A

Calcium + Vit D

33
Q

Treatment for AKI caused by hyperphosphatemia?

A

phosphate binders

34
Q

Treatment for CKD and hyperphosphatemia?

A

Restrict dietary phosphate and need to take phosphate binders forever

35
Q

How to diagnose hypophosphatemia?

A
  • Serum phosphorous

- Urinary phosphorous excretion

36
Q

Treatment of asymptomatic hypophosphatemia with serum phosphate <2.0?

A

oral phosphate

37
Q

Treatment of symptomatic hypophosphatemia 1.0-1.9

A

Oral but IV if rhabdo, CNS or hemolysis

38
Q

Treatment of symptomatic hypophosphatemia <1.0

A

IV phosphate but switch to PO once serum phosphate is >1.5

39
Q

Treatment of hypophosphatemia urinary phosphate wasting?

A

Dipyridamole QID

-helps to increase phosphate levels

ClinMedEx 4 (16 decks)

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