Brainscape's Knowledge GenomeTM

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


See full index

Spring ER > Metabolic Emergencies > Flashcards

Metabolic Emergencies Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
1
Q

Osmolarity =

A

2*NA + glucose/20 + BUN/3

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

In true hyponatremia the osmolality is

A

decreased

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

hyponatremia with an osmotic pressure >295

A

Hypertonic hyponatremia

MCC is hyperglycemia

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

hyponatremia with an osmotic pressure 275-295

A

Isotonic hyponatremia

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

hyponatremia with an osmotic pressure <275

A

Hypotonic Hyponatremia

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

Causes of hypovolemic hyponatremia

A

Renal: urinary sodium >20
Extrarental: urinary sodium <20

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

SIADH causes what kind of hyponatremia typically

A

euvolemic hyponatremia

= hypotonic

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

during treatment of hyponatremia, do not raise the sodium more than ______mEq/L/hr

A

2

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

What sodium level is hypernatremia

A

> 150

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

What sodium level is hyponatremia

A

<135

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

hypervolemic hyponatremia with urinary sodium >20

A

renal failure

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

MC lyte abnormality

A

Hypokalemia

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

ECG –T wave flattening or inversion, U waves, ST depression, PVC’s, wide QRS, tachyarrhythmias

A

Hypokalemia

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

When K is <___ you should use IV replacement

A

2.5

admit

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

K>2.5 and no ECG findings significant symptoms treatment is

A

PO K replacement and discharge home

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

MCC of hyperkalemia

A

factitious

dt hemolysis during phlebotomy

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

Treatment of severe/emergent hyperkalemia

A 
Albuterol
Calcium chloride & gluconate
Sodium bicarb
Insulin & glucose
Furosemid
~Dialysis
Sodium polystyrene sulfonate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cushings disease could be implicated in what lyte abnormality commonly

A

hypernatremia

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

EKG changes seen with hyperkalemia

A 
prolonged PR
tall peaked T waves
short QT
flat p waves, QRS wide
become sinusoidal pattern
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

hypocalcemia reflexes

A

hyperreflexia
=Trouseeau’s sign
carpopedal spasm
Chvostek’s sign

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

Chovostek’s sign

A

contraction of the facial muscles after percussion over the facial nerve
=HYPOcalcemia

22
Q

what EKG changes are seen with hypocalcemia

A

prolonged QT
sinus brady
heart block
VT/VF

23
Q

acutely symptomatic or severe hypocalcemia treatment

A

IV calcium gluconated 10ml over 10-15min

24
Q

hypercalcemia usually caused by

A

malignancy or hyperparathyroidism

25
Q

stones bones moans and groans

A

hypercalcemia

26
Q

EKG of hypercalcemia

A

shortened QT
widened t waves
bradys, BBB, AV blocks

27
Q

Hypocalcemia treatment

A 
Volume replacement
Mithramycin- decreases levels
Pamidronate- inhibits bone resorption
Calcitonin
Hydrocortisone
~furosemide
~dialysis if severe
28
Q

what is seen on EKG with hypomagnesemia

A

tachys
torsades
prolonged PR and QT

29
Q

tx for hypermagnesemia

A

calcium gluconate/chloride (antagonizes)
Furosemide + IV NS
Dialysis if very high or renal failure

30
Q

pH down
HC03- down
CO2 down

A

Metabolic acidosis

31
Q

pH up
HCO3 up
CO2 up

A

Metabolic alkalosis

32
Q

pH down
HCO3 up
CO2 up

A

Respiratory acidosis

33
Q

pH up
HCO3 down
CO2 down

A

Respiratory alkalosis

34
Q

COPD likely to cause what acid base imbalance

A

respiratory acidosis

35
Q

Asthma likely to cause what acid base imbalance

A

resp alkalosis

36
Q

salicylate toxicity

A

likely to cause what acid base imbalance

37
Q

Normal anion gap

A

10-12

38
Q

causes of anion gap acidosis

A 
Alcohol
Methanol
Uremia
Diabetic ketoacidosis
Paraldehyde
Iron, Isoniazid
Lactic acidosis
Ethylene glycol
Carbon monoxide
Aspirin
Toluene
39
Q

MCC anion gap metabolic acidosis

A

lactic acidosis dt decreased oxygen to tissues

sepsis, shock

40
Q

diarrhea associated with what acid base imbalance

A

losing bicarb

=non AG metabolic acidosis

41
Q

osmolar gap

A

difference between measured and calculated – normal < 10

42
Q

Bicarb is given in metabolic acidosis if

A

<7.2

not responding to measures and myocardial irritability

43
Q

if alcoholic and hypoglycemic

A

give thiamine IV before dextrose to prevent Wernicke-Korsakoff syndrome

44
Q

if pt isn’t awake and cant establish IV with hypoglycemia

A

glucagon IM

effective in 10min

45
Q

tx in sulfonylurea induced hypoglycemia

A

octreotide SQ

46
Q

DKA labs

A

can do venous BG (vs ABG)

venous is 0.03 less than arterial

47
Q

order or priorities in treatment of DKA

A 
Volume
   NS, glucose to 250 then D%
Potassium correction
   replace if <5.3
   follow q2hrs
Insulin
   drip
   follow q1hr
48
Q

hyperosmolar hyperglycemic state seen in

A

DMII (most commonly)

49
Q 
glucose >600
Osmolality >315
bicarb >15
pH >7.3
ketones neg- few
A

hyperosmolar hyperglycemic state

50
Q

thyrotoxicosis is

A

excess circulating hormone from any cause

51
Q

AMS
ophthalmoplegia
gait ataxia

A

Wernicke-Korsakoff syn

Spring ER (10 decks)

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