Metabolic Disturbances Flashcards
1
Q
What causes hyperkalaemia?
A
- AKI
- Meds
- Metabolic acidosis
- Addison’s disease
- Rhabdomyolysis
- Massive blood transfusion
2
Q
What medications cause hyperkalaemia?
A
- K-sparing diuretics
- ACEi
- ARBs
- Spironolactone
- Ciclosporin
- Heparin
3
Q
What medications cause hypokalaemia?
A
- Diuretics (thiazide and loop)
- Laxatives and enemas
- Corticosteroids
- Insulin overdose
- Verapamil intoxication
4
Q
What causes hypokalaemia?
A
- Hypomagnesemia
- Cushing’s syndrome
- Conn’s syndrome (primary hyperaldosteronism)
- Diarrhoea
- Partially treated DKA
- Renal tubular acidosis
- Thyrotoxicosis
5
Q
What causes hyponatraemia with urinary sodium >20mmol/l?
A
- Renal loss (often hypovolaemic) - diuretics (thiazide, loop), addison’s disease, diuretic stage of renal failure
- Euvolaemic - SIADH, hypothyroidism
6
Q
What causes hyponatraemia with urinary sodium <20mmol/l?
A
- Extra-renal loss - diarrhoea, vomiting, sweating, burns, adenoma of rectum
- Water excess (hypovolaemic and oedematous) - secondary hyperaldosteronism (HF, liver cirrhosis), nephrotic syndrome, IV dextrose, psychogenic polydipsia
7
Q
What causes hypernatraemia?
A
- Dehydration
- Osmotic diuresis e.g. hyperosmolar non-ketotic diabetic coma
- Diabetes insipidus
- Excess IV saline
8
Q
What causes hypermagnesaemia?
A
- Drugs: diuretics, PPIs
- Total parenteral nutrition
- Diarrhoea
- Alcohol
- Hypokalaemia
- Hypocalcaemia
9
Q
What causes hypocalaemia?
A
- Vit D deficiency (ostemalacia)
- CKD
- Hypoparathyroidism
- Rhabdomyolysis
- Mg deficiency
- Massive blood transfusion
- Acute pancreatitis
10
Q
What is given to treat hyperkalaemia?
A
- Short-acting insulin e.g. actrapid/novorapid, with glucose (dextrose to prevent hypoglycaemia)
- Example: 10 units actrapid in 100ml of 20% dextrose over 30min IV
- Can also give salbutamol 2nd line 2.5-5mg NEB STAT
11
Q
When should metformin be avoided?
A
When a patient has raised creatinine >150 due to risk of lactic acidosis.
