EM Endocrine, Fluid and Electrolyte Emergencies Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

what is the number one cause of hyperkalemia

A

bad sample, hemolysis during collection
- if not consistent with story, recheck
- always get EKG

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

what is true hyperkalemia due to

A

renal failure
acidosis
rhabdo (crush, other cell death)
meds or drugs

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

how does hyperkalemia affect electrical conduction

A

peaked T waves
Loss of P waves
wide QRS
sine wave

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

what is the treatment of hyperkalemia

A

push K+ back into the cell
- glucose
- insulin
- albuterol
- if acidotic: bicarb

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

what are most common causes of hypokalemia

A

water loss through GI causes
renal loss iwth DM
loop diuretics
malnutrition
ETOH

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

what should be assumed with hypokalemia

A

hypomagnesemia

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

what is seen with hypokalemia

A

ST depression
T wave inversions
U waves

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

What is normal magnesium range

A

1.9 - 2.4

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

what are causes of hypermagnesemia

A

typically secondary to exogenous magnesium supplementation

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

what are symptoms of hypermagnesemia

A

decreased relfexes, paralysis, cardiac hyperexcitability

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

what is the treatment of hypermagnesemia

A

calcium gluconate
calcium chloride
can help flush out with fluids and diuretics
may require hemodialysis

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

what can hypomagnesemia progress to on EKG

A

cardiac dysfunction -> torsades do pointes

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

what are causes of hypernatremia

A

Hypovolemia
euvolemia: water loss but no real saltloss
Hypervolemic (very uncommon)

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

what is the treatment of hypernatremia

A

need volume
(do not shift rapidly)
often require admission for slow replenishment

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

what is the presentation of hyponatremia

A

appear dry
may be hypotensive
peripheral edema
watch pt for mentation

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

what is the treatment of hyponatremia

A

correct slowly
risk of osmotic demyelination syndrome if replced too fast

17
Q

what is alcoholic ketoacidosis

A

chronic ETOH intake results in decrease nutritional states, low glycogen states
starvation state, decreased insulin

18
Q

what is the presentation of alcoholic ketoacidosis

A

hx ETOH abuse (binge drinking)
Pancreatitis
tachy, hypotension, slow cap refill
abdominal pain
intact mental status

19
Q

what is the workup for alcoholic ketoacidosis

A

elevated anion gap
CMP
ABG
ketones in urine may be falsely low/neg
lipase

20
Q

what is the treatment of alcoholic ketoacidosis

A

fluid resuscitation
give glucose
replenish electrolytes
symptomatic management
thiamine

21
Q

Whats on ABG

A

pH
pCO2
HCO3
pO2
SaO2