Metabolic

Question 1

Correction of hypernatraemia too fast

why is it bad?

Answer 1

conc of sodium in blood is too low than the tissue

fluid is pulled our of the hypotonic blood into hypertonic tissues > cerebral oedema and seizure

Question 2

what metabolic changes can excess furesomide use cause?

Answer 2

hypernatraemi and hypokalaemia - due to dehydration

Question 3

what is wrong with correcting hyponatremia too fast?

Answer 3

fluid is pulled out of tissues > blood

fluid out of the cenrebral tissue and myelin is high is fat and fluids = demyelination

Question 4

what does Low to high the pons dies relate to?

what condition?
what imbalance?

Answer 4

central pontine demyelination

hyponatraemia

Question 5

what is a good rate of sodium correction?

Answer 5

it is generally accepted that a rate of no greater than 0.5 mmol/hour correction is appropriate

Question 6

Causes of hypernatraemia

Answer 6

dehydration
osmotic diuresis e.g. hyperosmolar non-ketotic diabetic coma
diabetes insipidus
excess IV saline

Question 7

SIADHhyponatraemia

Answer 7

hyponatremia with low serum osmolality and concentrated urine

euvolemic

Question 8

hyponatraemia hypovolaemic

Answer 8

diuretics
addisons
diuretic stage of renal failure

Question 9

hyponatraemic euvolaemic

Answer 9

Patient often euvolaemic
SIADH (urine osmolality > 500 mmol/kg)
hypothyroidism