Fluid and electrolytes

Question 1

normal NA+ values

Answer 1

133-146mmol/L

Question 2

Symptoms of hypernatramia

Answer 2

convulsions, dehydration, thirst, oliguria, postural hypo, tachycardia , hypovolameia (volume depletion)

Question 3

drug causes of hypernatramia

Answer 3

lithium , sodium content in IV antibiotics, oral corticosteroids, sodium bicarbonation, contraceptives

Question 4

how to treat hypernatraemia causes by diabetes insipidus

Answer 4

IV glucose

Question 5

symptoms hyponatraemia

Answer 5

convulsions, drowsy ,confusion, n/v, nausea cramps

Question 6

drug cause hyponatreamia

Answer 6

loop and thiazide diuretics
desmopressin
carbamazepine
antidepressants

Question 7

treat mild to mod hyponatraemia

Answer 7

oral sodium chloride/ sodium bicarb (add glucose if volume depletion)

Question 8

treat mod to severe hyponatraemia

Answer 8

IV saline (via peripheral vein= isotonic but central vein= concentrated)

Question 9

why must you give IV saline slowly in a hypo

Answer 9

risk of osmotic demyelination- CNS effect

Question 10

Rehydration therapy (loss of electrolyte) tx and how long it is given over

Answer 10

electrolyte imbalance : Ort (K+, na+ glucose)
- given over 3 to 4 hrs in diarrhoea
given over 12 when due to hyponatraemia ie. insipidus

Question 11

replacing water deficit in electrolyte imbalance?

Answer 11

IV glucose, should not be given alone unless no significant loss of electrolytes . i.e insipidus or hyper calcemaim

Question 12

metabolic acidosis (hypercholamia) what is it

Answer 12

Cl- ions in blood increase beyond normal val 103 mol/l, makes blood more acidic

Question 13

tx metabolic acidosis

Answer 13

sodium bicarb (alkaline)
if k+low then give potassium bicarb

Question 14

normal calcium value

Answer 14

2.10-2.58 mol/l

Question 15

tx of hypercalcaemia

Answer 15

bisphosphonates and corticosteroid reduce serum calcium

Question 16

tx of hypercalcaemia of malignancy

Answer 16

calcitonin

Question 17

tx of hypercalcaemia of hyperparathyroidism and in renal failure

Answer 17

cinacalcet reduces parathyroid hormone therefore calcium

and to tx in renal failure is paracalcitol

Question 18

how to treat hypercalciuria

Answer 18

Bendroflumetiazide increase fluid intake and increase dietary calcium

Question 19

what can hypocalcaemia cause

Answer 19

osteoporosis

Question 20

tx mild mod hypocalcaemia

Answer 20

vit d and calcium supplement

Question 21

severe acute hypocalcaeima

Answer 21

iv calcium gluconate (down give too fast = arrhythmia)

Question 22

normal phosphate range

Answer 22

0.85-1.45 mol/l

Question 23

hyperphosphatemia tx and hypo

Answer 23

calcium containing preparation (phosphate binding agents) for hyper
hypo= iv phosphate

Question 24

Magnesium normal range

Answer 24

0.7-1.05mmol/l

Question 25

where is hypomagnaemsia common and what happens

Answer 25

common in alcoholics,
hypomagnesiua, mean low k+,ca2+, and NA+ all linked

Question 26

potassium normal range

Answer 26

3.5-5.3 mol/l

Question 27

symptoms hyperkalemia

Answer 27

ventricular tachycardia and cardiac arrest

Question 28

drug causes of hyprkalameia “had beans”

Answer 28

H= heparin
a=acei/arb
d=digoxin
beta blockers
e=eplerenone
amiloride
nsaids
spironolactone

Question 29

mild mod hyperkalemia tx no ecg change

Answer 29

calcium resonium

Question 30

acute severe hyperkalemia >6.5mmol

Answer 30

IV slow calcium gluconate
can give insulin salbutamol and glucose in addition

add sodium bicarb to prevent compounding acidosis

Question 31

should u give calcium gluconate and sodium bicarb the same line

Answer 31

no same line = thrombosis

Question 32

symptoms hypokalaemia

Answer 32

muscle hypotonia, arrhythmia

Question 33

drug causes hypokalemaia

Answer 33

dare insult Bettys tough carpet
diurectic, insulin, beta 2 agonist, theophylline corticosteroids

Question 34

mild hypokalemia tx

Answer 34

oral slow potassium chloride
- nausea and vomiting cause poor compliance
- reduce dose in renal impairment
-if caused by diuretic = k+ sparing instead