Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med Exam 4 > Electrolytes pt 3 > Flashcards

Electrolytes pt 3 Flashcards

1
Q

Hypermagnesia is magnsium above?

A

2.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Oral ingestion of laxatives, enemas, infusion, and renal insufficiency can all cause?

A

Hypermagnesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common clinical feature of hypermagnesium?

A

Neuromuscular toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Nausea, flushing, headahce, lethargy, drowsiness, and decreased DTRs occur at what level of magensium?

A

4-6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Somnolence, hypocalcemia, absent DTRs, hypotension, bradycardia, and EKG changes occur at what level of magnesium?

A

6-10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Muscle paralysis –> flaccid quadriplegia, apnea, respiratory failure, complete heart block and cardiac arrest occur at what magnesium levels?

A

>10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do you diagnose hypermagnesia?

A

Magnesium level

BMP

EKG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What EKG changes will there be with hypermagnesia?

A

Diminished conduction

Widened QRS

Prolonged PQ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you treat hypermagnesia?

A

Stop offending agent, add diuretic maybe

Calcium gluconate is given IV - to help stabilize cardiac membrane

Hemodialysis if severe + renal impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hypomagnesia occurs below?

A

1.8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the most common causes of hypomagnesia?

A

Chronic diuretic therapy (loop and thiazide)

Chronic alcoholism

Chronic diarrhea

Chronic PPI usage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tetany - positive Trousseau and chovstek sign, muscle spasm, seizures, involuntary movements are neurologic findings of what?

A

Hypomagnesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What EKG findings are associated with hypomagnesia?

A

Widening of QRS, peaked T waves

Prolonged PR interval, QRS widening and diminished T wave (more severe)

Frequent PACs and PVCs - ventricular arrythmias.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Patients with hypomagnesia usually have concurrent?

A

Hypokalemia and hypocalcemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Can’t determine where your hypomagnesia is coming from. What test should you do?

A

24 hour urine magneisum excretion or fraction excretion of magnesium to help differentiate between GI and renal losses.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment of severe symptoms like tetany, arrythmias, or seizures due to hypomagnesium should be treated with what?

A

IV magnesium sulfate

Continuous cardiac monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment of asymptomatic or minimal symptoms of hypomagneisum should be treated with?

A

Oral replacement - magnesium chloride or magnesium oxide - diarrhea major effect.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Malignancy such as ectopic secretion of PTH by tumor, multiple myeloma, and bone mets can cause what?

A

Hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Hyperparathyroidism, MEN, hyperthyroidism, pheochromocytoma, and adrenal insufficiency can cause?

A

Hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Granulomatous disease such as sarcoidosis, TB, histoplasmosis, Berylliosis and coccidiomycosis can cause what?

A

Hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Drugs such as Vitamins A and D, thiazide diuretics, estrogens, Milk-alkali syndrome, lithium can cause what?

A

Hypercalcemia.

22
Q

Dehydration, prolonged immobilization, iatrogenic, rhabdo, familial, and lab error can cause?

A

Hypercalcemia.

23
Q

Two most important causes of hypercalcemia?

A

Malignancy

Hyperparathyroidism.

24
Q
A
25
Q

Hypercalcemia symptoms?

A

Vague- nonspecific

Stones, groans, bones, and psychiatric overtones.

26
Q

Severe hypercalcemia can present as?

A

Lethargy, altered mental status, seizures, coma

Cardiac conduction abnormalities - bradyarrhythmias, sinus arrests, av blocks, af, vt, lbbb, rbbb

27
Q

What are EKG findings associated with severe hypercalcemia?

A

bradyarrythmias, sinus arrests, AV blocks, AF, VT, LBBB, RBB

ST segment elevation,

“short QT interval - classic finding”

28
Q

How do you diagnose hypercalcemia?

A

Ionized calcium versus total calcium

Serum total calcium represents both bound and unbound calcium

ionized needs albumin

29
Q

A patient with hypercalcemia might have normal caclcium if what protein is low?

A

Albumin

30
Q

Corrected calcium equation?

A

CC = measured total calcium x [0.8 (4-albumin)]

31
Q

After you confirm hypercalcemia what next test should you run?

A

Serum PTH

32
Q

If Serum PTH is high, dx? Low?

A

High - primary hyperparathyroidism

low - check vit d levels and PTHrp

33
Q

How do you treat hypercalcemia?

A

Usually dehydrated - NS open wide.

Bisphosphonates, calcitonin, glucocorticoids.

34
Q

Short QT =

Prolonged QT

A

Short QT = hypercalcemia

Prolonged = hypocalcemia.

35
Q

What are the major causes of hypocalcemia?

A

Hypoparathyroid

Drugs

Hypomagnesia

36
Q

Carpal tunnel spasm after BP cuff is applied for 3 minutes

A

Trousseau sign

37
Q

Spasm of facial muscle after tapping facial nerve in front of ear

A

Chovstek sign.

38
Q

Acute and severely symptomatic hypocalcemia should be treated with?

A

IV calcium gluconate

39
Q

Mild hypocalcemia should be treated with?

A

Oral calcium and vit D

40
Q

What are acute causes of hyperphosphatemia?

A

Acute renal failure

Tumor lysis syndrome

Hypoparathyroidism.

41
Q

What are chronic causes of hyperphosphatemia?

A

CKD

Hypoparathyroidism.

42
Q

Although most asymptomatic from hyperphosphatemia, some can have accompanying symptoms from hypocalcemia like?

A

Tetany, muscle cramps, perioral numbness, tingling

Trousseau or chovstek sign.

43
Q

Hyperphosphatemia may cause uremia signs which include?

A

Fatigue, n/v, pruritus, SOB, sleep disturbances

44
Q

How do you diagnose hyperphosphatemia?

A

Serum phosphorus,

PTH, and serum calcium

Vit D levels

Renal ultrasound.?

45
Q

Actue hyperphosphatemia and normal renal function can be treated with?

A

Saline and loop diuretics

46
Q

AKI is treated with phosphate binders in hyperphosphatemia when levels are above? What type of binders?

A

>6

Depends on calcium levels too

Use calcium based bindings if calcium is low

Use noncalcium if calcium is high - sevelamer, aluminum hydroxide.

47
Q

CKD patients should above what foods that are high in phosphates?

A

Dark colas, oysters, cheese, milk, organ meats, ice cream, chocolate, nuts/seeds

48
Q

Treat hypophosphatemia if 1.0-1.9 with?

Below 1?

A

Oral phosphate

Iv phosphate. - switch above 1.5

49
Q

Dipyridmadole can help treat what?

A

Phosphate wasting in the urine.

50
Q
A

Clin Med Exam 4 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions